An Amber a Day: The Functional PCOS Podcast

Your PCOS Weight Loss Questions Answered: Top Questions on Weight Loss for PCOS Answered by a PCOS Nutritionist

May 28, 2024 Amber Fischer, MS, CNS, LDN Season 4 Episode 11
Your PCOS Weight Loss Questions Answered: Top Questions on Weight Loss for PCOS Answered by a PCOS Nutritionist
An Amber a Day: The Functional PCOS Podcast
More Info
An Amber a Day: The Functional PCOS Podcast
Your PCOS Weight Loss Questions Answered: Top Questions on Weight Loss for PCOS Answered by a PCOS Nutritionist
May 28, 2024 Season 4 Episode 11
Amber Fischer, MS, CNS, LDN

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. 

Mentioned in the episode (scroll down for course links!)
Rhodiola - https://s.thorne.com/mVyrH
Berberine - https://s.thorne.com/Sqdp2
Inositol- https://s.thorne.com/esr0F
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.

Fit, Healthy & Happy Podcast
Welcome to the Fit, Healthy and Happy Podcast hosted by Josh and Kyle from Colossus...

Listen on: Apple Podcasts   Spotify

Support the Show.

Join the Functional PCOS newsletter- free tips every Friday! https://functionalpcos.myflodesk.com/npy6c3m0vq

Did this podcast help you? Becoming a supporter is like buying me a coffee once a month and just a small way to say thank you for the content you love! Become a supporter here.

Another great way to support is a 5 star review- it help the podcast SO much! Consider leaving one if the podcast has helped you on itunes here!

PCOS Facial Hair Freedom- https://amberfischer.thinkific.com/courses/pcos-facial-hair-freedom

PCOS Foundations - https://amberfischer.thinkific.com/courses/pcos-foundations

Functional PCOS- https://functional-pcos.teachable.com/p/functional-pcos

Group- Starts May 22- https://hannah-s-school-09e9.thinkific.com/courses/pcos-essentials-academy-may-2024

View updated links: ...

An Amber a Day: The Functional PCOS Podcast +
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Show Notes Transcript Chapter Markers

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. 

Mentioned in the episode (scroll down for course links!)
Rhodiola - https://s.thorne.com/mVyrH
Berberine - https://s.thorne.com/Sqdp2
Inositol- https://s.thorne.com/esr0F
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.

Fit, Healthy & Happy Podcast
Welcome to the Fit, Healthy and Happy Podcast hosted by Josh and Kyle from Colossus...

Listen on: Apple Podcasts   Spotify

Support the Show.

Join the Functional PCOS newsletter- free tips every Friday! https://functionalpcos.myflodesk.com/npy6c3m0vq

Did this podcast help you? Becoming a supporter is like buying me a coffee once a month and just a small way to say thank you for the content you love! Become a supporter here.

Another great way to support is a 5 star review- it help the podcast SO much! Consider leaving one if the podcast has helped you on itunes here!

PCOS Facial Hair Freedom- https://amberfischer.thinkific.com/courses/pcos-facial-hair-freedom

PCOS Foundations - https://amberfischer.thinkific.com/courses/pcos-foundations

Functional PCOS- https://functional-pcos.teachable.com/p/functional-pcos

Group- Starts May 22- https://hannah-s-school-09e9.thinkific.com/courses/pcos-essentials-academy-may-2024

View updated links: ...

Speaker 1:

Hi guys, welcome back to Functional PCOS. Today I'm going to be answering your top PCOS weight loss questions. Okay, so I polled my Instagram followers If you don't follow me on Instagram, why not? And I also asked the internet. I looked at the top Google search terms for PCOS and weight loss and I put together a collection of I actually have not counted this. It looks like about 20 questions, 15 to 20 questions and I'm just going to go through each of them and give an explanation of how a nutrition professional coming from the functional nutrition world would help you with your PCOS weight loss and explain things to you in a way that, hopefully, will help make it more understandable why you're struggling so much with weight loss and what some solutions are that you can do. Okay, so let's get into it.

