Weight loss with PCOS
An important subject for millions of women, we’re talking about weight loss with PCOS. Not only is excess weight linked to multiple other health issues, it’s also linked to infertility. Basically a double whammy for overweight women with PCOS that are trying to get pregnant! In this video/podcast that’s exactly what we’re going to cover, in order to help you get rid of the extra weight as well as control symptoms of poly cystic ovary syndrome.
And if you have “thin PCOS”? This information is still great for you! Because following the tips we talk about, you should see a reduction in your symptoms as well.
Dr. Robert Gellibolian’s bio:
I am a scientist with 25+ years of experience in molecular medicine and genetics. I spent a good part of my career in the academic as well as biotech and pharmaceutical industries developing ‘toxins’ in the areas of cancer, inflammation, hormonal regulation and toxicogenomics (this is where we study how genes behave in response to toxins). Two years ago, I decided to follow my passion and integrate my knowledge of functional biochemistry with my skills in coaching and educating to help men and women with various health issues achieve sustainable and long-lasting balance. This is why PhD Nootrition was born in late 2015. I focus on various aspects of health ranging from hormonal imbalance, cancer management and prevention, heart health, cholesterol balance, weight management, osteoporosis and bone health, inflammation, and intestinal dysfunctions.
Weight loss and PCOS video interview
What is PCOS and how does it affect the body?
It’s a very prevalent endocrine disorder and has serious consequences to women’s health, and infertility is a very big issue with those that have it. There has still been no research that proves the underlying cause, but the underlying commonalities in symptoms are hormonal disturbances:
- hyper-andorgenemia (high testosterone)
- insulin resistance (80+% of cases deal with this)
- hyper insulinemia (to compensate for the insulin resistance)
Basically, insulin sits on top of the cascade of hormone imbalances – when it’s “off”, estrogen, testosterone, etc are off as well. So you can’t just focus on something like high androgen levels and use supplements to lower it – you have to look at the upstream elements to take care of the cascade.
Many women with PCOS deal with weight gain – why is this and why can’t we lose it easily?
Insulin is a big regulator and disrupts all components of the hypothalamic, pituitary, and gonadal axis pathway. (HPG)
The brain is the master conductor and hormone balance signals come from this HPG pathway. So when insulin resistance sets in the ovarian tissue it results in impaired metabolic activity and this changes the pattern of sex hormone production and this favors the production of androgen and testosterone. But then testosterone feeds back into insulin resistance and increases the level of free fatty acids. Women get caught in this vicious cycle and this is how the weight comes on and you begin to struggle with this issue.
It’s not a question of increasing your exercise levels as that impacts the stress on your body. Some women that have added weight and they go on to exercise too much will begin to see the weight come back. Or they can’t burn it off as fast as it’s coming on.
You have to tackle insulin resistance first.
The body fires in one of two modes – fight or flight or the rest and digest mode. Our bodies are supposed to be 90% in the rest mode and only 10% in stress mode. 60-70% of the hormone signaling comes from the brain, so if we are chronically stressed, this is the signal our reproductive system is getting.
What are some tips for weight loss with PCOS?
First, figure out how your body is metabolizing sugar.
Make sure you get enough fiber in your diet as it allows your body to get rid of excess androgens and hormones. (Some people may have difficulty with a higher fiber diet depending on gut microbiome – which is another link to weight, independent of PCOS.)
Supplements that may help with insulin resistance:
It’s important to remember that while supplements may be helpful in reducing insulin resistance, and do work, that these should be used as short-term supplements and not as a replacement for dietary changes. And this is not an issue that will solve itself overnight. It may take some time for the body to begin to sort itself out.
- There are different forms of inositol – I’d recommend d-chiro inositol as controlled studies have shown it to have beneficial effects in regards to weight loss. Myo-inositol can also be effective, but not as beneficial as d-chiro. (there are also supplements that combine these two versions) D-pinitol is like a methylated version of inositol, but may not be readily available.
- Another supplement I use often with clients is N-acetol-cystine. Cystine is important for glutothione regulation and can impact insulin insensitivity, but make sure you don’t get too much. Depending on methylation status, too much can backfire, so a low dose (say, 5oomgs) per day or every other day may be helpful.
- Berberine actually as effective as metformin.
Research has shown that even a 5% reduction in insulin resistance can have a huge impact on weight.
What should your blood sugar levels be?
You do need some glucose in your blood, insulin response is necessary to live, but too much is a problem. Doctors will say anything below 100 is considered normal, but we scientists don’t think 100 is a good number. If you’re at 100 or above you’re prediabetic. You should be at 85 or below for fasting insulin levels.
I often use the HOMA-IR test with my patients. It’s a homeostatic model that shows where you are with insulin resistance. Most people are 80% higher than they should be.
You should also check post postprandial glucose levels – what your glucose levels do after you eat. I recommend purchasing a simple blood glucose meter. Check it before eating. Eat, then check at one hour, two hours later, three hours later. You don’t want your blood sugar to spike over 130 at any of those checks. Monitor if for a few days to a week, and it will help you see a pattern and see how your body responds to food.
Tackling sugar levels and insulin resistance is priority for women with PCOS.
As for diet, food is also really important. Frying foods has a harmful effect of producing advanced glycation end products – sugars that every food has, when fried the heat and the sugar change the molecules and prohibit their activity. Reduce the amount of frying overall and use a bit of lemon in the pan will actually help reduce glycation by about 70%. Stewing is the best way to go – heating in water greatly reduces the risk of glycation. Even grilled meats are a problem. This glycation end product affects your insulin resistance.
