Text with your questions & comments for future episodes!
In this episode, I'm answering your top PCOS (polycystic ovary syndrome) weight loss questions (about 20 of them) to help explain with more context all the reasons PCOS impacts our weight and what kind of diet helps the most for PCOS weight loss.
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Rhodiola - https://s.thorne.com/mVyrH
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Probiotic - https://s.thorne.com/RaN5D
Why does weight loss with PCOS often feel like a battle against your own body? Get ready to unlock the answers as we dissect the complicated relationship between weight and PCOS. With the latest insights, we strip away the myths and focus on the complex dance of metabolism, hormones, and genetics. Discover how abdominal fat is not just a matter of aesthetics, but a central player in the inflammation and insulin resistance story. We'll guide you through a balanced dietary approach, emphasizing the often-underrated roles of fiber and protein in blood sugar control, and how this ripples out to affect your metabolic health.
We'll discuss set point theory, which suggests your body has a comfortable weight it stubbornly clings to, and learn the strategies for real, sustainable change. We'll discuss the vital role of metabolic flexibility, offering practical advice on how strategic fasting periods and meal structuring can enhance insulin sensitivity, an important factor in managing PCOS. Plus, hear our thoughts on the exciting potential of GLP-1s to support your weight loss journey while navigating the nuances of cravings and appetite.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Hi guys, welcome back to Functional PCOS.
Today I'm going to be answeringyour top PCOS weight loss
questions.
Okay, so I polled my Instagramfollowers If you don't follow me
on Instagram, why not?
And I also asked the internet.
I looked at the top Googlesearch terms for PCOS and weight
(00:24):
loss and I put together acollection of I actually have
not counted this.
It looks like about 20questions, 15 to 20 questions
and I'm just going to go througheach of them and give an
explanation of how a nutritionprofessional coming from the
functional nutrition world wouldhelp you with your PCOS weight
(00:45):
loss and explain things to youin a way that, hopefully, will
help make it more understandablewhy you're struggling so much
with weight loss and what somesolutions are that you can do.
Okay, so let's get into it.
So, number one why is it hard tolose weight with PCOS?
You know I see a lot of contenton the internet that is women
(01:09):
with PCOS lamenting theirinability to lose weight and the
difficulty of it, and there areso many horrendous comments on
these kinds of videos.
I saw one the other day of anutritionist who is over 200
pounds.
She said so in her video andshe said you're just trying to
help people eat healthy in aworld where you're not allowed
(01:32):
to be overweight, as anutritionist and man.
The people came for her in thecomments.
It was horrible and I just feltso sorry for her because I
believe she has PCOS and I knowfor myself and for so many of us
who have PCOS the lifelongstruggle with losing weight is
so real and maintaining weightloss right.
(01:55):
And so all the comments inthere were just like you can't
violate the law ofthermodynamics, man, calories in
, calories out, whatever.
And what these simple-mindedfolks fail to understand is the
complex metabolic system that'sat play with weight maintenance
and weight management.
They don't recognize theimportance of hormone balance in
(02:20):
weight loss and they don'trecognize the importance of
stress and stress hormonebalance in weight loss and they
don't recognize the importanceof stress and stress hormone
balance in weight loss.
So there's several things thatare going on with PCOS
specifically that do make itmore difficult for us to lose
weight.
There's kind of two theories ofweight loss and weight
maintenance.
There's the calories incalories out law of
(02:42):
thermodynamics blah, blah, blah.
Calories in calories out law ofthermodynamics blah, blah blah,
which has there's validity tothat.
It is part of the picture, butit's not the whole thing.
And then there's a newer modelof weight loss, weight
management, called thecarbohydrate insulin model, and
a lot of the research reallyfavors this model.
But it's the concept thatinsulin, which is a hormone.
(03:02):
It's the concept that insulin,which is a hormone, acts as a
fat storage hormone, and so whenthere's too much in the system,
the body preferentially storesfat.
And if you look across the rangeof people, right, everybody has
a different sort of baselineweight.
There's a lot of genetics thatplay there too.
(03:23):
And you look at some people whoare naturally very thin, some
people who struggle more.
Why is that?
Well, the carbohydrate insulinmodel of weight loss accounts
for some of that.
Right, because if we have toomuch insulin in our system,
which is a problem in PCOS, thenour bodies are going to prefer
to store our food as fat.
(03:45):
And where this kind of comesinto play from a genetic
perspective is that a lot ofpeople think that the genetics
of those with PCOS may havestemmed from ancestors who went
through famine, other foodinsecurity, to the point where
the genes sort of morphed toaccommodate for that.
So if you were growing up in aworld where food was really
(04:09):
insecure.
But you could also maintainbody fat really well and store
body fat for use later.
You would be more likely tosurvive, right?
Because think about a longwinter where there's no food.
If you've got a lot of body fat, then you've got a lot to live
off of.
(04:29):
Have you ever watched that showAlone?
So there was a season of Alonewhere the guy survived by
gaining a tremendous amount ofweight before he went on the
show.
He barely did anything the lasthalf of the show.
These other people are outthere like building shelter.
They're fishing all the time,they're wasting a lot of energy
(04:49):
trying to find food and heinstead, just kind of like a
bear, went in his den andhibernated for the rest of the
show and he ended up winningbecause he had all those body
fat stores and he just ate offof his body fat stores.
So the concept is a little bitsimilar in PCOS, right?
We preferentially store bodyfat and so we have it there for
(05:11):
a rainy day.
And of course I know this isnot everyone with PCOS.
There are many women with PCOSwho are actually underweight.
But for those of us who arehaving difficulty with weight
management, that's part ofwhat's going on too much insulin
.
The other thing that's going onis that our stress hormone
balance can be out of whack andwe also can have some issues
with our thyroid, and so we knowthat sluggish thyroid is going
(05:33):
to lead to some weight gain anddifficulty, weight stubbornness,
and that having high cortisollevels, for example, is also
going to have us preferentiallystore body fat in the abdomen,
have us preferentially storebody fat in the abdomen, and
when we store body fat in theabdomen, that becomes more
inflammatory to our system andthat extra inflammation in the
(05:53):
system can then make us moreinsulin resistant, create more
insulin, and it can be kind of avicious cycle.
If you've ever noticed and I'venoticed this for myself too that
when you gain weight with PCOS,there might be a sweet spot
with your weight, but if youhappen to gain five, 10 pounds
or something during a stressfultime, all of a sudden it's like
(06:14):
it's a snowball rolling right.
It gets easier and easier andeasier to gain weight.
What I always say about weightmanagement and PCOS is that it
is more difficult for us becauseit's not that it's harder to
lose weight for the most part,if we're accommodating for
everything that we're going tokind of talk about here.
(06:36):
It's not that it's necessarilyharder to lose weight, but it's
easier to gain.
So if you take a week where youlose half a pound, for example,
and then over the weekend youjust kind of stop paying
attention, like most people dowhen they're on a weight loss
journey, they're like, okay,I'll do this all week and then
on Saturdays I have my free day,or whatever.
For the average person theywould still make progress with
(06:58):
PCOS.
Because of that insulinresponse.
They might store an extraamount of body fat.
That doesn't make sense withthe math and it could just be a
wash right, or it could evenresult in weight gain if they're
not careful.
And so if it's easy to gain butmoderately hard to lose, you're
in the favor of weight gain.
(07:19):
Does that make sense?
So basically, the law ofthermodynamics doesn't
necessarily apply to humanbeings perfectly.
There are a lot of otherfactors that can tweak it a bit
and the slightest little tweakover years and years and years
of your life can result inweight gain.
Okay, we'll get into more ofthis as we go on, but let's talk
(07:40):
about the next question, whichis does weight matter for PCOS
and will losing weight help PCOS.
So this is a mixed answer, likea lot of things.
Does your weight matter?
I would love to say that itdoesn't matter at all.
I don't think that the researchis on the side of that.
I do believe in health at everysize and I definitely don't
(08:03):
believe that everyone with PCOSneeds to be like a little twig
or needs to lose as much weightas possible.
I definitely think that therange of what can be healthy for
the human body is higher thanwhat society tells us.
However, your weight does matterto an extent, mostly because of
the impact of abdominal fat onyour inflammation levels.
(08:25):
That's the biggest part.
So we know that like moreabdominal fat you have, it goes
from being like localizedinflammatory response in the
abdomen region specifically to,if there's a lot of body fat, to
it becoming more systemic.
There are a lot of reasons forinflammation in PCOS, but that's
one of them is that abdominalfat, and all of us with PCOS are
(08:46):
dealing with that.
Abdominal fat storage.
That's where our bodies preferto store it, and it's because of
high testosterone levels, it'sbecause of high insulin levels,
it's because of high cortisollevels.
Basically, all the hormonalstuff we've got going on is like
put it in the belly.
All of us have multipledifferent hormonal factors that
(09:08):
cause us to want to gain bellyfat.
I know, isn't it fun, I'mliving with this too.
Okay, we always say the PCOSbody is an apple-shaped body, if
you guys remember the fruitshape, sometimes more
pear-shaped, but it's usually.
There's a lot of body fatcollection in the middle of the
body and a thicker waist, and soit's that inflammation that
(09:29):
really triggers a lot of longerterm issues.
If that weren't the case, then,no, your weight probably
wouldn't really matter, becauseit would be about what your diet
looks like.