Speaker 1:

So, number one why is it hard to lose weight with PCOS? You know I see a lot of content on the internet that is women with PCOS lamenting their inability to lose weight and the difficulty of it, and there are so many horrendous comments on these kinds of videos. I saw one the other day of a nutritionist who is over 200 pounds. She said so in her video and she said you're just trying to help people eat healthy in a world where you're not allowed to be overweight, as a nutritionist and man. The people came for her in the comments. It was horrible and I just felt so sorry for her because I believe she has PCOS and I know for myself and for so many of us who have PCOS the lifelong struggle with losing weight is so real and maintaining weight loss right. And so all the comments in there were just like you can't violate the law of thermodynamics, man, calories in, calories out, whatever. And what these simple-minded folks fail to understand is the complex metabolic system that's at play with weight maintenance and weight management. They don't recognize the importance of hormone balance in weight loss and they don't recognize the importance of stress and stress hormone balance in weight loss and they don't recognize the importance of stress and stress hormone balance in weight loss. So there's several things that are going on with PCOS specifically that do make it more difficult for us to lose weight.

Speaker 1:

There's kind of two theories of weight loss and weight maintenance. There's the calories in calories out law of thermodynamics blah, blah, blah. Calories in calories out law of thermodynamics blah, blah blah, which has there's validity to that. It is part of the picture, but it's not the whole thing. And then there's a newer model of weight loss, weight management, called the carbohydrate insulin model, and a lot of the research really favors this model. But it's the concept that insulin, which is a hormone. It's the concept that insulin, which is a hormone, acts as a fat storage hormone, and so when there's too much in the system, the body preferentially stores fat.

Speaker 1:

And if you look across the range of people, right, everybody has a different sort of baseline weight. There's a lot of genetics that play there too. And you look at some people who are naturally very thin, some people who struggle more. Why is that? Well, the carbohydrate insulin model of weight loss accounts for some of that. Right, because if we have too much insulin in our system, which is a problem in PCOS, then our bodies are going to prefer to store our food as fat. And where this kind of comes into play from a genetic perspective is that a lot of people think that the genetics of those with PCOS may have stemmed from ancestors who went through famine, other food insecurity, to the point where the genes sort of morphed to accommodate for that. So if you were growing up in a world where food was really insecure. But you could also maintain body fat really well and store body fat for use later. You would be more likely to survive, right? Because think about a long winter where there's no food. If you've got a lot of body fat, then you've got a lot to live off of.

Speaker 1:

Have you ever watched that show Alone? So there was a season of Alone where the guy survived by gaining a tremendous amount of weight before he went on the show. He barely did anything the last half of the show. These other people are out there like building shelter. They're fishing all the time, they're wasting a lot of energy trying to find food and he instead, just kind of like a bear, went in his den and hibernated for the rest of the show and he ended up winning because he had all those body fat stores and he just ate off of his body fat stores.

Speaker 1:

So the concept is a little bit similar in PCOS, right? We preferentially store body fat and so we have it there for a rainy day. And of course I know this is not everyone with PCOS. There are many women with PCOS who are actually underweight. But for those of us who are having difficulty with weight management, that's part of what's going on too much insulin. The other thing that's going on is that our stress hormone balance can be out of whack and we also can have some issues with our thyroid, and so we know that sluggish thyroid is going to lead to some weight gain and difficulty, weight stubbornness, and that having high cortisol levels, for example, is also going to have us preferentially store body fat in the abdomen, have us preferentially store body fat in the abdomen, and when we store body fat in the abdomen, that becomes more inflammatory to our system and that extra inflammation in the system can then make us more insulin resistant, create more insulin, and it can be kind of a vicious cycle.

Speaker 1:

If you've ever noticed and I've noticed this for myself too that when you gain weight with PCOS, there might be a sweet spot with your weight, but if you happen to gain five, 10 pounds or something during a stressful time, all of a sudden it's like it's a snowball rolling right. It gets easier and easier and easier to gain weight. What I always say about weight management and PCOS is that it is more difficult for us because it's not that it's harder to lose weight for the most part, if we're accommodating for everything that we're going to kind of talk about here. It's not that it's necessarily harder to lose weight, but it's easier to gain. So if you take a week where you lose half a pound, for example, and then over the weekend you just kind of stop paying attention, like most people do when 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.

Speaker 1:

For the average person they would still make progress with PCOS. Because of that insulin response. They might store an extra amount of body fat. That doesn't make sense with the math and it could just be a wash right, or it could even result in weight gain if they're not careful. And so if it's easy to gain but moderately hard to lose, you're in the favor of weight gain. Does that make sense? So basically, the law of thermodynamics doesn't necessarily apply to human beings perfectly. There are a lot of other factors that can tweak it a bit and the slightest little tweak over years and years and years of your life can result in weight gain.

