Managing PCOS when you have no weight to lose

Polycystic ovary syndrome (PCOS) is commonly associated with weight gain, but many women experience lean PCOS, where they maintain a healthy weight yet endure a range of challenging symptoms. As a qualified PCOS dietitian, I want to shed light on how nutrition can be your most powerful tool in managing this condition, particularly when you’re not focused on weight loss.

Understanding lean PCOS

Lean PCOS can still present a host of symptoms that impact quality of life, including:

• Irregular menstrual cycles: Women may experience infrequent or absent periods, complicating reproductive health.
• Hormonal imbalances: Elevated androgen levels can lead to symptoms like acne, hair loss, and hirsutism, affecting self-esteem and mental health.
• Insulin resistance: A significant but often overlooked aspect of lean PCOS, insulin resistance can lead to fatigue, mood swings, and difficulty concentrating, even in the absence of weight gain.
• Infertility challenges: Many women with PCOS face reproductive challenges, and the lack of excess weight doesn’t mitigate the risk of infertility.

In view of the above, for women with lean PCOS, a comprehensive nutritional approach is crucial in managing symptoms and improving overall health.

How to tailor your nutrition effectively for lean PCOS

Combating insulin resistance

Insulin resistance is a hallmark of PCOS, and it can occur even in those who are not overweight. Consuming low-glycaemic index (GI) foods helps regulate blood sugar levels. Include whole grains, legumes, and non-starchy vegetables to prevent insulin spikes. Pairing carbohydrates with proteins and healthy fats can further enhance blood sugar stability.

Hormonal balance

A well-balanced diet rich in anti-inflammatory foods can help regulate hormone levels. Omega-3 fatty acids, found in fatty fish (like salmon), walnuts, and flaxseeds, can reduce inflammation and support overall hormonal health. Incorporating foods rich in antioxidants, such as berries and leafy greens, is also beneficial.

Nutrient sufficiency

Ensuring that you’re getting a wide range of nutrients is essential for managing PCOS symptoms. Deficiencies in key vitamins and minerals can exacerbate hormonal imbalances. Focus on:

• Vitamin D: Many women with PCOS are found to have low vitamin D levels. Consider fortified foods or supplements to maintain adequate levels, as this vitamin plays a critical role in insulin sensitivity and reproductive health.
• B Vitamins: Particularly B12 and folate, are vital for energy levels and hormone regulation. Incorporate sources like leafy greens, beans, and whole grains.
• Magnesium and zinc: These minerals can improve insulin sensitivity and support hormonal balance. Foods like nuts, seeds, and whole grains are excellent sources.

Dietary patterns

Rather than adopting a restrictive diet, focus on a balanced and varied eating pattern that promotes health. Here are some dietary patterns that can be beneficial:

• Mediterranean diet: Emphasising whole grains, healthy fats, lean proteins, and plenty of fruits and vegetables can support overall health and reduce inflammation.
• Plant-based diet: A diet rich in plant-based foods can improve insulin sensitivity and reduce inflammation. Remember, incorporating plant-based foods doesn't mean you need to forgo animal products entirely. Think of a plant-forward approach where vegetables, legumes, nuts, seeds, whole grains, and fruits and vegetables take centre stage.
• Enjoying your favourite foods mindfully: One of the biggest misconceptions about managing PCOS is that you must cut out all your favourite foods. The truth is, you don’t have to eliminate anything; rather, it's about changing proportions and finding healthier alternatives. For example, instead of completely avoiding pizza, consider using less cheese and adding plenty of veggies, which can add nutritional value without sacrificing taste. If you love pasta, opt for whole grain or legume-based varieties and pair them with a rich tomato sauce filled with vegetables and a source of protein.

Ultimately, the key is to focus on balance and moderation. By prioritising larger servings of nutritious foods and smaller portions of less healthy options, you can enjoy your meals while still making progress toward managing your PCOS symptoms. By prioritising a balanced diet rich in anti-inflammatory foods, managing insulin resistance, and ensuring nutrient sufficiency, you can alleviate symptoms and improve your overall quality of life.

As a dedicated PCOS dietitian, I encourage you to seek personalised guidance tailored to your unique situation, so you can explore how nutrition can be a powerful ally in your PCOS journey. You deserve a comprehensive approach that celebrates your individuality and empowers you to thrive.