And there are exceptions tothis, because there are some
people who, genetically, arelarger and are perfectly healthy
.
Those people do exist, but Ithink the vast majority of us
(09:50):
with PCOS, we're working with aparadigm where, yes, having
excess weight on us to an extentis damaging, because that extra
inflammation makes us moreinsulin resistant and with time
that then makes a lot of othermetabolic things go wrong.
And we're young.
It may not show up on our labwork, we may look fine on lab
(10:12):
work, but as we age it kind ofdoes start to impact us.
So, yes, it matters.
Will losing weight help?
Yes and no.
So the idea of losing weighthelping PCOS comes from a study
that found that if you loseabout 10% of your body weight
it's more likely to regulateyour cycles.
And did the medical communitywant to run with that one right?
(10:35):
So, yes, losing 10% of yourbody weight technically will
help with your PCOS symptoms,which overall, will mean that
you are a healthier individual.
However, I think the real keyhere is looking at why does
weight loss happen in the firstplace?
In PCOS, and because we have somuch metabolic damage, it's
(10:55):
really difficult for us to loseweight unless either we're going
about it in a really unhealthyway, which I think long-term
means that losing that 10%doesn't really it's a wash right
, because you're like if you'regoing on a crash diet, you're
damaging your adrenals, you'remaking it much more likely that
you're going to regain all ofthese negative side effects, so
(11:17):
your cycles might returnmomentarily, but then all it's
impossible to lose it unlessyou're doing that.
Or if you're managing andaccounting for a lot of
different pieces and factors inyour diet, managing for your
insulin, your inflammation andyour adrenals, all with your
diet, which can be overwhelmingif you don't know how to do that
(11:38):
.
So if you're doing it.
If you're losing weight in ahealthy way and you lose that
10%, then theoretically, yes,that could be helpful.
But it's not really the 10% ofbody weight that you've lost,
it's more all the positivechanges that you've made.
But I'd love to see a study ofjust women who do like a crash
diet to lose 10% of their bodyfat and see how that helps their
(11:58):
PCOS.
You know what I mean.
I'm not entirely sure thatthat's the root of the issue.
I think weight in a lot of waysis just a symptom of PC PCOS.
It's very easy to blame bodyfat for your PCOS and a lot of
people do say, well, you havePCOS because you're fat.
But no, we're fat because wehave PCOS and we struggle with
(12:21):
our weight because of our PCOS,and then that in turn means that
losing weight might be helpful.
But it's because we're alsoworking on the metabolic issues
at the root of the PCOS first.
I hope that's making sense.
It's a touchy topic.
So what I've seen here is thatif you kind of fall on the
higher end of the normal rangeor into the overweight or obese
(12:45):
ranges on like the BMI scale,then potentially losing a little
weight could help, butotherwise, no, I wouldn't worry
about it from a weight lossperspective.
I'd really worry about managingyour overall metabolic health
and honestly, that goes foreveryone.
Metabolic health first andforemost.
Let weight come along assecondary to all of that.
(13:06):
Okay, which is more importantcalories or carbs?
This goes back to the insulincarbohydrate model of weight
loss and the law ofthermodynamics, right.
So you'll hear people say it'sall calories and calories out.
If you're gaining weight, youhave to be eating too many
calories.
If you're losing weight, it'sbecause you're in a calorie
deficit.
Then you hear people say, no,it's because of insulin, and
(13:30):
insulin's a fat storage hormone,and so if you just lower your
insulin, then your body won'tprefer to store fat and you'll
lose weight.
So the truth is actually in themiddle of these two things.
Especially with PCOS, we haveto account for both, because
both are going on.
So, when it comes tocarbohydrates, we don't want to
(13:51):
cut them completely.
We may.
Potentially, depending on whereyou're at with your diet, we
may want to reduce them some.
I find that a lot of people areprobably eating a bit too much,
so they could stand to lowerthings a smidge.
However, it's really more aboutyour fiber amounts and your
protein amounts and those cankind of help balance your blood
(14:11):
sugar, more so than just lettingin cutting and cutting carbs.
Because if you cut carbs, yes,you will reduce your insulin
impact, at least in the moment,because you produce insulin when
you eat carbs.
So if you're not eating carbsyou're not producing as much
insulin, right, that will helpmomentarily.
But let's say you're not eatingcarbs, you're not producing as
much insulin, right, that willhelp momentarily.
But let's say you are loweringyour carbs, you're producing
(14:34):
less insulin, but you're stilleating too many calories, or
you're still eating morecalories than what your body
actually needs for the day.
Your body will still store thatextra as fat.
So sometimes going on a low carbdiet, at least for the first
little while, will be helpfulfor weight loss, because it's
(14:56):
more satiating and it's higherin protein and fats and so those
fill you up more.
You end up accidentally eatingless calories and sometimes it
is that reduction in insulinkind of helps your body sort of
find more of an equilibrium atfirst, but you tend to get stuck
at a certain point therebecause there is still that
(15:17):
factor of if you're eating morethan you need for that day, your
body has to do something withit.
It doesn't just flush it out,it has to go somewhere, and so
it's going to go to body fatstores.
Let's look at it from the otherside.
Let's say that you are eating alow calorie diet or you're
eating lower calories than whatyour body technically needs
(15:37):
according to the math, butyou're also eating mostly
starchy foods and little ahundred calorie packs and just
things that are emptynutritionally.
What's going to happen there isthat you may actually end up
maybe potentially not storingextra body fat although I have
seen that happen but usually youmight still be losing weight,
(16:00):
but it's going to be likepainfully slow, especially for
how many calories you're eating.
You're going to be eating like1200 calories and be like why am
I not losing?
According to the math, you'relosing half a pound a week, when
you should be losing two poundsa week based on what you're
eating.
That's the impact of insulinthere, so it can slow things
(16:21):
down because it's that easy gain.
So it's over 24 hours You'rehaving these spikes of fat
storage and then you're reducingfats.
Fat storage, reducing fat.
It's all happening all the time, right, there's an exchange
happening all the time, and soboth of these things are wrong,
(16:42):
and both of these things areright.
It's about managing the twotogether, and I would argue as
well that the calories matter,but carbs.
It's not so much about carbs,like I said, it's more about
managing your blood sugar, andthat can be done without
reducing your carbs too too much.
The cool thing about that is,if you're managing your blood
(17:02):
sugar really well, then yourweight loss should respond more
like a normal person.
Then your weight loss shouldrespond more like a normal
person, and so with your caloriecounts, you won't have to go
just to an ungodly low level.
You won't have to go 800calories a day or 1200 calories
a day or whatever it is that'sworked for you in the past.
You'll be able to do 1800 andstill lose.
(17:24):
You know what I mean, and thatmakes it a lot more easy and
sustainable to continue with theweight loss process.
All right, and that brings me tothe next question, which is do
women with PCOS have slowermetabolisms and do they need
less calories?
There have been some studiesdone on this, actually, because
people were wondering Becauseweight loss resistance is such a
thing in PCOS?
(17:45):
I mean, there's been numerousstudies about it, so it just
makes me so mad to see people onthe internet kind of being like
that's not real Because I canlook up the scientific evidence
on it.
It's right there in front ofyour face.
But whatever, there have beenstudies done to investigate
whether the metabolism in PCOSwas fundamentally slower,
because that's what a lot ofpeople thought for a while.
If there's this much issue withweight, there must be something
(18:08):
going on with the way the bodyburns energy, and what was found
through those studies was thatthat wasn't part of it, that the
metabolism at its core, thebasics of the metabolism, work
the same as anybody else's.
It's all the hormonal factorson top of it that alter the way
that we store fat, and so do wehave a naturally slower
(18:33):
metabolism.
It depends on what you mean bythat.
If you're looking at thescientific version of what
metabolism means, no, we don'thave a slower metabolism.
But if you're talking aboutmetabolism from the sense of
most people, use it colloquially.
But if you're talking aboutmetabolism from the sense of
most people, use it colloquially.
Which is my metabolism is howeasy it is for me to lose weight
, or how hard, how easy is itfor me to gain weight, et cetera
(18:55):
, et cetera, yes, we have aslower metabolism in that sense,
but it's not the metabolismitself really, and this is
really just kind of like it'ssemantics at this point.
It's just wording.
But we don't technically have aslower metabolism, so we don't
technically need less caloriesthan the average person.
(19:15):
However, as you probably havegathered from this so far and
have noticed in your own life,if you follow the calorie advice
that you might get on an applike MyFitnessPal or something,
even if you follow it to a T,you might find yourself gaining
weight at that 1800 calories orwhatever.
And it's not necessarily thatthe math is wrong.
(19:36):
It's that all the hormonalfactors are not being well
managed, and so what you'redoing is hitting up against a
brick wall, basically, okay.
So what's the first thing totackle when you want to lose
weight with PCOS?
The first thing that I would dois really work hard on your
blood sugar balance.
So there's quite a few thingshere to that, and I've done a
(20:00):
lot of content on this topic.
You look at anything I've doneon insulin resistance and
that'll be a great startingpoint.
I've got lots of podcasts onthat and I have courses and
things that'll walk you throughthat.
But the very first thing wouldbe eating more protein, because
protein actively counteractsthat insulin response, so it's
(20:21):
key to get enough of that.
I would eat a low glycemic loaddiet.
If you look up the low glycemicload charts, you can see what
foods are higher and what foodsare lower.