Speaker 1:

Okay, we'll get into more of this as we go on, but let's talk about the next question, which is does weight matter for PCOS and will losing weight help PCOS. So this is a mixed answer, like a lot of things. Does your weight matter? I would love to say that it doesn't matter at all. I don't think that the research is on the side of that. I do believe in health at every size and I definitely don't believe that everyone with PCOS needs to be like a little twig or needs to lose as much weight as possible. I definitely think that the range of what can be healthy for the human body is higher than what society tells us.

Speaker 1:

However, your weight does matter to an extent, mostly because of the impact of abdominal fat on your inflammation levels. That's the biggest part. So we know that like more abdominal fat you have, it goes from being like localized inflammatory 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 for inflammation in PCOS, but that's one of them is that abdominal fat, and all of us with PCOS are dealing with that. Abdominal fat storage. That's where our bodies prefer to store it, and it's because of high testosterone levels, it's because of high insulin levels, it's because of high cortisol levels. Basically, all the hormonal stuff we've got going on is like put it in the belly. All of us have multiple different hormonal factors that cause us to want to gain belly fat. I know, isn't it fun, I'm living with this too.

Speaker 1:

Okay, we always say the PCOS body is an apple-shaped body, if you guys remember the fruit shape, sometimes more pear-shaped, but it's usually. There's a lot of body fat collection in the middle of the body and a thicker waist, and so it's that inflammation that really triggers a lot of longer term issues. If that weren't the case, then, no, your weight probably wouldn't really matter, because it would be about what your diet looks like. And there are exceptions to this, because there are some people who, genetically, are larger and are perfectly healthy. Those people do exist, but I think the vast majority of us with PCOS, we're working with a paradigm where, yes, having excess weight on us to an extent is damaging, because that extra inflammation makes us more insulin resistant and with time that then makes a lot of other metabolic things go wrong. And we're young. It may not show up on our lab work, we may look fine on lab work, but as we age it kind of does start to impact us. So, yes, it matters.

Speaker 1:

Will losing weight help? Yes and no. So the idea of losing weight helping PCOS comes from a study that found that if you lose about 10% of your body weight it's more likely to regulate your cycles. And did the medical community want to run with that one right? So, yes, losing 10% of your body weight technically will help with your PCOS symptoms, which overall, will mean that you are a healthier individual. However, I think the real key here is looking at why does weight loss happen in the first place?

Speaker 1:

In PCOS, and because we have so much metabolic damage, it's really difficult for us to lose weight unless either we're going about it in a really unhealthy way, which I think long-term means that losing that 10% doesn't really it's a wash right, because you're like if you're going on a crash diet, you're damaging your adrenals, you're making it much more likely that you're going to regain all of these negative side effects, so your cycles might return momentarily, but then all it's impossible to lose it unless you're doing that. Or if you're managing and accounting for a lot of different pieces and factors in your diet, managing for your insulin, your inflammation and your adrenals, all with your diet, which can be overwhelming if you don't know how to do that. So if you're doing it. If you're losing weight in a healthy way and you lose that 10%, then theoretically, yes, that could be helpful. But it's not really the 10% of body weight that you've lost, it's more all the positive changes that you've made. But I'd love to see a study of just women who do like a crash diet to lose 10% of their body fat and see how that helps their PCOS. You know what I mean.

Speaker 1:

I'm not entirely sure that that's the root of the issue. I think weight in a lot of ways is just a symptom of PC PCOS. It's very easy to blame body fat for your PCOS and a lot of people do say, well, you have PCOS because you're fat. But no, we're fat because we have PCOS and we struggle with our weight because of our PCOS, and then that in turn means that losing weight might be helpful. But it's because we're also working 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 that if you kind of fall on the higher end of the normal range or into the overweight or obese ranges on like the BMI scale, then potentially losing a little weight could help, but otherwise, no, I wouldn't worry about it from a weight loss perspective. I'd really worry about managing your overall metabolic health and honestly, that goes for everyone. Metabolic health first and foremost. Let weight come along as secondary to all of that.

