PCOS (Polycystic Ovary Syndrome) and weight lose

Dragonwolf

Hi,

Thanks for sharing your story. Over the past few days I have really been doing my research and getting advice from other ladies with PCOS who have managed to succeed and lose a lot of weight. The main thing I hear is NO CARBS NO CARBS NO CARBS!!! I was even told to cut my fruit intake. Although it is natural sugar, it is still sugar. Geesh, so the question is, what the heck can I eat. The best thing is to try a high protein/vegetable diet. I am still doing research because different things work for different people, but I am going to try everything until I find a solution to get this weight off!!! I hope this has helped a little!!

Low carb, high fat, moderate protein. Get your carbs from vegetables, but other than that, eat a lot of things like fatty meats. Fat is not the enemy, and protein also triggers an insulin response.

It actually works out to less food, overall, because fatty foods are more satiating and calorie-dense. Here's a sample day:

Breakfast:
Omelet with peppers, sausage/ham, mushrooms, etc
Or Bulletproof Coffee (coffee + 1 tbsp butter (ideally grassfed) + 1 tbsp coconut oil)

Lunch:
Mixed greens salad with grilled steak, avocado, cheese, almonds, sunflower seeds, etc., topped with oil and vinegar dressing

Dinner:
Roast beef or dark meat chicken with skin (ideally pastured, on both accounts), or an oily fish, steamed broccoli with butter/coconut oil or other vegetable side

Snacks (if you need them, but most people find they don't):
Almonds or other nuts
Nut butter with celery or carrots
Berries and heavy cream
Full-fat (and low-sugar) yogurt

And, to those that have asked, yes fruit is "bad" in the sense that even though it's a natural source, it's still sugar. To get your fruit fix, go for low-sugar fruits, particularly berries (strawberry, blueberry, avocado, etc) and limit your intake of other fruits, particularly tropical ones, which are often the highest in sugar.

Dragonwolf

I was just diagnosed with PCOS the other day during an ultrasound at a fertility clinic.
I am also a Type II Insulin-Resistant diabetic, have been for about two years now (diagnosed at least).

I was first put on, I guess what you'd call normal metformin, but it wreaked havoc with my body. I went to a new primary doctor who provided me with an on-site diabetic nutritionist/educator and she has me on Metformin Extended Release - my body tolerates it much better, as long as I do not take it on an empty stomach, or take it and eat something sweet.

My initial educator gave me a cookie cutter meal plan of 1,500 calories a day, 45-60g carbs per meal. It broke it down into how many 15g carb servings of each food group I should have at each meal. I followed it and exercised and went from 207 to 187, but once I deterred from it I put it back on. I felt like I was always hungry! I always thought 45-60g was too much (I hit in the 300s without medicine) and figured if I need to lower it, shouldn't I lower my carb amounts? My new educator told me I don't have to count carbs anymore and there is a place for sugar in my diet. This confuses me. I track and still count

Now that I have gone off topic.. I am just curious what role PCOS plays in all this. It's already being treated since I take met.. Now what? I haven't had a regular period in 12 years, though it seems when I take my metformin regularly it almost evens it out. I thought it was coincidental before but I guess if I had PCOS all along it would make sense then, right?

/end blabbing

Sounds like your new educator doesn't really get PCOS (which is, unfortunately, rather common), and while there may be room for sugar in someone who simply had T2D or IR, it's often not the case with PCOS, in part because it's not always the sugar that causes the Insulin Resistance in PCOS.

PCOS is known to cause elevated insulin levels (hyperinsulinemia), and it's part of the reason everything else gets out of whack (and/or vice-versa, the initial cause is still unknown, but the fact remains that you ultimately end up in a vicious cycle with your hormones).

There are really only three ways to remedy this, and it often takes all three (at least for a time) - a low-carb/high-fat diet, exercise, and Metformin. Exercise increases insulin sensitivity, diet reduces the external triggers of insulin, and Metformin increases the liver's insulin sensitivity.

For those that are interested, I wrote a whole big thing explaining the "basics" of how Metformin and insulin work in PCOS (and why we have such trouble losing weight) in the PCOSis group (which I also recommend joining) - http://www.myfitnesspal.com/topics/show/1139450-new-pcos-diagnosis-and-about-to-start-metformin

dontwishforit_workforit

I was just diagnosed with PCOS the other day during an ultrasound at a fertility clinic.
I am also a Type II Insulin-Resistant diabetic, have been for about two years now (diagnosed at least).