I mean, you're looking at awhole foods diet here, so you're
looking at proteins, meats,vegetables and healthy fats and
then like whole grains and stufflike that and you're reducing
(20:43):
your simple starches.
I would think about doingsomething like a continuous
glucose monitor as well, becausethat can tell you what your
blood sugar is really lookinglike compared to the meals that
you're actually eating.
So what I find for a lot ofpeople is that they don't
realize how much they areactually spiking their own blood
(21:04):
sugar with their meals, becausetheir meal looks on their plate
like it's a perfectly healthymeal, and it may be, but your
insulin and carb tolerance is sounique to you.
I know for myself.
I wore a continuous glucosemonitor and I found that I had a
much bigger response tostarches like potatoes and sweet
(21:24):
potatoes than I did to likegrains, and I thought it was
going to be the opposite, but no, it handled rice and stuff much
better than I could potato,even though the two are similar
glycemic loads.
So your responses to things aregoing to depend a lot on you,
your genetics, your history withfood, your insulin balance at
(21:46):
the moment, and historically andgenetically, and it's also
going to depend a lot on yourhistory with dieting, your
current weight, just what timeof day it is, I mean, how
stressed you are, like so manydifferent factors.
So the very first thing youneed to do is manage your blood
sugar better.
If you can manage your bloodsugar really really well and
(22:07):
beyond the right calorie deficitfor you, you should see
progress.
Okay, what are some methods ofweight loss that are sustainable
over two to five years?
This person says 95% of dietsfail.
Yes, it's true, 95% of dietsfail.
There are some philosophicalsort of arguments to be made
here.
I mean some of the aspects ofweight we don't have any control
(22:30):
over.
I don't think human beings arereally designed to have to need
to lose weight.
You know you go back, however,many hundred years and our
bodies sort of naturally didwhat they needed to do and now
they don't.
And the question is, why?
Is it your fault?
Because you're eating too manyempty calories or whatever.
(22:53):
There's an element of personalresponsibility to it, but
there's also an element of justthe world has changed and life
has changed.
I don't think the human body ismeant to diet.
That, I think, is a big reasonwhy it fails a lot.
Because the body doesn't wantto lose weight.
It gains weight.
It gains fat to protect itself.
(23:13):
First and foremost, weight is aprotection mechanism.
It's there to be there in timesof famine.
It's there when your body can'tfully process things through
its detoxification systems.
It's got to store it somewhere,so it's a storage unit.
So there's a lot of complicatedfactors here as to why diets
(23:37):
don't work.
But a big factor, I think, inwhy diets don't work is that
people don't think long-term.
With their diet, they getreally frustrated with
themselves and reallyoverwhelmed and they just are
like, okay, I'm going to do this, I'm going to buckle down, I'm
going to get the weight off, andthen they don't put enough,
(24:00):
they don't save enough energy, Iguess for the maintenance part.
So there's something called setpoint theory, which is that
your body has a set weight thatit likes to be, and if you gain
weight, your set point kind ofgoes up with it.
And then if you lose weight,your body still wants to go back
to that old set point and a lotof people think that the set
(24:24):
point will change with time.
But the weight loss has to bemaintained for a significant
length of time before the setpoint changes and I think that
there's truth to that.
I've seen that before.
So what I always tell my clientsto do is plan ahead for that
maintenance phase.
Assume that once you hit yourgoal weight whatever you end up
(24:45):
making your goal weight thatyou're going to have to work on
maintenance of that weight forat least three months, but
probably more like six months toa year, following the same kind
of structure and plan that youwere following to lose weight,
which means that there may besome tracking involved.
There may be portioninginvolved.
You may not just be able to gooff and just live if you want to
(25:07):
maintain that weight.
Unfortunately, that's just kindof how it is, because our body
kicks up a lot of hungerhormones and things once we've
lost a significant amount ofweight in an effort to get us
back to that set point.
I think is the wisest thing todo with this is to lose weight
slowly.
(25:28):
I think it's better to do it ina way where it's not terribly
uncomfortable day to day, with asmall calorie deficit, working
on your overall health, workingon your blood sugar balance, et
cetera, and a small to moderatecalorie deficit, because that's
doable, that's sustainable andit doesn't take a lot out of you
(25:50):
emotionally, mentally.
Willpower is not aninexhaustible resource.
It's like a pool that you drawfrom and if you draw too much of
that willpower at the beginning, you will burn out.
Once you burn out you've beenthere just as much as I've been
there Once you burn out on theweight loss thing, you're just
like, and even despite you knowbeating yourself up for it
(26:12):
whatever you just let thatweight kind of creep back up
because you have no willpowerleft for it or that maintenance
piece.
So slowly over time, I think isprobably the wisest thing to do
on your own and doing it in away where it's not all just
calorie deficit stuff, it's notall about not eating as much,
(26:33):
it's also about you know youincrease your activity some.
You find something that youreally like, that kind of gets
you moving more and that subtlyburns some extra for you and
things like that.
Is intermittent fasting helpful,yes and no, you and things like
that.
Is intermittent fasting helpful?
(26:53):
Yes and no, okay.
So I think intermittent fastingcan be helpful in a few
specific cases.
If a person's insulinresistance is very severe, and
even doing all the things Italked about before managing
blood sugar, eating a healthy,all that if that's really not
moving the needle at all.
And I have seen that beforewhere the insulin resistance is
so severe that things just don'tbudge sometimes.
(27:16):
Intermittent fasting can behelpful there, because it'll
give your body a break fromproducing insulin and it can
help you maintain a caloriedeficit a little bit easier.
Postmenopause, I think it can behelpful as well, because our
mitochondria need a little bitmore support postmenopause, and
intermittent fasting does helpwith mitochondrial function,
(27:37):
which is a good thing.
Mitochondria are like ourenergy makers of ourselves, so
there's some positives forintermittent fasting, for sure.
I would caution you against it,though, if you have any kind of
like major stress in your life,if you have a stressful job, if
you have a history of adrenalissues with PCOS, if you are
parenting, if you are in yourfertile years and you're still
(28:00):
trying to get pregnant at somepoint.
I would just caution youagainst it during those times,
because it can be really, reallyhard on your stress responses
to skip meals, and I woulddefinitely caution you against
skipping breakfast.
Next question is if I'm in mymid-40s or I'm post-menopause,
how do I lose weight?
(28:20):
Well, intermittent fasting canbe helpful there, but really the
principles of weight losspost-menopause are the same,
although your metabolism doesslow down post-menopause.
The principles are the same,but it takes longer.
But I would really work onmanaging your insulin and your
inflammation post-menopause,because those are the two things
(28:41):
that usually cause the mostproblems, and a lot of that's
doing the same things that I'vebeen talking about before.
But your calorie deficit mayneed to be a little bit larger.
That's because we end upburning less.
We need less fuel as we age,and so a lot of times people are
really used to a certain amountand it's just a little bit too
(29:04):
much, and so if they account foreverything else and they can
reduce that somewhat, they mayfind that they end up having
more success, which is whereintermittent fasting could be a
nice way to play around withthat too.
Somebody asked how long of afast from evening to morning is
best.
So I don't recommend skippingmeals, but it is good to give
(29:27):
your body a break overnight.
A lot of us unintentionally endup eating too late into the
night and too early in themorning and we don't give our
body enough time to fast.
Twelve hours of fasting dailyis ideal for everyone, so that
means you know, 8 pm to 8 amright, 7.30 pm to 7.30 am to 8
(29:49):
am right, 7.30 pm to 7.30 am,whenever it is that you eat
breakfast, go back 12 hours fromthere.
That should be your last foodintake, ideally.
Now there is a concept calledmetabolic flexibility, and when
you are healthier and when yourinsulin and inflammation and all
that are more balanced, youhave more metabolic flexibility,
(30:11):
which means that you can golonger without meals, you can
skip meals, you can fast, youcan do this and that you might
not feel great, but you're notgoing to pass out, you're not
miserable, you're not feelinghorrible, you're not feeling
like you absolutely have to eat.
That's good.
You want that.
You want that metabolicflexibility.
So if you don't have thattolerance for 12 hours overnight
(30:34):
, that's an indicator that yourinsulin resistance may not be as
well controlled as you think itis, because you should have
that metabolic tolerance Now.
Over time we can build that.
So I would look at.
Okay, I can't do 12 hour fast,right, I need to eat, or it's
like impacting my sleep,whatever.
So how much can you do?
(30:54):
Can you do 11 hours?
Can you do 10 hours?
Can you do nine hours?
Can you do eight hours and kindof work your way forward to
where you get to 12 and you'restill able to sleep well, and
all of that stuff?
Cause that is really good wayto give your body a break from
insulin and a good way to kindof clear, clear stuff out, give
(31:17):
you a clean slate for the nextday for energy usage.
All right, uh, what's the bestway to manage cravings and
appetite when you're trying tolose weight in PCOS?
Yeah, this is a big factor.
So you know, talked aboutbefore.
There's all these hormonalfactors, right, there's all
(31:39):
these metabolism factors, andone of the things that I do find
that kind of stumbles people upis sometimes they do end up not
realizing how much extrasnacking they're doing.
Little things do add up,especially when you're on a
weight loss protocol.
(31:59):
With a weight loss protocol,usually I have to have my
clients and even for myself, Ireally can't eat a lot of snacks
.
I have to be on a structure.
It's got to be breakfast, lunch, dinner and an afternoon snack
and that's kind of it.