Speaker 1:

Okay, which is more important calories or carbs? This goes back to the insulin carbohydrate model of weight loss and the law of thermodynamics, right. So you'll hear people say it's all calories and calories out. If you're gaining weight, you have to be eating too many calories. If you're losing weight, it's because you're in a calorie deficit. Then you hear people say, no, it's because of insulin, and insulin's a fat storage hormone, and so if you just lower your insulin, then your body won't prefer to store fat and you'll lose weight. So the truth is actually in the middle of these two things. Especially with PCOS, we have to account for both, because both are going on.

Speaker 1:

So, when it comes to carbohydrates, we don't want to cut them completely. We may. Potentially, depending on where you're at with your diet, we may want to reduce them some. I find that a lot of people are probably eating a bit too much, so they could stand to lower things a smidge. However, it's really more about your fiber amounts and your protein amounts and those can kind of help balance your blood sugar, more so than just letting in 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 carbs you're not producing as much insulin, right, that will help momentarily. But let's say you're not eating carbs, you're not producing as much insulin, right, that will help momentarily. But let's say you are lowering your carbs, you're producing less insulin, but you're still eating too many calories, or you're still eating more calories than what your body actually needs for the day. Your body will still store that extra as fat.

Speaker 1:

So sometimes going on a low carb diet, at least for the first little while, will be helpful for weight loss, because it's more satiating and it's higher in protein and fats and so those fill you up more. You end up accidentally eating less calories and sometimes it is that reduction in insulin kind of helps your body sort of find more of an equilibrium at first, but you tend to get stuck at a certain point there because there is still that factor of if you're eating more than you need for that day, your body has to do something with it. It doesn't just flush it out, it has to go somewhere, and so it's going to go to body fat stores. Let's look at it from the other side. Let's say that you are eating a low calorie diet or you're eating lower calories than what your body technically needs according to the math, but you're also eating mostly starchy foods and little a hundred calorie packs and just things that are empty nutritionally. What's going to happen there is that you may actually end up maybe potentially not storing extra body fat although I have seen that happen but usually you might still be losing weight, but it's going to be like painfully slow, especially for how many calories you're eating. You're going to be eating like 1200 calories and be like why am I not losing? According to the math, you're losing half a pound a week, when you should be losing two pounds a week based on what you're eating. That's the impact of insulin there, so it can slow things down because it's that easy gain. So it's over 24 hours You're having these spikes of fat storage and then you're reducing fats.

Speaker 1:

Fat storage, reducing fat. It's all happening all the time, right, there's an exchange happening all the time, and so both of these things are wrong, and both of these things are right. It's about managing the two together, 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, and that can be done without reducing your carbs too too much. The cool thing about that is, if you're managing your blood sugar really well, then your weight loss should respond more like a normal person. Then your weight loss should respond more like a normal person, and so with your calorie counts, you won't have to go just to an ungodly low level. You won't have to go 800 calories a day or 1200 calories a day or whatever it is that's worked for you in the past. You'll be able to do 1800 and still lose. You know what I mean, and that makes it a lot more easy and sustainable to continue with the weight loss process.

Speaker 1:

All right, and that brings me to the next question, which is do women with PCOS have slower metabolisms and do they need less calories? There have been some studies done on this, actually, because people were wondering Because weight loss resistance is such a thing in PCOS? I mean, there's been numerous studies about it, so it just makes me so mad to see people on the internet kind of being like that's not real Because I can look up the scientific evidence on it. It's right there in front of your face. But whatever, there have been studies done to investigate whether the metabolism in PCOS was fundamentally slower, because that's what a lot of people thought for a while.

Speaker 1:

If there's this much issue with weight, there must be something going on with the way the body burns energy, and what was found through those studies was that that wasn't part of it, that the metabolism at its core, the basics of the metabolism, work the same as anybody else's. It's all the hormonal factors on top of it that alter the way that we store fat, and so do we have a naturally slower metabolism. It depends on what you mean by that. If you're looking at the scientific version of what metabolism means, no, we don't have a slower metabolism. But if you're talking about metabolism from the sense of most people, use it colloquially. But if you're talking about metabolism from the sense of most people, use it colloquially. Which is my metabolism is how easy it is for me to lose weight, or how hard, how easy is it for me to gain weight, et cetera, et cetera, yes, we have a slower metabolism in that sense, but it's not the metabolism itself really, and this is really just kind of like it's semantics at this point. It's just wording. But we don't technically have a slower metabolism, so we don't technically need less calories than the average person.