I was first put on, I guess what you'd call normal metformin, but it wreaked havoc with my body. I went to a new primary doctor who provided me with an on-site diabetic nutritionist/educator and she has me on Metformin Extended Release - my body tolerates it much better, as long as I do not take it on an empty stomach, or take it and eat something sweet.

My initial educator gave me a cookie cutter meal plan of 1,500 calories a day, 45-60g carbs per meal. It broke it down into how many 15g carb servings of each food group I should have at each meal. I followed it and exercised and went from 207 to 187, but once I deterred from it I put it back on. I felt like I was always hungry! I always thought 45-60g was too much (I hit in the 300s without medicine) and figured if I need to lower it, shouldn't I lower my carb amounts? My new educator told me I don't have to count carbs anymore and there is a place for sugar in my diet. This confuses me. I track and still count

Now that I have gone off topic.. I am just curious what role PCOS plays in all this. It's already being treated since I take met.. Now what? I haven't had a regular period in 12 years, though it seems when I take my metformin regularly it almost evens it out. I thought it was coincidental before but I guess if I had PCOS all along it would make sense then, right?

/end blabbing

Sounds like your new educator doesn't really get PCOS (which is, unfortunately, rather common), and while there may be room for sugar in someone who simply had T2D or IR, it's often not the case with PCOS, in part because it's not always the sugar that causes the Insulin Resistance in PCOS.

PCOS is known to cause elevated insulin levels (hyperinsulinemia), and it's part of the reason everything else gets out of whack (and/or vice-versa, the initial cause is still unknown, but the fact remains that you ultimately end up in a vicious cycle with your hormones).

There are really only three ways to remedy this, and it often takes all three (at least for a time) - a low-carb/high-fat diet, exercise, and Metformin. Exercise increases insulin sensitivity, diet reduces the external triggers of insulin, and Metformin increases the liver's insulin sensitivity.

For those that are interested, I wrote a whole big thing explaining the "basics" of how Metformin and insulin work in PCOS (and why we have such trouble losing weight) in the PCOSis group (which I also recommend joining) - http://www.myfitnesspal.com/topics/show/1139450-new-pcos-diagnosis-and-about-to-start-metformin

I just wanted to note that I haven't seen my diabetic educator since I've been diagnosed with PCOS (was just diagnosed first week of December, last saw my DE beginning of November but will be seeing her in about two weeks for a check up). I am glad to hear that it can affect my glucose levels - not happy to hear it, but I think it might explain why I'm not at where she thinks I should be at. In the 6 months I have had her, I have pretty much only learned that: Exercise helps lower insulin, frosted shredded wheats is A-OK for breakfast every day, with some fruit on top, because it has 5g of fiber per meal and that is VERY important apparently, and... that's it. Aside from the obvious hour-long monthly spiel "Your numbers aren't where we want them, you need to lose weight" despite taking my meds daily and exercising three times a week.

When I mentioned to my primary doctor that I got PCOS, she shrugged it off like no big thing - "You're on metformin already, and that's how it's treated, so we're all good!" ...Again, this leaves me a little confused because I feel like maybe I am just overthinking it? Is there really 'nothing' to be concerned about?

Dragonwolf

I just wanted to note that I haven't seen my diabetic educator since I've been diagnosed with PCOS (was just diagnosed first week of December, last saw my DE beginning of November but will be seeing her in about two weeks for a check up). I am glad to hear that it can affect my glucose levels - not happy to hear it, but I think it might explain why I'm not at where she thinks I should be at. In the 6 months I have had her, I have pretty much only learned that: Exercise helps lower insulin, frosted shredded wheats is A-OK for breakfast every day, with some fruit on top, because it has 5g of fiber per meal and that is VERY important apparently, and... that's it. Aside from the obvious hour-long monthly spiel "Your numbers aren't where we want them, you need to lose weight" despite taking my meds daily and exercising three times a week.

When I mentioned to my primary doctor that I got PCOS, she shrugged it off like no big thing - "You're on metformin already, and that's how it's treated, so we're all good!" ...Again, this leaves me a little confused because I feel like maybe I am just overthinking it? Is there really 'nothing' to be concerned about?

:noway: :grumble:

Fire your doctors and get new ones. Ideally, try to find ones that are actually familiar with PCOS (and not just "oh, you have PCOS? Here's a script for Metformin and the birth control pill." That's not familiarity).