I don't get to do a littlemid-morning snack and a little
after dinner snack.
(32:20):
If I do that, but my activitylevel isn't there, you know, if
I'm not very active et cetera,then I do find that people can
just stay the same or even gainweight a little bit, and a lot
of that comes from those littlecravings that we get, because
when we lose weight our bodydoesn't like it, it doesn't want
(32:41):
to do it.
So it sends you a lot ofsignals.
It tells you eat, eat.
I think there's thismisconception out there that you
can lose weight without beinghungry at all.
A lot of fad diets sort ofprofit off of this particularly
like low-carb diets have for along time profited off of this
idea Eat whatever you want, eatas much as you want of these
(33:03):
specific foods and you won'tfeel hungry and you'll lose
weight.
Hunger is your body's reactionto not getting enough fuel.
When it doesn't get enough fuel, it has to look for that fuel
somewhere, and the first placeit's going to look is your
muscles and your liver, becauseyou store some stuff there.
(33:24):
But then after that it's goingto start looking at your fat
stores.
So a little bit of hunger is agood thing, because that means
that your body is activelyworking to find fuel, and what
you'll find is that at thebeginning of a weight loss
journey this is typically worse.
If you do cycle regularly as awoman, you'll notice this is
worse during the second half ofyour cycle and there's a lot to
(33:49):
that.
But hunger is not a bad thing ona weight loss diet.
Now, if you are shaky and weakand feel like you're going to
pass out and literally you'rebarely getting through the day,
you're probably not eatingenough.
You're probably trying to gotoo low with your calorie
deficit, but you should have aslight hunger feeling during
(34:10):
different parts of the day.
So hunger is not a bad thing.
It's those overwhelmingcravings that are a bad thing.
So the key to that is makingsure that you are eating a lot
of protein, because protein isvery satiating.
It keeps you full to the pointwhere sometimes, when people
start eating a lot of protein,they actually don't feel hungry
(34:31):
and do still lose weight.
That is possible.
It usually evens out with time,but protein is very satiating.
Make sure you're not cuttingtoo much of the healthy fats and
make sure you're eating a lotof fiber.
That's also satiating too.
Try to avoid artificialsweeteners too, because those
can make you crave more sweetsand different things like that.
(34:53):
What is the role of GLP-1s inPCOS weight loss?
I'm actually very excited aboutGLP-1s.
I mean, the more I've hadclients beyond them, the more
excited I am, because there aresome people who are very, very
weight loss resistant and it'sbecause their abdominal fat is
creating that extra inflammationinsulin response that is then
making all the efforts with thefood and the calorie reduction
(35:19):
really slow.
Those people can make progress,but it just it takes a long
time and it can be reallyfrustrating and it's you run out
of willpower, all that stuff.
So GLP-1s, I think, are greatfor a certain population of
people.
They work by helping to lowerthe amount of insulin that
(35:40):
you're producing.
They also do work on yourappetite a bit, so they suppress
appetite, which is nice,because a lot of times in weight
loss with people who have a lotof insulin resistance, the
cravings factor is really highand there's also something
called leptin resistance whichmakes it difficult for you to
tell when you're full.
So a lot of people overeat whenthey have leptin resistance
(36:03):
because they don't get thatsignal that they're full until
it's too late.
So for those people, glp-1s canbe really, really effective.
They almost let the food noiseout.
So I'm a fan for the most part.
They do sometimes have someside effects and I'm still
holding out they're new.
So I'm holding out thatsometimes things that seem too
(36:25):
good to be true are too good tobe true, but I am optimistic
about them for the time being.
And, yeah, they just kind ofwork on your insulin resistance
and that's great because withPCOS we can really use that.
(36:45):
What are the best exercises forthe different PCOS types when it
comes to weight loss?
So you guys know the types I'vetalked about before and there's
a lot of overlap.
Most people have more than onetype going on, but we've got
insulin resistant type,inflammation, chronic
inflammation type, my gut healthgirlies, my IBS ladies, and
(37:06):
then we have the adrenal type,the ones who are stressed, the
anxious among us.
You know, relatable, I am alsoan anxious person.
So what are the best exercisesfor the different types for
weight loss?
Well, for everyone, strengthtraining.
Now for my adrenal girliesplease don't go do CrossFit, I
(37:29):
mean, unless you really, really,really love it or really,
really, really want to, and thenyou know we can find a way to
make it work.
But for the ones who haveadrenal stuff, take what?
If you've historically done alot of exercises, anxiety relief
, let's say this a lot ofexercises, anxiety relief.
(37:54):
Let's say this Take what youwant to do and cut back by half
and then do that.
Everyone can benefit fromstrength training, from heavy
weights.
This burns a lot of calories.
It revs your metabolism a lotfor quite a long time afterwards
, for like 72 hours after.
So a couple of two to threestrength training sessions a
week are um that do the fullbody, are really helpful for
(38:17):
weight loss and from therecardio.
And cardio can look differentdepending on where you're at
with your adrenals.
So if you don't have a lot ofadrenal issues, more cardio.
Take what you want to do andpractice, bump it up some.
Now start slow, start small,start with what you can manage.
But if you're getting 2000steps a day, usually think about
(38:44):
getting yourself a littlefitness watch and pushing
yourself a bit.
The cool thing about exerciseand energy is that energy breeds
energy.
So the more exercise you do,the more energetic you will be
and the more energy, you'll haveto do more exercise, and so I
would say try to do exercisesmaller amounts more regularly
(39:10):
rather than large amounts spacedout, and this is more for habit
building purposes.
So if right now you're totallysedentary, start with 15 minutes
, but do it every day.
If you are already doingsomething kind of similar to
that, then bump up to 30, 25, 30.
You can break that into chunks.
(39:31):
You can do 10, 10, and 10.
You can do 15 and 15, or youcan just do it all at once in
the evening or something likethat.
But take where you're at, addto it and continue.
Now, if you already do 45minutes of walking pretty much
every day, well then maybe thinkabout a couple days a week
(39:52):
taking away the walk and doing amore intense form of
cardiovascular activity instead.
And I don't necessarily meanHIIT training, although a little
bit of HIIT training can behelpful for weight loss if we
don't have a lot of adrenalstuff going on.
But it could be somethingthat's going to get your heart
rate up.
Maybe a class, a fitness class,zumba, or you could take dance
(40:13):
lessons like I do, somethingthat's gonna really kind of get
you get your heart rate up andget your breathing a little bit
heavier.
That can be helpful as well forweight loss.
It burns a little bit more.
It's important not to overdothat kind of exercise, but a
nice balance of a couple days aweek of doing something like
that can be great.
(40:33):
You could also think aboutstarting to incorporate
something like Pilates, which isreally helpful for weight loss
and is a little bit more intense, right.
So bump up the intensity a bit.
If you're more sedentary, ifyou already are a heavy
exerciser or an athlete or youhave a lot of adrenal issues,
think about bumping down whatyou're doing currently.
(40:56):
So if you're doing intenseactivity five days a week, cut
back to three.
Replace those other days withsomething gentle yoga, walking,
something.
That's going to be a little biteasier on your stress, hormone
production.
And final question are there anysupplements that help weight
loss?
Yes, there's quite a fewactually, and what I really
(41:25):
usually suggest is picking asupplement that's going to help
with your PCOS root cause.
So if you don't know the PCOSroot causes very well or you're
not really sure what, so if youdon't know the PCOS root causes
really well, or you're notreally sure which ones you have,
or you know what is what I?
If you don't know the PCOS rootcauses really well or you're
not really sure which ones youhave, or you know what is what,
I'd highly recommend taking myPCOS foundations course.
It's budget friendly, it's aquick little four week kind of
(41:49):
meal plan course and then I haveseveral video modules in there
that'll teach you about yourPCOS, all the different root
cause issues and somesupplements and things that can
help.
But I would say, if you're moreinsulin resistant and that's
where a lot of this is comingfrom that I would really work
(42:10):
heavily on your blood sugarbalance and some supplements
that can help for weight loss.
There are the inositols.
I'll link to the ones that Iusually recommend.
There's an inositol blend thatI really like that can be
helpful.
Berberine can be helpful, soI'll link to those.
If you're more of a gut healthinflammation person like you
(42:31):
deal with IBS and otherdigestive issues you're going to
really want to work on thatfirst and that will in turn help
with the weight loss.
So probiotics possibly evenprebiotics if you tolerate them,
and maybe even something likeinacetylcysteine, which is a
(42:53):
potent antioxidant precursorthat can be really effective for
reducing inflammation, whichwill then help your body kind of
feel safe enough to let go ofweight and then, if we've got
adrenal stuff going on, the big,big key here is getting good
sleep.
So I would work first ongetting good sleep and you
wouldn't believe how much betterthe weight loss process works
(43:13):
if you're getting enough sleep.
It really really does make abig difference because of those
stress hormones.
So maybe something likeashwagandha or rhodiola or, if
you're postmenopause, somethinglike lemon balm.
Those things can be L-theanineas well.
Those can be really helpful forcalming the nervous system and
(43:34):
helping you get better sleep,which then will help your body
with recovery and processing andeventually weight loss.
But I don't typically recommenddoing appetite suppressants or
metabolism boosters or a lot ofthese things that you'll see at
like supplement stores.
Just in my experience theydon't work very well and they
(44:01):
seem like a little bit of awaste of money.