Speaker 1:

However, as you probably have gathered from this so far and have noticed in your own life, if you follow the calorie advice that you might get on an app like MyFitnessPal or something, even if you follow it to a T, you might find yourself gaining weight at that 1800 calories or whatever. And it's not necessarily that the math is wrong. It's that all the hormonal factors are not being well managed, and so what you're doing is hitting up against a brick wall, basically, okay. So what's the first thing to tackle when you want to lose weight with PCOS? The first thing that I would do is really work hard on your blood sugar balance. So there's quite a few things here to that, and I've done a lot of content on this topic. You look at anything I've done on insulin resistance and that'll be a great starting point. I've got lots of podcasts on that and I have courses and things that'll walk you through that.

Speaker 1:

But the very first thing would be eating more protein, because protein actively counteracts that insulin response, so it's key to get enough of that. I would eat a low glycemic load diet. If you look up the low glycemic load charts, you can see what foods are higher and what foods are lower. I mean, you're looking at a whole foods diet here, so you're looking at proteins, meats, vegetables and healthy fats and then like whole grains and stuff like that and you're reducing your simple starches. I would think about doing something like a continuous glucose monitor as well, because that can tell you what your blood sugar is really looking like compared to the meals that you're actually eating. So what I find for a lot of people is that they don't realize how much they are actually spiking their own blood sugar with their meals, because their meal looks on their plate like it's a perfectly healthy meal, and it may be, but your insulin and carb tolerance is so unique to you. I know for myself. I wore a continuous glucose monitor and I found that I had a much bigger response to starches like potatoes and sweet potatoes than I did to like grains, 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 are going to depend a lot on you, your genetics, your history with food, your insulin balance at the moment, and historically and genetically, and it's also going to depend a lot on your history with dieting, your current weight, just what time of day it is, I mean, how stressed you are, like so many different factors. So the very first thing you need to do is manage your blood sugar better. If you can manage your blood sugar really really well and beyond the right calorie deficit for you, you should see progress.

Speaker 1:

Okay, what are some methods of weight loss that are sustainable over two to five years? This person says 95% of diets fail. Yes, it's true, 95% of diets fail. There are some philosophical sort of arguments to be made here. I mean some of the aspects of weight we don't have any control over. I don't think human beings are really designed to have to need to lose weight. You know you go back, however, many hundred years and our bodies sort of naturally did what they needed to do and now they don't. And the question is, why? Is it your fault? Because you're eating too many empty calories or whatever. There's an element of personal responsibility to it, but there's also an element of just the world has changed and life has changed.

Speaker 1:

I don't think the human body is meant to diet. That, I think, is a big reason why it fails a lot. Because the body doesn't want to lose weight. It gains weight. It gains fat to protect itself. First and foremost, weight is a protection mechanism. It's there to be there in times of famine. It's there when your body can't fully 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 complicated factors here as to why diets don't work.

Speaker 1:

But a big factor, I think, in why diets don't work is that people don't think long-term. With their diet, they get really frustrated with themselves and really overwhelmed 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, and then they don't put enough, they don't save enough energy, I guess for the maintenance part. So there's something called set point theory, which is that your body has a set weight that it likes to be, and if you gain weight, your set point kind of goes up with it. And then if you lose weight, your body still wants to go back to that old set point and a lot of people think that the set point will change with time. But the weight loss has to be maintained for a significant length of time before the set point changes and I think that there's truth to that. I've seen that before.

Speaker 1:

So what I always tell my clients to do is plan ahead for that maintenance phase. Assume that once you hit your goal weight whatever you end up making your goal weight that you're going to have to work on maintenance of that weight for at least three months, but probably more like six months to a year, following the same kind of structure and plan that you were following to lose weight, which means that there may be some tracking involved. There may be portioning involved. You may not just be able to go off and just live if you want to maintain that weight. Unfortunately, that's just kind of how it is, because our body kicks up a lot of hunger hormones and things once we've lost a significant amount of weight in an effort to get us back to that set point.