Being on Metformin is a good start, but it really depends on how much you, specifically need (ie - the last time I started Metformin, I was on 500mg twice daily and it didn't do a thing; once I doubled it to 1000mg twice daily, I'm losing weight without effort and am pretty certain that my insulin levels are dropping). If you're on Metformin for more than a month or two, and your insulin hasn't gone down (and/or you haven't seen any other improvements), then your dosage needs to be increased. That's how getting the right dosage of Metformin works.

I read the part about frosted shredded wheat with fruit is "a-ok" and cringe. While the hyperinsulinemia isn't necessarily caused by diet, it certainly doesn't help matters, especially when the entire meal is essentially sugar. Just thinking about that kind of meal kind of makes me nauseous just thinking about it, especially considering it's supposed to be breakfast.

No, even if the Metformin lets you stomach that, it's likely going to set you up for failure for the rest of the day when it comes to food, in the sense that you'll be hungry within a couple of hours, and more likely to reach for all the wrong foods.

The idea that the best way for people to eat is every couple of hours is (in my opinion) ludicrous. Only recently did we as humans even have the luxury of food freely available that often, or did we have the personal freedom to eat every couple of hours. Even 50 years ago (in the US, at least), people were largely working jobs that only allowed for a half hour lunch and maybe a 15 minute break (and there was no desk to eat at), and before that, it was all day on the farm, and before that, it was spending days hunting and gathering. There were times (even in the agricultural era) where people didn't even eat every day, let alone six times a day. Not only are we built to not have to eat that often, but for people with PCOS, the usual advice of eating that often can be counterproductive unless the entire contents of the snack/meal is fat, because both protein and carbs prompt the body to release insulin, which would in turn keep your insulin levels up. Since it takes (roughly) 3-4 hours for insulin levels to drop after eating, then eating a protein and/or carb every 2/3 hours would keep those levels up as the body continues to try to handle the food.

For the sake of your mental and physical health, don't put up with clueless doctors that blow you and your concerns off. They're not worth your time. Find new ones that at least attempt to understand what you're dealing with and are willing to listen to and work with you to find a solution that works.

diwijo13

Bump

dontwishforit_workforit

:noway: :grumble:

Fire your doctors and get new ones. Ideally, try to find ones that are actually familiar with PCOS (and not just "oh, you have PCOS? Here's a script for Metformin and the birth control pill." That's not familiarity).

Being on Metformin is a good start, but it really depends on how much you, specifically need (ie - the last time I started Metformin, I was on 500mg twice daily and it didn't do a thing; once I doubled it to 1000mg twice daily, I'm losing weight without effort and am pretty certain that my insulin levels are dropping). If you're on Metformin for more than a month or two, and your insulin hasn't gone down (and/or you haven't seen any other improvements), then your dosage needs to be increased. That's how getting the right dosage of Metformin works.

I read the part about frosted shredded wheat with fruit is "a-ok" and cringe. While the hyperinsulinemia isn't necessarily caused by diet, it certainly doesn't help matters, especially when the entire meal is essentially sugar. Just thinking about that kind of meal kind of makes me nauseous just thinking about it, especially considering it's supposed to be breakfast.

No, even if the Metformin lets you stomach that, it's likely going to set you up for failure for the rest of the day when it comes to food, in the sense that you'll be hungry within a couple of hours, and more likely to reach for all the wrong foods.

The idea that the best way for people to eat is every couple of hours is (in my opinion) ludicrous. Only recently did we as humans even have the luxury of food freely available that often, or did we have the personal freedom to eat every couple of hours. Even 50 years ago (in the US, at least), people were largely working jobs that only allowed for a half hour lunch and maybe a 15 minute break (and there was no desk to eat at), and before that, it was all day on the farm, and before that, it was spending days hunting and gathering. There were times (even in the agricultural era) where people didn't even eat every day, let alone six times a day. Not only are we built to not have to eat that often, but for people with PCOS, the usual advice of eating that often can be counterproductive unless the entire contents of the snack/meal is fat, because both protein and carbs prompt the body to release insulin, which would in turn keep your insulin levels up. Since it takes (roughly) 3-4 hours for insulin levels to drop after eating, then eating a protein and/or carb every 2/3 hours would keep those levels up as the body continues to try to handle the food.

For the sake of your mental and physical health, don't put up with clueless doctors that blow you and your concerns off. They're not worth your time. Find new ones that at least attempt to understand what you're dealing with and are willing to listen to and work with you to find a solution that works.