You might as well put yourmoney towards good quality
supplements that help with yourPCOS root cause issues because,
let's face it, the PCOS rootcause issues are the reason why
we're having issues with theweight gain and weight loss in
the first place.
So that's what I wouldrecommend.
I'll link to some of myfavorites.
I'll also link to my PCOSFoundations course.
But thank you for being here,thank you for watching this
(44:24):
video all the way through, andif you have any further
questions about weight loss,please drop them in the comments
.
Let me know.
If you have any comments oranything resonated for you, let
me know as well and I'll try toanswer any questions that I get.
And yeah, I'll talk to you guyssoon.
Have a great day.
Hi guys, welcome back to Functional PCOS.
Today I'm going to be answeringyour top PCOS weight loss
questions.
Okay, so I polled my Instagramfollowers If you don't follow me
on Instagram, why not?
And I also asked the internet.
I looked at the top Googlesearch terms for PCOS and weight
(00:24):
loss and I put together acollection of I actually have
not counted this.
It looks like about 20questions, 15 to 20 questions
and I'm just going to go througheach of them and give an
explanation of how a nutritionprofessional coming from the
functional nutrition world wouldhelp you with your PCOS weight
(00:45):
loss and explain things to youin a way that, hopefully, will
help make it more understandablewhy you're struggling so much
with weight loss and what somesolutions are that you can do.
Okay, so let's get into it.
So, number one why is it hard tolose weight with PCOS?
You know I see a lot of contenton the internet that is women
(01:09):
with PCOS lamenting theirinability to lose weight and the
difficulty of it, and there areso many horrendous comments on
these kinds of videos.
I saw one the other day of anutritionist who is over 200
pounds.
She said so in her video andshe said you're just trying to
help people eat healthy in aworld where you're not allowed
(01:32):
to be overweight, as anutritionist and man.
The people came for her in thecomments.
It was horrible and I just feltso sorry for her because I
believe she has PCOS and I knowfor myself and for so many of us
who have PCOS the lifelongstruggle with losing weight is
so real and maintaining weightloss right.
(01:55):
And so all the comments inthere were just like you can't
violate the law ofthermodynamics, man, calories in
, calories out, whatever.
And what these simple-mindedfolks fail to understand is the
complex metabolic system that'sat play with weight maintenance
and weight management.
They don't recognize theimportance of hormone balance in
(02:20):
weight loss and they don'trecognize the importance of
stress and stress hormonebalance in weight loss and they
don't recognize the importanceof stress and stress hormone
balance in weight loss.
So there's several things thatare going on with PCOS
specifically that do make itmore difficult for us to lose
weight.
There's kind of two theories ofweight loss and weight
maintenance.
There's the calories incalories out law of
(02:42):
thermodynamics blah, blah, blah.
Calories in calories out law ofthermodynamics blah, blah blah,
which has there's validity tothat.
It is part of the picture, butit's not the whole thing.
And then there's a newer modelof weight loss, weight
management, called thecarbohydrate insulin model, and
a lot of the research reallyfavors this model.
But it's the concept thatinsulin, which is a hormone.
(03:02):
It's the concept that insulin,which is a hormone, acts as a
fat storage hormone, and so whenthere's too much in the system,
the body preferentially storesfat.
And if you look across the rangeof people, right, everybody has
a different sort of baselineweight.
There's a lot of genetics thatplay there too.
(03:23):
And you look at some people whoare naturally very thin, some
people who struggle more.
Why is that?
Well, the carbohydrate insulinmodel of weight loss accounts
for some of that.
Right, because if we have toomuch insulin in our system,
which is a problem in PCOS, thenour bodies are going to prefer
to store our food as fat.
(03:45):
And where this kind of comesinto play from a genetic
perspective is that a lot ofpeople think that the genetics
of those with PCOS may havestemmed from ancestors who went
through famine, other foodinsecurity, to the point where
the genes sort of morphed toaccommodate for that.
So if you were growing up in aworld where food was really
(04:09):
insecure.
But you could also maintainbody fat really well and store
body fat for use later.
You would be more likely tosurvive, right?
Because think about a longwinter where there's no food.
If you've got a lot of body fat, then you've got a lot to live
off of.
(04:29):
Have you ever watched that showAlone?
So there was a season of Alonewhere the guy survived by
gaining a tremendous amount ofweight before he went on the
show.
He barely did anything the lasthalf of the show.
These other people are outthere like building shelter.
They're fishing all the time,they're wasting a lot of energy
(04:49):
trying to find food and heinstead, just kind of like a
bear, went in his den andhibernated for the rest of the
show and he ended up winningbecause he had all those body
fat stores and he just ate offof his body fat stores.
So the concept is a little bitsimilar in PCOS, right?
We preferentially store bodyfat and so we have it there for
(05:11):
a rainy day.
And of course I know this isnot everyone with PCOS.
There are many women with PCOSwho are actually underweight.
But for those of us who arehaving difficulty with weight
management, that's part ofwhat's going on too much insulin
.
The other thing that's going onis that our stress hormone
balance can be out of whack andwe also can have some issues
with our thyroid, and so we knowthat sluggish thyroid is going
(05:33):
to lead to some weight gain anddifficulty, weight stubbornness,
and that having high cortisollevels, for example, is also
going to have us preferentiallystore body fat in the abdomen,
have us preferentially storebody fat in the abdomen, and
when we store body fat in theabdomen, that becomes more
inflammatory to our system andthat extra inflammation in the
(05:53):
system can then make us moreinsulin resistant, create more
insulin, and it can be kind of avicious cycle.
If you've ever noticed and I'venoticed this for myself too that
when you gain weight with PCOS,there might be a sweet spot
with your weight, but if youhappen to gain five, 10 pounds
or something during a stressfultime, all of a sudden it's like
(06:14):
it's a snowball rolling right.
It gets easier and easier andeasier to gain weight.
What I always say about weightmanagement and PCOS is that it
is more difficult for us becauseit's not that it's harder to
lose weight for the most part,if we're accommodating for
everything that we're going tokind of talk about here.
(06:36):
It's not that it's necessarilyharder to lose weight, but it's
easier to gain.
So if you take a week where youlose half a pound, for example,
and then over the weekend youjust kind of stop paying
attention, like most people dowhen they're on a weight loss
journey, they're like, okay,I'll do this all week and then
on Saturdays I have my free day,or whatever.
For the average person theywould still make progress with
(06:58):
PCOS.
Because of that insulinresponse.
They might store an extraamount of body fat.
That doesn't make sense withthe math and it could just be a
wash right, or it could evenresult in weight gain if they're
not careful.
And so if it's easy to gain butmoderately hard to lose, you're
in the favor of weight gain.
(07:19):
Does that make sense?
So basically, the law ofthermodynamics doesn't
necessarily apply to humanbeings perfectly.
There are a lot of otherfactors that can tweak it a bit
and the slightest little tweakover years and years and years
of your life can result inweight gain.
Okay, we'll get into more ofthis as we go on, but let's talk
(07:40):
about the next question, whichis does weight matter for PCOS
and will losing weight help PCOS.
So this is a mixed answer, likea lot of things.
Does your weight matter?
I would love to say that itdoesn't matter at all.
I don't think that the researchis on the side of that.
I do believe in health at everysize and I definitely don't
(08:03):
believe that everyone with PCOSneeds to be like a little twig
or needs to lose as much weightas possible.
I definitely think that therange of what can be healthy for
the human body is higher thanwhat society tells us.
However, your weight does matterto an extent, mostly because of
the impact of abdominal fat onyour inflammation levels.
(08:25):
That's the biggest part.
So we know that like moreabdominal fat you have, it goes
from being like localizedinflammatory response in the
abdomen region specifically to,if there's a lot of body fat, to
it becoming more systemic.
There are a lot of reasons forinflammation in PCOS, but that's
one of them is that abdominalfat, and all of us with PCOS are
(08:46):
dealing with that.
Abdominal fat storage.
That's where our bodies preferto store it, and it's because of
high testosterone levels, it'sbecause of high insulin levels,
it's because of high cortisollevels.
Basically, all the hormonalstuff we've got going on is like
put it in the belly.
All of us have multipledifferent hormonal factors that
(09:08):
cause us to want to gain bellyfat.
I know, isn't it fun, I'mliving with this too.
Okay, we always say the PCOSbody is an apple-shaped body, if
you guys remember the fruitshape, sometimes more
pear-shaped, but it's usually.
There's a lot of body fatcollection in the middle of the
body and a thicker waist, and soit's that inflammation that
(09:29):
really triggers a lot of longerterm issues.
If that weren't the case, then,no, your weight probably
wouldn't really matter, becauseit would be about what your diet
looks like.
And there are exceptions tothis, because there are some
people who, genetically, arelarger and are perfectly healthy
.
Those people do exist, but Ithink the vast majority of us
(09:50):
with PCOS, we're working with aparadigm where, yes, having
excess weight on us to an extentis damaging, because that extra
inflammation makes us moreinsulin resistant and with time
that then makes a lot of othermetabolic things go wrong.
And we're young.
It may not show up on our labwork, we may look fine on lab
(10:12):
work, but as we age it kind ofdoes start to impact us.
So, yes, it matters.
Will losing weight help?
Yes and no.
So the idea of losing weighthelping PCOS comes from a study
that found that if you loseabout 10% of your body weight
it's more likely to regulateyour cycles.