Speaker 1:

I think is the wisest thing to do with this is to lose weight slowly. I think it's better to do it in a way where it's not terribly uncomfortable day to day, with a small calorie deficit, working on your overall health, working on your blood sugar balance, et cetera, and a small to moderate calorie deficit, because that's doable, that's sustainable and it doesn't take a lot out of you emotionally, mentally. Willpower is not an inexhaustible resource. It's like a pool that you draw from and if you draw too much of that willpower at the beginning, you will burn out. Once you burn out you've been there just as much as I've been there Once you burn out on the weight loss thing, you're just like, and even despite you know beating yourself up for it whatever you just let that weight kind of creep back up because you have no willpower left for it or that maintenance piece. So slowly over time, I think is probably the wisest thing to do on your own and doing it in a way where it's not all just calorie deficit stuff, it's not all about not eating as much, it's also about you know you increase your activity some. You find something that you really like, that kind of gets you moving more and that subtly burns some extra for you and things like that.

Speaker 1:

Is intermittent fasting helpful, yes and no, you and things like that. Is intermittent fasting helpful? Yes and no, okay. So I think intermittent fasting can be helpful in a few specific cases. If a person's insulin resistance is very severe, and even doing all the things I talked 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 before where the insulin resistance is so severe that things just don't budge sometimes. Intermittent fasting can be helpful there, because it'll give your body a break from producing insulin and it can help you maintain a calorie deficit a little bit easier.

Speaker 1:

Postmenopause, I think it can be helpful as well, because our mitochondria need a little bit more support postmenopause, and intermittent fasting does help with mitochondrial function, which is a good thing. Mitochondria are like our energy makers of ourselves, so there's some positives for intermittent 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 adrenal issues with PCOS, if you are parenting, if you are in your fertile years and you're still trying to get pregnant at some point. I would just caution you against it during those times, because it can be really, really hard on your stress responses to skip meals, and I would definitely caution you against skipping breakfast.

Speaker 1:

Next question is if I'm in my mid-40s or I'm post-menopause, how do I lose weight? Well, intermittent fasting can be helpful there, but really the principles of weight loss post-menopause are the same, although your metabolism does slow down post-menopause. The principles are the same, but it takes longer. But I would really work on managing your insulin and your inflammation post-menopause, because those are the two things that usually cause the most problems, and a lot of that's doing the same things that I've been talking about before. But your calorie deficit may need to be a little bit larger. That's because we end up burning less. We need less fuel as we age, and so a lot of times people are really used to a certain amount and it's just a little bit too much, and so if they account for everything else and they can reduce that somewhat, they may find that they end up having more success, which is where intermittent fasting could be a nice way to play around with that too.

Speaker 1:

Somebody asked how long of a fast from evening to morning is best. So I don't recommend skipping meals, but it is good to give your body a break overnight. A lot of us unintentionally end up eating too late into the night and too early in the morning and we don't give our body enough time to fast. Twelve hours of fasting daily is ideal for everyone, so that means you know, 8 pm to 8 am right, 7.30 pm to 7.30 am to 8 am right, 7.30 pm to 7.30 am, whenever it is that you eat breakfast, go back 12 hours from there. That should be your last food intake, ideally.

Speaker 1:

Now there is a concept called metabolic flexibility, and when you are healthier and when your insulin and inflammation and all that are more balanced, you have more metabolic flexibility, which means that you can go longer without meals, you can skip meals, you can fast, you can do this and that you might not feel great, but you're not going to pass out, you're not miserable, you're not feeling horrible, you're not feeling like you absolutely have to eat. That's good. You want that. You want that metabolic flexibility. So if you don't have that tolerance for 12 hours overnight, that's an indicator that your insulin resistance may not be as well controlled as you think it is, because you should have that metabolic tolerance Now. Over time we can build that.

Speaker 1:

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? Can you do 11 hours? Can you do 10 hours? Can you do nine hours? Can you do eight hours and kind of work your way forward to where you get to 12 and you're still able to sleep well, and all of that stuff? Cause that is really good way to give your body a break from insulin and a good way to kind of clear, clear stuff out, give you a clean slate for the next day for energy usage.

Speaker 1:

All right, uh, what's the best way to manage cravings and appetite when you're trying to lose weight in PCOS? Yeah, this is a big factor. So you know, talked about before. There's all these hormonal factors, right, there's all these metabolism factors, and one of the things that I do find that kind of stumbles people up is sometimes they do end up not realizing how much extra snacking they're doing. Little things do add up, especially when you're on a weight loss protocol.