I am hoping during my check-up with my DE that she will handle the diagnosis better and actually give me information - like recommended carb intake, and what numbers I should aim for, not just "Don't count carbs, and eat a lot of fiber and protein". Everyone is different, obviously, and I was hoping when I got her that she would help me handle that too. I have only been with her and my primary since July 2013. My primary before that diagnosed me with diabetes, sent me home with a meter, and told me there were 12 *optional* educational classes I could take - she failed to tell me they were $500 apiece. I didn't get a bill until two classes in - surprise! So, I am dreading looking for another new doctor.

I think the reason my primary doesn't really acknowledge it is because 1) She's my primary, not a OB/GYN and 2) We're trying to get pregnant and she has no hand in that. I am not sure. In October they doubled my metformin from one pill twice a day, to two pills twice a day, but it doesn't seem to have quite the effect - it is helping, but I am still looking at 130ish fasting BS and 160ish 2-hour. I decided today to aim for 50g carbs/day (down from my 135-180g carbs a day) and see if that helps. I realize the Internet has a lot of information, but I get a little lost looking at all the numbers and trying to figure out what works *for me*. Obviously for my health my A1C needs to get down, but we can't move forward in fertility until I am below 7 (currently 7.8, down from the 9.1 in July). Dual reasons to get this ball really rolling

And yes: the frosted mini-wheats for breakfast every day? I think sometimes the lady really DOES have a few missing marbles.. I did it for about a week then quit and went back to my egg whites and sauteed zucchini and glass of 1% milk.

Skarlet13

I was diagnosed with PCOS maybe 7 years ago. When I went to college, I blew up and gained about 80 lbs! I have A LOT of excess hair and I was not getting my periods regularly, maybe twice a year. Well, 2 years ago, I researched something about wheat products and PCOS. I I decided to stop eating wheat and after a month, not only did I lose about 10 lbs, but I got my period! I was prescribed many medications, but I am a firm believer that you can do it naturally without the help of any drugs, so I never took them. My heaviest was 260 and I am about 225-230 now. I have not lost any weight in a long time, but that is because I was not really doing what I need to be doing, however I am starting up again. I STILL get my period every single month. Just that little bit of weight loss cured some of my PCOS symptoms. Now it is time to get healthy, fit, and stay that way. I realized that it maybe be harder for me to lose weight because of the PCOS, but I don't mind working hard. We can do it!

Funny cause I got diagnosed with celiac disease, went off gluten and wheat and my period came back too. There's definitely a connection with gluten and pcos.

littlelexical

I think the best thing you can do is research everything you are told to find out WHY it is good/bad - dont ever accept a blanket statement, whoever it comes from.

Dragonwolf

And yes: the frosted mini-wheats for breakfast every day? I think sometimes the lady really DOES have a few missing marbles.. I did it for about a week then quit and went back to my egg whites and sauteed zucchini and glass of 1% milk.

I recommend switching to whole milk or coconut or almond milk (watch the additives in store-bought, though). 1% is only conventionally "good," because of the low-fat hype (which is so far wrong, it's quite sad), and by stripping out the fats, you're increasing the concentration of sugar per serving (because once you take out the fat, what are you left with? Sugar, protein, and water). And, of course, high concentration of sugar doesn't help matters (to be fair, it is offset by the protein in the eggs and fiber in the zucchini, so it won't spike your blood sugar as high and fast, but the sugar is still there and still needs to be metabolized). Additionally, Vitamins A, D, E, and K are fat-soluable vitamins, meaning they need fat to be absorbed - so when you strip out the fat sources (the milk fat, the egg yolks) from your meals, you're also stripping out your ability to absorb those vitamins.

Also, don't be afraid of whole eggs. Egg whites are great for protein....and that's about it, while the yolk is loaded with nutrients, including choline, folate (a must for pregnancy, and appears to help the effects of Metformin), Omega-3 fats, and Vitamin E, among others.

For both milk and eggs (and all animal products, really), try to get the best you can - namely raw (or at the very least, not homogenized - the homogenization process is what's so horrible about the fat in milk) and pastured/grass fed milk, and pastured or (truly) cage-free eggs. This allows the animals to eat species-appropriate diets, which improves the nutrient profiles of the foods.