And did the medical communitywant to run with that one right?
(10:35):
So, yes, losing 10% of yourbody weight technically will
help with your PCOS symptoms,which overall, will mean that
you are a healthier individual.
However, I think the real keyhere is looking at why does
weight loss happen in the firstplace?
In PCOS, and because we have somuch metabolic damage, it's
(10:55):
really difficult for us to loseweight unless either we're going
about it in a really unhealthyway, which I think long-term
means that losing that 10%doesn't really it's a wash right
, because you're like if you'regoing on a crash diet, you're
damaging your adrenals, you'remaking it much more likely that
you're going to regain all ofthese negative side effects, so
(11:17):
your cycles might returnmomentarily, but then all it's
impossible to lose it unlessyou're doing that.
Or if you're managing andaccounting for a lot of
different pieces and factors inyour diet, managing for your
insulin, your inflammation andyour adrenals, all with your
diet, which can be overwhelmingif you don't know how to do that
(11:38):
.
So if you're doing it.
If you're losing weight in ahealthy way and you lose that
10%, then theoretically, yes,that could be helpful.
But it's not really the 10% ofbody weight that you've lost,
it's more all the positivechanges that you've made.
But I'd love to see a study ofjust women who do like a crash
diet to lose 10% of their bodyfat and see how that helps their
(11:58):
PCOS.
You know what I mean.
I'm not entirely sure thatthat's the root of the issue.
I think weight in a lot of waysis just a symptom of PC PCOS.
It's very easy to blame bodyfat for your PCOS and a lot of
people do say, well, you havePCOS because you're fat.
But no, we're fat because wehave PCOS and we struggle with
(12:21):
our weight because of our PCOS,and then that in turn means that
losing weight might be helpful.
But it's because we're alsoworking on the metabolic issues
at the root of the PCOS first.
I hope that's making sense.
It's a touchy topic.
So what I've seen here is thatif you kind of fall on the
higher end of the normal rangeor into the overweight or obese
(12:45):
ranges on like the BMI scale,then potentially losing a little
weight could help, butotherwise, no, I wouldn't worry
about it from a weight lossperspective.
I'd really worry about managingyour overall metabolic health
and honestly, that goes foreveryone.
Metabolic health first andforemost.
Let weight come along assecondary to all of that.
(13:06):
Okay, which is more importantcalories or carbs?
This goes back to the insulincarbohydrate model of weight
loss and the law ofthermodynamics, right.
So you'll hear people say it'sall calories and calories out.
If you're gaining weight, youhave to be eating too many
calories.
If you're losing weight, it'sbecause you're in a calorie
deficit.
Then you hear people say, no,it's because of insulin, and
(13:30):
insulin's a fat storage hormone,and so if you just lower your
insulin, then your body won'tprefer to store fat and you'll
lose weight.
So the truth is actually in themiddle of these two things.
Especially with PCOS, we haveto account for both, because
both are going on.
So, when it comes tocarbohydrates, we don't want to
(13:51):
cut them completely.
We may.
Potentially, depending on whereyou're at with your diet, we
may want to reduce them some.
I find that a lot of people areprobably eating a bit too much,
so they could stand to lowerthings a smidge.
However, it's really more aboutyour fiber amounts and your
protein amounts and those cankind of help balance your blood
(14:11):
sugar, more so than just lettingin cutting and cutting carbs.
Because if you cut carbs, yes,you will reduce your insulin
impact, at least in the moment,because you produce insulin when
you eat carbs.
So if you're not eating carbsyou're not producing as much
insulin, right, that will helpmomentarily.
But let's say you're not eatingcarbs, you're not producing as
much insulin, right, that willhelp momentarily.
But let's say you are loweringyour carbs, you're producing
(14:34):
less insulin, but you're stilleating too many calories, or
you're still eating morecalories than what your body
actually needs for the day.
Your body will still store thatextra as fat.
So sometimes going on a low carbdiet, at least for the first
little while, will be helpfulfor weight loss, because it's
(14:56):
more satiating and it's higherin protein and fats and so those
fill you up more.
You end up accidentally eatingless calories and sometimes it
is that reduction in insulinkind of helps your body sort of
find more of an equilibrium atfirst, but you tend to get stuck
at a certain point therebecause there is still that
(15:17):
factor of if you're eating morethan you need for that day, your
body has to do something withit.
It doesn't just flush it out,it has to go somewhere, and so
it's going to go to body fatstores.
Let's look at it from the otherside.
Let's say that you are eating alow calorie diet or you're
eating lower calories than whatyour body technically needs
(15:37):
according to the math, butyou're also eating mostly
starchy foods and little ahundred calorie packs and just
things that are emptynutritionally.
What's going to happen there isthat you may actually end up
maybe potentially not storingextra body fat although I have
seen that happen but usually youmight still be losing weight,
(16:00):
but it's going to be likepainfully slow, especially for
how many calories you're eating.
You're going to be eating like1200 calories and be like why am
I not losing?
According to the math, you'relosing half a pound a week, when
you should be losing two poundsa week based on what you're
eating.
That's the impact of insulinthere, so it can slow things
(16:21):
down because it's that easy gain.
So it's over 24 hours You'rehaving these spikes of fat
storage and then you're reducingfats.
Fat storage, reducing fat.
It's all happening all the time, right, there's an exchange
happening all the time, and soboth of these things are wrong,
(16:42):
and both of these things areright.
It's about managing the twotogether, and I would argue as
well that the calories matter,but carbs.
It's not so much about carbs,like I said, it's more about
managing your blood sugar, andthat can be done without
reducing your carbs too too much.
The cool thing about that is,if you're managing your blood
(17:02):
sugar really well, then yourweight loss should respond more
like a normal person.
Then your weight loss shouldrespond more like a normal
person, and so with your caloriecounts, you won't have to go
just to an ungodly low level.
You won't have to go 800calories a day or 1200 calories
a day or whatever it is that'sworked for you in the past.
You'll be able to do 1800 andstill lose.
(17:24):
You know what I mean, and thatmakes it a lot more easy and
sustainable to continue with theweight loss process.
All right, and that brings me tothe next question, which is do
women with PCOS have slowermetabolisms and do they need
less calories?
There have been some studiesdone on this, actually, because
people were wondering Becauseweight loss resistance is such a
thing in PCOS?
(17:45):
I mean, there's been numerousstudies about it, so it just
makes me so mad to see people onthe internet kind of being like
that's not real Because I canlook up the scientific evidence
on it.
It's right there in front ofyour face.
But whatever, there have beenstudies done to investigate
whether the metabolism in PCOSwas fundamentally slower,
because that's what a lot ofpeople thought for a while.
If there's this much issue withweight, there must be something
(18:08):
going on with the way the bodyburns energy, and what was found
through those studies was thatthat wasn't part of it, that the
metabolism at its core, thebasics of the metabolism, work
the same as anybody else's.
It's all the hormonal factorson top of it that alter the way
that we store fat, and so do wehave a naturally slower
(18:33):
metabolism.
It depends on what you mean bythat.
If you're looking at thescientific version of what
metabolism means, no, we don'thave a slower metabolism.
But if you're talking aboutmetabolism from the sense of
most people, use it colloquially.
But if you're talking aboutmetabolism from the sense of
most people, use it colloquially.
Which is my metabolism is howeasy it is for me to lose weight
, or how hard, how easy is itfor me to gain weight, et cetera
(18:55):
, et cetera, yes, we have aslower metabolism in that sense,
but it's not the metabolismitself really, and this is
really just kind of like it'ssemantics at this point.
It's just wording.
But we don't technically have aslower metabolism, so we don't
technically need less caloriesthan the average person.
(19:15):
However, as you probably havegathered from this so far and
have noticed in your own life,if you follow the calorie advice
that you might get on an applike MyFitnessPal or something,
even if you follow it to a T,you might find yourself gaining
weight at that 1800 calories orwhatever.
And it's not necessarily thatthe math is wrong.
(19:36):
It's that all the hormonalfactors are not being well
managed, and so what you'redoing is hitting up against a
brick wall, basically, okay.
So what's the first thing totackle when you want to lose
weight with PCOS?
The first thing that I would dois really work hard on your
blood sugar balance.
So there's quite a few thingshere to that, and I've done a
(20:00):
lot of content on this topic.
You look at anything I've doneon insulin resistance and
that'll be a great startingpoint.
I've got lots of podcasts onthat and I have courses and
things that'll walk you throughthat.
But the very first thing wouldbe eating more protein, because
protein actively counteractsthat insulin response, so it's
(20:21):
key to get enough of that.
I would eat a low glycemic loaddiet.
If you look up the low glycemicload charts, you can see what
foods are higher and what foodsare lower.
I mean, you're looking at awhole foods diet here, so you're
looking at proteins, meats,vegetables and healthy fats and
then like whole grains and stufflike that and you're reducing
(20:43):
your simple starches.
I would think about doingsomething like a continuous
glucose monitor as well, becausethat can tell you what your
blood sugar is really lookinglike compared to the meals that
you're actually eating.
So what I find for a lot ofpeople is that they don't
realize how much they areactually spiking their own blood
(21:04):
sugar with their meals, becausetheir meal looks on their plate
like it's a perfectly healthymeal, and it may be, but your
insulin and carb tolerance is sounique to you.
I know for myself.