Speaker 1:

With a weight loss protocol, usually I have to have my clients and even for myself, I really 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 little mid-morning snack and a little after dinner snack. If I do that, but my activity level 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 gain weight a little bit, and a lot of that comes from those little cravings that we get, because when we lose weight our body doesn't like it, it doesn't want to do it. So it sends you a lot of signals. It tells you eat, eat. I think there's this misconception out there that you can lose weight without being hungry at all. A lot of fad diets sort of profit off of this particularly like low-carb diets have for a long time profited off of this idea Eat whatever you want, eat as much as you want of these specific foods and you won't feel hungry and you'll lose weight.

Speaker 1:

Hunger is your body's reaction to not getting enough fuel. When it doesn't get enough fuel, it has to look for that fuel somewhere, and the first place it's going to look is your muscles and your liver, because you store some stuff there. But then after that it's going to start looking at your fat stores. So a little bit of hunger is a good thing, because that means that your body is actively working to find fuel, and what you'll find is that at the beginning of a weight loss journey this is typically worse. If you do cycle regularly as a woman, you'll notice this is worse during the second half of your cycle and there's a lot to that.

Speaker 1:

But hunger is not a bad thing on a weight loss diet. Now, if you are shaky and weak and feel like you're going to pass out and literally you're barely getting through the day, you're probably not eating enough. You're probably trying to go too low with your calorie deficit, but you should have a slight hunger feeling during different parts of the day. So hunger is not a bad thing. It's those overwhelming cravings that are a bad thing. So the key to that is making sure that you are eating a lot of protein, because protein is very satiating. It keeps you full to the point where sometimes, when people start eating a lot of protein, they actually don't feel hungry and do still lose weight. That is possible. It usually evens out with time, but protein is very satiating. Make sure you're not cutting too much of the healthy fats and make sure you're eating a lot of fiber. That's also satiating too. Try to avoid artificial sweeteners too, because those can make you crave more sweets and different things like that.

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What is the role of GLP-1s in PCOS weight loss? I'm actually very excited about GLP-1s. I mean, the more I've had clients beyond them, the more excited I am, because there are some people who are very, very weight loss resistant and it's because their abdominal fat is creating that extra inflammation insulin response that is then making all the efforts with the food and the calorie reduction really slow. Those people can make progress, but it just it takes a long time and it can be really frustrating and it's you run out of willpower, all that stuff. So GLP-1s, I think, are great for a certain population of people. They work by helping to lower the amount of insulin that you're producing. They also do work on your appetite a bit, so they suppress appetite, which is nice, because a lot of times in weight loss with people who have a lot of insulin resistance, the cravings factor is really high and there's also something called leptin resistance which makes it difficult for you to tell when you're full. So a lot of people overeat when they have leptin resistance because they don't get that signal that they're full until it's too late. So for those people, glp-1s can be really, really effective. They almost let the food noise out. So I'm a fan for the most part. They do sometimes have some side effects and I'm still holding out they're new. So I'm holding out that sometimes things that seem too good to be true are too good to be true, but I am optimistic about them for the time being. And, yeah, they just kind of work on your insulin resistance and that's great because with PCOS we can really use that.

Speaker 1:

What are the best exercises for the different PCOS types when it comes to weight loss? So you guys know the types I've talked about before and there's a lot of overlap. Most people have more than one type going on, but we've got insulin resistant type, inflammation, chronic inflammation type, my gut health girlies, my IBS ladies, and then we have the adrenal type, the ones who are stressed, the anxious among us. You know, relatable, I am also an anxious person. So what are the best exercises for the different types for weight loss? Well, for everyone, strength training. Now for my adrenal girlies please don't go do CrossFit, I mean, unless you really, really, really love it or really, really, really want to, and then you know we can find a way to make it work. But for the ones who have adrenal stuff, take what? If you've historically done a lot of exercises, anxiety relief, let's say this a lot of exercises, anxiety relief. Let's say this Take what you want to do and cut back by half and then do that.

Speaker 1:

Everyone can benefit from strength training, from heavy weights. This burns a lot of calories. It revs your metabolism a lot for quite a long time afterwards, for like 72 hours after. So a couple of two to three strength training sessions a week are um that do the full body, are really helpful for weight loss and from there cardio. And cardio can look different depending on where you're at with your adrenals. So if you don't have a lot of adrenal issues, more cardio.