Which type of diet or nutritional plan is best for women with PCOS?
I’ve read all of those things (referring to paleo vs vegetarian and other PCOS diets) and to this day I’m allergic to the word holistic or nutrition or paleo or…
We hear so much about these things that is has people so confused. In one camp you hear that something you’re eating is killing you, in another you hear that someone was a vegetarian for 50 years and it totally healthy.
I don’t care which diet you follow, but each one needs to be done well. As a species we are one of the only ones called omnivores. Just like you can’t take a cow and put him on a meat diet, he won’t do well, a lion won’t do well on a diet of salad. Our adaptation because we began to migrate has changed us. Some people in Africa have a high carbohydrate diet and are fine – the traditional Eskimos live on mostly meat and fat they also are healthy.
In my opinion a mix of everything is best. So if you think of going paleo, this doesn’t mean only meat and bacon with no carbs. Without carbs (glucose) you don’t get a proper insulin response and without proper insulin response you don’t get your thyroid to function properly. If your thyroid isn’t functioning properly you can not metabolize food properly and your body’s need for energy is not met. (I’m not talking about table sugar, we’re talking about natural sugars in food like potatoes.) And then load it up with a high fiber diet! I tend to be more paleo, but not strictly paleo, as that is how we are more genetically wired.
I have a lot of clients that are vegetarians and have been doing it for a long time but you have to be really careful as B12 isn’t found in plant material. Choline and CLA are coming from animal products as well and are important.
A balanced diet works. Eat your red meat, eat your potatoes, but with a healthy dose of fruits and veggies (fiber).
And don’t worry about the sugar in fruits – it’s not isolated sugar. In the matrix of fruit, it’s a slow release sugar and released when you need it. In our house we have unrestricted use of fruits and veggies, especially veggies.
Will losing weight reduce the symptoms of PCOS?
Yes – studies have shown that even a 5% reduction in weight has been shown to greatly reduce symptoms and begins to balance out the hormones.
So, we’ve talked about the HPG axis before, now let’s move on to the HPA axis. (hypothalamic-pituitary-adrenal). Fat is basically the depot of making cortisol. It’s very efficient at mobilizing cortisol as it’s actually an anti- inflammatory. Your body is trying to protect your organs from danger, whether the stress/danger is imagined or real. The fat absorbs the impact and protects the organs. That is how the brain is wired, it tells the fat cells to make more cortisol. The more fat you have, the more cortisol you make and hyper activates the HPA axis. It makes more cortisol and that impacts the sex hormone-binding globulin (SHBG) which is the protein that is used to sequester (or bind to) all of these sex hormones so they aren’t just free-floating around the body. So elevated cortisol lowers the amount of this protein and creates more free testosterone in the body.
That causes havoc. When you lower the fat you lower the cortisol, SHBG goes up and estrogen begins to normalize and testosterone is being bound to the SHBG. What you then find is acne begins to clear up and everything starts normalizing.
So what you’re saying is that by balancing our insulin response and getting our blood glucose levels down to start getting rid of some of that fat as well as dealing with your stress response and lowering stress to reduce the amount of cortisol produced, the two of these together then create the situation for weight loss?
It’s the ultimate start for sure. It’s all about how your body perceives, metabolizes, and mobilizes sugar.
Insulin response is like the CEO of the body and cortisol is it’s number two. With bad management on their part, things start going bad really fast.
Top tips for losing weight with PCOS
- Don’t push the limits when it comes to exercise. And if you’re not losing weight by exercising more, that’s not where your problem lies, so there’s no need to push yourself more.
- Look at your blood sugar levels.
- Don’t restrict your calories. Your sex hormones depend on cholesterol, so eat it in moderation.
- Make sure to eat fat and saturated fat as it promotes the burning of stored fat. If you’re exercising you’ll burn fat better.
- Remember that muscle weighs more, so going up in weight is normal if you’re exercising and putting on muscle.
- Eat less fried foods.
- Eat higher fiber.
- Pay attention to your gut microbiome.
- Use insulin supplements like inositol, berberine, N-acetol-cystine when needed, though you will want to eventually get off of them.
- Yoga, tai chi, etc. has a profound effect on the sympathetic and para sympathetic nervous system. Train the brain to calm down the fight or flight mode.
- Don’t eat and go! We’re killing ourselves in the name of productivity. Chill out, take your time and have your lunch, ignore the phone and other business.
- Sleep is also really important and could cause disregulation of cortisol.
You don’t have to see a functional this or that, just do the right things. Our bodies simply haven’t adapted to our modern lifestyle so we need to slow down and get back to basics.
Science is science, and it is exact. But life is not science and food and nutrition are not about science. If you think about it, if you were “mother nature” you wouldn’t design a life form that was on absolute terms or it would just fall apart. We’ve been created with a buffer zone, so the body is made to clean itself up. But we live on the edge of our buffer zone making it more difficult to be in homeostasis.
Exact nutritional plans that stress you out are going to cause the body to not absorb the nutrients coming its way.
Regardless of the symptoms, you have to chill first and get the body to realize that not everything is stress.
Make sure to listen to it when you get a chance as the above is not a direct transcription. Below are links to a few of the supplements Dr. Robert mentioned. They are simply from brands I’ve used before and trust, though I may not have taken these exact supplements. Feel free to do more research on the subject.
I hope this interview gave you hope that you can use natural remedies for PCOS and find a reduction in your symptoms.
This is the glucose meter I’ve been using