I wore a continuous glucosemonitor and I found that I had a
much bigger response tostarches like potatoes and sweet
(21:24):
potatoes than I did to likegrains, and I thought it was
going to be the opposite, but no, it handled rice and stuff much
better than I could potato,even though the two are similar
glycemic loads.
So your responses to things aregoing to depend a lot on you,
your genetics, your history withfood, your insulin balance at
(21:46):
the moment, and historically andgenetically, and it's also
going to depend a lot on yourhistory with dieting, your
current weight, just what timeof day it is, I mean, how
stressed you are, like so manydifferent factors.
So the very first thing youneed to do is manage your blood
sugar better.
If you can manage your bloodsugar really really well and
(22:07):
beyond the right calorie deficitfor you, you should see
progress.
Okay, what are some methods ofweight loss that are sustainable
over two to five years?
This person says 95% of dietsfail.
Yes, it's true, 95% of dietsfail.
There are some philosophicalsort of arguments to be made
here.
I mean some of the aspects ofweight we don't have any control
(22:30):
over.
I don't think human beings arereally designed to have to need
to lose weight.
You know you go back, however,many hundred years and our
bodies sort of naturally didwhat they needed to do and now
they don't.
And the question is, why?
Is it your fault?
Because you're eating too manyempty calories or whatever.
(22:53):
There's an element of personalresponsibility to it, but
there's also an element of justthe world has changed and life
has changed.
I don't think the human body ismeant to diet.
That, I think, is a big reasonwhy it fails a lot.
Because the body doesn't wantto lose weight.
It gains weight.
It gains fat to protect itself.
(23:13):
First and foremost, weight is aprotection mechanism.
It's there to be there in timesof famine.
It's there when your body can'tfully process things through
its detoxification systems.
It's got to store it somewhere,so it's a storage unit.
So there's a lot of complicatedfactors here as to why diets
(23:37):
don't work.
But a big factor, I think, inwhy diets don't work is that
people don't think long-term.
With their diet, they getreally frustrated with
themselves and reallyoverwhelmed and they just are
like, okay, I'm going to do this, I'm going to buckle down, I'm
going to get the weight off, andthen they don't put enough,
(24:00):
they don't save enough energy, Iguess for the maintenance part.
So there's something called setpoint theory, which is that
your body has a set weight thatit likes to be, and if you gain
weight, your set point kind ofgoes up with it.
And then if you lose weight,your body still wants to go back
to that old set point and a lotof people think that the set
(24:24):
point will change with time.
But the weight loss has to bemaintained for a significant
length of time before the setpoint changes and I think that
there's truth to that.
I've seen that before.
So what I always tell my clientsto do is plan ahead for that
maintenance phase.
Assume that once you hit yourgoal weight whatever you end up
(24:45):
making your goal weight thatyou're going to have to work on
maintenance of that weight forat least three months, but
probably more like six months toa year, following the same kind
of structure and plan that youwere following to lose weight,
which means that there may besome tracking involved.
There may be portioninginvolved.
You may not just be able to gooff and just live if you want to
(25:07):
maintain that weight.
Unfortunately, that's just kindof how it is, because our body
kicks up a lot of hungerhormones and things once we've
lost a significant amount ofweight in an effort to get us
back to that set point.
I think is the wisest thing todo with this is to lose weight
slowly.
(25:28):
I think it's better to do it ina way where it's not terribly
uncomfortable day to day, with asmall calorie deficit, working
on your overall health, workingon your blood sugar balance, et
cetera, and a small to moderatecalorie deficit, because that's
doable, that's sustainable andit doesn't take a lot out of you
(25:50):
emotionally, mentally.
Willpower is not aninexhaustible resource.
It's like a pool that you drawfrom and if you draw too much of
that willpower at the beginning, you will burn out.
Once you burn out you've beenthere just as much as I've been
there Once you burn out on theweight loss thing, you're just
like, and even despite you knowbeating yourself up for it
(26:12):
whatever you just let thatweight kind of creep back up
because you have no willpowerleft for it or that maintenance
piece.
So slowly over time, I think isprobably the wisest thing to do
on your own and doing it in away where it's not all just
calorie deficit stuff, it's notall about not eating as much,
(26:33):
it's also about you know youincrease your activity some.
You find something that youreally like, that kind of gets
you moving more and that subtlyburns some extra for you and
things like that.
Is intermittent fasting helpful,yes and no, you and things like
that.
Is intermittent fasting helpful?
(26:53):
Yes and no, okay.
So I think intermittent fastingcan be helpful in a few
specific cases.
If a person's insulinresistance is very severe, and
even doing all the things Italked about before managing
blood sugar, eating a healthy,all that if that's really not
moving the needle at all.
And I have seen that beforewhere the insulin resistance is
so severe that things just don'tbudge sometimes.
(27:16):
Intermittent fasting can behelpful there, because it'll
give your body a break fromproducing insulin and it can
help you maintain a caloriedeficit a little bit easier.
Postmenopause, I think it can behelpful as well, because our
mitochondria need a little bitmore support postmenopause, and
intermittent fasting does helpwith mitochondrial function,
(27:37):
which is a good thing.
Mitochondria are like ourenergy makers of ourselves, so
there's some positives forintermittent fasting, for sure.
I would caution you against it,though, if you have any kind of
like major stress in your life,if you have a stressful job, if
you have a history of adrenalissues with PCOS, if you are
parenting, if you are in yourfertile years and you're still
(28:00):
trying to get pregnant at somepoint.
I would just caution youagainst it during those times,
because it can be really, reallyhard on your stress responses
to skip meals, and I woulddefinitely caution you against
skipping breakfast.
Next question is if I'm in mymid-40s or I'm post-menopause,
how do I lose weight?
(28:20):
Well, intermittent fasting canbe helpful there, but really the
principles of weight losspost-menopause are the same,
although your metabolism doesslow down post-menopause.
The principles are the same,but it takes longer.
But I would really work onmanaging your insulin and your
inflammation post-menopause,because those are the two things
(28:41):
that usually cause the mostproblems, and a lot of that's
doing the same things that I'vebeen talking about before.
But your calorie deficit mayneed to be a little bit larger.
That's because we end upburning less.
We need less fuel as we age,and so a lot of times people are
really used to a certain amountand it's just a little bit too
(29:04):
much, and so if they account foreverything else and they can
reduce that somewhat, they mayfind that they end up having
more success, which is whereintermittent fasting could be a
nice way to play around withthat too.
Somebody asked how long of afast from evening to morning is
best.
So I don't recommend skippingmeals, but it is good to give
(29:27):
your body a break overnight.
A lot of us unintentionally endup eating too late into the
night and too early in themorning and we don't give our
body enough time to fast.
Twelve hours of fasting dailyis ideal for everyone, so that
means you know, 8 pm to 8 amright, 7.30 pm to 7.30 am to 8
(29:49):
am right, 7.30 pm to 7.30 am,whenever it is that you eat
breakfast, go back 12 hours fromthere.
That should be your last foodintake, ideally.
Now there is a concept calledmetabolic flexibility, and when
you are healthier and when yourinsulin and inflammation and all
that are more balanced, youhave more metabolic flexibility,
(30:11):
which means that you can golonger without meals, you can
skip meals, you can fast, youcan do this and that you might
not feel great, but you're notgoing to pass out, you're not
miserable, you're not feelinghorrible, you're not feeling
like you absolutely have to eat.
That's good.
You want that.
You want that metabolicflexibility.
So if you don't have thattolerance for 12 hours overnight
(30:34):
, that's an indicator that yourinsulin resistance may not be as
well controlled as you think itis, because you should have
that metabolic tolerance Now.
Over time we can build that.
So I would look at.
Okay, I can't do 12 hour fast,right, I need to eat, or it's
like impacting my sleep,whatever.
So how much can you do?
(30:54):
Can you do 11 hours?
Can you do 10 hours?
Can you do nine hours?
Can you do eight hours and kindof work your way forward to
where you get to 12 and you'restill able to sleep well, and
all of that stuff?
Cause that is really good wayto give your body a break from
insulin and a good way to kindof clear, clear stuff out, give
(31:17):
you a clean slate for the nextday for energy usage.
All right, uh, what's the bestway to manage cravings and
appetite when you're trying tolose weight in PCOS?
Yeah, this is a big factor.
So you know, talked aboutbefore.
There's all these hormonalfactors, right, there's all
(31:39):
these metabolism factors, andone of the things that I do find
that kind of stumbles people upis sometimes they do end up not
realizing how much extrasnacking they're doing.
Little things do add up,especially when you're on a
weight loss protocol.
(31:59):
With a weight loss protocol,usually I have to have my
clients and even for myself, Ireally can't eat a lot of snacks
.
I have to be on a structure.
It's got to be breakfast, lunch, dinner and an afternoon snack
and that's kind of it.
I don't get to do a littlemid-morning snack and a little
after dinner snack.
(32:20):
If I do that, but my activitylevel isn't there, you know, if
I'm not very active et cetera,then I do find that people can
just stay the same or even gainweight a little bit, and a lot
of that comes from those littlecravings that we get, because
when we lose weight our bodydoesn't like it, it doesn't want
(32:41):
to do it.
So it sends you a lot ofsignals.
It tells you eat, eat.
I think there's thismisconception out there that you
can lose weight without beinghungry at all.