Speaker 1:

Take what you want to do and practice, bump it up some. Now start slow, start small, start with what you can manage. But if you're getting 2000 steps a day, usually think about getting yourself a little fitness watch and pushing yourself a bit. The cool thing about exercise and energy is that energy breeds energy. So the more exercise you do, the more energetic you will be and the more energy, you'll have to do more exercise, and so I would say try to do exercise smaller amounts more regularly rather than large amounts spaced out, and this is more for habit building purposes. So if right now you're totally sedentary, start with 15 minutes, but do it every day. If you are already doing something kind of similar to that, then bump up to 30, 25, 30. You can break that into chunks. You can do 10, 10, and 10. You can do 15 and 15, or you can just do it all at once in the evening or something like that. But take where you're at, add to it and continue.

Speaker 1:

Now, if you already do 45 minutes of walking pretty much every day, well then maybe think about a couple days a week taking away the walk and doing a more intense form of cardiovascular activity instead. And I don't necessarily mean HIIT training, although a little bit of HIIT training can be helpful for weight loss if we don't have a lot of adrenal stuff going on. But it could be something that's going to get your heart rate up. Maybe a class, a fitness class, zumba, or you could take dance lessons like I do, something that's gonna really kind of get you get your heart rate up and get your breathing a little bit heavier. That can be helpful as well for weight loss. It burns a little bit more. It's important not to overdo that kind of exercise, but a nice balance of a couple days a week of doing something like that can be great. You could also think about starting to incorporate something like Pilates, which is really helpful for weight loss and is a little bit more intense, right. So bump up the intensity a bit. If you're more sedentary, if you already are a heavy exerciser or an athlete or you have a lot of adrenal issues, think about bumping down what you're doing currently. So if you're doing intense activity five days a week, cut back to three. Replace those other days with something gentle yoga, walking, something. That's going to be a little bit easier on your stress, hormone production.

Speaker 1:

And final question are there any supplements that help weight loss? Yes, there's quite a few actually, and what I really usually suggest is picking a supplement that's going to help with your PCOS root cause. So if you don't know the PCOS root causes very well or you're not really sure what, so if you don't know the PCOS root causes really well, or you're not really sure which ones you have, or you know what is what I? If you don't know the PCOS root causes really well or you're not really sure which ones you have, or you know what is what, I'd highly recommend taking my PCOS foundations course. It's budget friendly, it's a quick little four week kind of meal plan course and then I have several video modules in there that'll teach you about your PCOS, all the different root cause issues and some supplements and things that can help.

Speaker 1:

But I would say, if you're more insulin resistant and that's where a lot of this is coming from that I would really work heavily on your blood sugar balance and some supplements that can help for weight loss. There are the inositols. I'll link to the ones that I usually recommend. There's an inositol blend that I really like that can be helpful. Berberine can be helpful, so I'll link to those.

Speaker 1:

If you're more of a gut health inflammation person like you deal with IBS and other digestive issues you're going to really want to work on that first and that will in turn help with the weight loss. So probiotics possibly even prebiotics if you tolerate them, and maybe even something like inacetylcysteine, which is a potent antioxidant precursor that can be really effective for reducing inflammation, which will then help your body kind of feel safe enough to let go of weight and then, if we've got adrenal stuff going on, the big, big key here is getting good sleep. So I would work first on getting good sleep and you wouldn't believe how much better the weight loss process works if you're getting enough sleep. It really really does make a big difference because of those stress hormones. So maybe something like ashwagandha or rhodiola or, if you're postmenopause, something like lemon balm. Those things can be L-theanine as well. Those can be really helpful for calming the nervous system and helping you get better sleep, which then will help your body with recovery and processing and eventually weight loss.

Speaker 1:

But I don't typically recommend doing appetite suppressants or metabolism boosters or a lot of these things that you'll see at like supplement stores. Just in my experience they don't work very well and they seem like a little bit of a waste of money. You might as well put your money towards good quality supplements that help with your PCOS root cause issues because, let's face it, the PCOS root cause issues are the reason why we're having issues with the weight gain and weight loss in the first place. So that's what I would recommend. I'll link to some of my favorites. I'll also link to my PCOS Foundations course. But thank you for being here, thank you for watching this video all the way through, and if you have any further questions about weight loss, please drop them in the comments. Let me know. If you have any comments or anything resonated for you, let me know as well and I'll try to answer any questions that I get. And yeah, I'll talk to you guys soon. Have a great day.

(Cont.) Your PCOS Weight Loss Questions Answered: Top Questions on Weight Loss for PCOS Answered by a PCOS Nutritionist