A lot of fad diets sort ofprofit off of this particularly
like low-carb diets have for along time profited off of this
idea Eat whatever you want, eatas much as you want of these
(33:03):
specific foods and you won'tfeel hungry and you'll lose
weight.
Hunger is your body's reactionto not getting enough fuel.
When it doesn't get enough fuel, it has to look for that fuel
somewhere, and the first placeit's going to look is your
muscles and your liver, becauseyou store some stuff there.
(33:24):
But then after that it's goingto start looking at your fat
stores.
So a little bit of hunger is agood thing, because that means
that your body is activelyworking to find fuel, and what
you'll find is that at thebeginning of a weight loss
journey this is typically worse.
If you do cycle regularly as awoman, you'll notice this is
worse during the second half ofyour cycle and there's a lot to
(33:49):
that.
But hunger is not a bad thing ona weight loss diet.
Now, if you are shaky and weakand feel like you're going to
pass out and literally you'rebarely getting through the day,
you're probably not eatingenough.
You're probably trying to gotoo low with your calorie
deficit, but you should have aslight hunger feeling during
(34:10):
different parts of the day.
So hunger is not a bad thing.
It's those overwhelmingcravings that are a bad thing.
So the key to that is makingsure that you are eating a lot
of protein, because protein isvery satiating.
It keeps you full to the pointwhere sometimes, when people
start eating a lot of protein,they actually don't feel hungry
(34:31):
and do still lose weight.
That is possible.
It usually evens out with time,but protein is very satiating.
Make sure you're not cuttingtoo much of the healthy fats and
make sure you're eating a lotof fiber.
That's also satiating too.
Try to avoid artificialsweeteners too, because those
can make you crave more sweetsand different things like that.
(34:53):
What is the role of GLP-1s inPCOS weight loss?
I'm actually very excited aboutGLP-1s.
I mean, the more I've hadclients beyond them, the more
excited I am, because there aresome people who are very, very
weight loss resistant and it'sbecause their abdominal fat is
creating that extra inflammationinsulin response that is then
making all the efforts with thefood and the calorie reduction
(35:19):
really slow.
Those people can make progress,but it just it takes a long
time and it can be reallyfrustrating and it's you run out
of willpower, all that stuff.
So GLP-1s, I think, are greatfor a certain population of
people.
They work by helping to lowerthe amount of insulin that
(35:40):
you're producing.
They also do work on yourappetite a bit, so they suppress
appetite, which is nice,because a lot of times in weight
loss with people who have a lotof insulin resistance, the
cravings factor is really highand there's also something
called leptin resistance whichmakes it difficult for you to
tell when you're full.
So a lot of people overeat whenthey have leptin resistance
(36:03):
because they don't get thatsignal that they're full until
it's too late.
So for those people, glp-1s canbe really, really effective.
They almost let the food noiseout.
So I'm a fan for the most part.
They do sometimes have someside effects and I'm still
holding out they're new.
So I'm holding out thatsometimes things that seem too
(36:25):
good to be true are too good tobe true, but I am optimistic
about them for the time being.
And, yeah, they just kind ofwork on your insulin resistance
and that's great because withPCOS we can really use that.
(36:45):
What are the best exercises forthe different PCOS types when it
comes to weight loss?
So you guys know the types I'vetalked about before and there's
a lot of overlap.
Most people have more than onetype going on, but we've got
insulin resistant type,inflammation, chronic
inflammation type, my gut healthgirlies, my IBS ladies, and
(37:06):
then we have the adrenal type,the ones who are stressed, the
anxious among us.
You know, relatable, I am alsoan anxious person.
So what are the best exercisesfor the different types for
weight loss?
Well, for everyone, strengthtraining.
Now for my adrenal girliesplease don't go do CrossFit, I
(37:29):
mean, unless you really, really,really love it or really,
really, really want to, and thenyou know we can find a way to
make it work.
But for the ones who haveadrenal stuff, take what?
If you've historically done alot of exercises, anxiety relief
, let's say this a lot ofexercises, anxiety relief.
(37:54):
Let's say this Take what youwant to do and cut back by half
and then do that.
Everyone can benefit fromstrength training, from heavy
weights.
This burns a lot of calories.
It revs your metabolism a lotfor quite a long time afterwards
, for like 72 hours after.
So a couple of two to threestrength training sessions a
week are um that do the fullbody, are really helpful for
(38:17):
weight loss and from therecardio.
And cardio can look differentdepending on where you're at
with your adrenals.
So if you don't have a lot ofadrenal issues, more cardio.
Take what you want to do andpractice, bump it up some.
Now start slow, start small,start with what you can manage.
But if you're getting 2000steps a day, usually think about
(38:44):
getting yourself a littlefitness watch and pushing
yourself a bit.
The cool thing about exerciseand energy is that energy breeds
energy.
So the more exercise you do,the more energetic you will be
and the more energy, you'll haveto do more exercise, and so I
would say try to do exercisesmaller amounts more regularly
(39:10):
rather than large amounts spacedout, and this is more for habit
building purposes.
So if right now you're totallysedentary, start with 15 minutes
, but do it every day.
If you are already doingsomething kind of similar to
that, then bump up to 30, 25, 30.
You can break that into chunks.
(39:31):
You can do 10, 10, and 10.
You can do 15 and 15, or youcan just do it all at once in
the evening or something likethat.
But take where you're at, addto it and continue.
Now, if you already do 45minutes of walking pretty much
every day, well then maybe thinkabout a couple days a week
(39:52):
taking away the walk and doing amore intense form of
cardiovascular activity instead.
And I don't necessarily meanHIIT training, although a little
bit of HIIT training can behelpful for weight loss if we
don't have a lot of adrenalstuff going on.
But it could be somethingthat's going to get your heart
rate up.
Maybe a class, a fitness class,zumba, or you could take dance
(40:13):
lessons like I do, somethingthat's gonna really kind of get
you get your heart rate up andget your breathing a little bit
heavier.
That can be helpful as well forweight loss.
It burns a little bit more.
It's important not to overdothat kind of exercise, but a
nice balance of a couple days aweek of doing something like
that can be great.
(40:33):
You could also think aboutstarting to incorporate
something like Pilates, which isreally helpful for weight loss
and is a little bit more intense, right.
So bump up the intensity a bit.
If you're more sedentary, ifyou already are a heavy
exerciser or an athlete or youhave a lot of adrenal issues,
think about bumping down whatyou're doing currently.
(40:56):
So if you're doing intenseactivity five days a week, cut
back to three.
Replace those other days withsomething gentle yoga, walking,
something.
That's going to be a little biteasier on your stress, hormone
production.
And final question are there anysupplements that help weight
loss?
Yes, there's quite a fewactually, and what I really
(41:25):
usually suggest is picking asupplement that's going to help
with your PCOS root cause.
So if you don't know the PCOSroot causes very well or you're
not really sure what, so if youdon't know the PCOS root causes
really well, or you're notreally sure which ones you have,
or you know what is what I?
If you don't know the PCOS rootcauses really well or you're
not really sure which ones youhave, or you know what is what,
I'd highly recommend taking myPCOS foundations course.
It's budget friendly, it's aquick little four week kind of
(41:49):
meal plan course and then I haveseveral video modules in there
that'll teach you about yourPCOS, all the different root
cause issues and somesupplements and things that can
help.
But I would say, if you're moreinsulin resistant and that's
where a lot of this is comingfrom that I would really work
(42:10):
heavily on your blood sugarbalance and some supplements
that can help for weight loss.
There are the inositols.
I'll link to the ones that Iusually recommend.
There's an inositol blend thatI really like that can be
helpful.
Berberine can be helpful, soI'll link to those.
If you're more of a gut healthinflammation person like you
(42:31):
deal with IBS and otherdigestive issues you're going to
really want to work on thatfirst and that will in turn help
with the weight loss.
So probiotics possibly evenprebiotics if you tolerate them,
and maybe even something likeinacetylcysteine, which is a
(42:53):
potent antioxidant precursorthat can be really effective for
reducing inflammation, whichwill then help your body kind of
feel safe enough to let go ofweight and then, if we've got
adrenal stuff going on, the big,big key here is getting good
sleep.
So I would work first ongetting good sleep and you
wouldn't believe how much betterthe weight loss process works
(43:13):
if you're getting enough sleep.
It really really does make abig difference because of those
stress hormones.
So maybe something likeashwagandha or rhodiola or, if
you're postmenopause, somethinglike lemon balm.
Those things can be L-theanineas well.
Those can be really helpful forcalming the nervous system and
(43:34):
helping you get better sleep,which then will help your body
with recovery and processing andeventually weight loss.
But I don't typically recommenddoing appetite suppressants or
metabolism boosters or a lot ofthese things that you'll see at
like supplement stores.
Just in my experience theydon't work very well and they
(44:01):
seem like a little bit of awaste of money.
You might as well put yourmoney towards good quality
supplements that help with yourPCOS root cause issues because,
let's face it, the PCOS rootcause issues are the reason why
we're having issues with theweight gain and weight loss in
the first place.
So that's what I wouldrecommend.
I'll link to some of myfavorites.
I'll also link to my PCOSFoundations course.
But thank you for being here,thank you for watching this
(44:24):
video all the way through, andif you have any further
questions about weight loss,please drop them in the comments
.
Let me know.
If you have any comments oranything resonated for you, let
me know as well and I'll try toanswer any questions that I get.
And yeah, I'll talk to you guyssoon.
Have a great day.
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