Good luck with your doctors. I'm of the mind that even your regular doctor shouldn't be dismissive of your needs and concerns. It's okay for them to not know much about a particular topic (though ideally, they'd take the time to at least gain cursory knowledge), but at the very least, they should be willing to work with you to find solutions that work for you. Otherwise, they're pretty useless except for getting antibiotics, and in my opinion, that shouldn't be doctors' only purpose (they should also be able to help with long-term preventative type of care). I can sympathize with not wanting to find yet another new doctor (I got basically laughed out of both my OB/GYN and my primary doctors' offices the last time I mentioned that I thought I needed Metformin again (yes, again, this wasn't even my first rodeo, it was even the same GYN that diagnosed me) - I was told that my inability to lose weight was my own fault and that I just needed to try harder; I finally got up the courage to find a new primary doctor and it was the best move of my life, medically - she went so far as to get the bloodwork results my GYN had ordered to humor me, and agreed that Metformin would probably be beneficial).

rissadiane

My doctor decided to not prescribe me Metformin and instead, put me on a birth control pill that would even out my hormones and told me to do the low carb high protein diet everyone is talking about AND told me to exercise at least 30 min/day, and I lost over 30 pounds and got pregnant. Unfortunately I had a miscarriage and gained back all the weight I lost (depression is terrible). I'm going to get back on my diet and get my weight back down because I know that works for me.

Sabine_Stroehm

Funny cause I got diagnosed with celiac disease, went off gluten and wheat and my period came back too. There's definitely a connection with gluten and pcos.

I'd say you're right... and on a related note, I've known a number of women, some with PCOS some without who had fertility issues, until they went off gluten. Several friends finally GOT pregnant, and one friend who'd had numerous miscarriages now has two kids. There's definitely a connection...

dontwishforit_workforit

And yes: the frosted mini-wheats for breakfast every day? I think sometimes the lady really DOES have a few missing marbles.. I did it for about a week then quit and went back to my egg whites and sauteed zucchini and glass of 1% milk.

I recommend switching to whole milk or coconut or almond milk (watch the additives in store-bought, though). 1% is only conventionally "good," because of the low-fat hype (which is so far wrong, it's quite sad), and by stripping out the fats, you're increasing the concentration of sugar per serving (because once you take out the fat, what are you left with? Sugar, protein, and water). And, of course, high concentration of sugar doesn't help matters (to be fair, it is offset by the protein in the eggs and fiber in the zucchini, so it won't spike your blood sugar as high and fast, but the sugar is still there and still needs to be metabolized). Additionally, Vitamins A, D, E, and K are fat-soluable vitamins, meaning they need fat to be absorbed - so when you strip out the fat sources (the milk fat, the egg yolks) from your meals, you're also stripping out your ability to absorb those vitamins.

Also, don't be afraid of whole eggs. Egg whites are great for protein....and that's about it, while the yolk is loaded with nutrients, including choline, folate (a must for pregnancy, and appears to help the effects of Metformin), Omega-3 fats, and Vitamin E, among others.

For both milk and eggs (and all animal products, really), try to get the best you can - namely raw (or at the very least, not homogenized - the homogenization process is what's so horrible about the fat in milk) and pastured/grass fed milk, and pastured or (truly) cage-free eggs. This allows the animals to eat species-appropriate diets, which improves the nutrient profiles of the foods.

Good luck with your doctors. I'm of the mind that even your regular doctor shouldn't be dismissive of your needs and concerns. It's okay for them to not know much about a particular topic (though ideally, they'd take the time to at least gain cursory knowledge), but at the very least, they should be willing to work with you to find solutions that work for you. Otherwise, they're pretty useless except for getting antibiotics, and in my opinion, that shouldn't be doctors' only purpose (they should also be able to help with long-term preventative type of care). I can sympathize with not wanting to find yet another new doctor (I got basically laughed out of both my OB/GYN and my primary doctors' offices the last time I mentioned that I thought I needed Metformin again (yes, again, this wasn't even my first rodeo, it was even the same GYN that diagnosed me) - I was told that my inability to lose weight was my own fault and that I just needed to try harder; I finally got up the courage to find a new primary doctor and it was the best move of my life, medically - she went so far as to get the bloodwork results my GYN had ordered to humor me, and agreed that Metformin would probably be beneficial).

Going to egg whites was a personal preference over a dietary one, but if it's more beneficial then I will suck it up and do more egg/egg white blending. I had never even considered the milk - I grew up drinking whole, but when I moved in with my partner only 2% was in the fridge and then 1% so I just went along with it.

My primary doctor has been awesome with everything else, even re-did my bloodwork when fertility clinic flagged a liver enzyme increase and stated my platelets were high. I am not too concerned with her lack of concern with my PCOS because I am assuming that the fact that I also see my DE, a fertility doctor and an OB/GYN pretty much tells her "Oh, it's covered".

I am on day 2 of lower carb eating (Goal is 50g-ish, didn't do terribly well today and was around 90g.. Prior DE told me 135-180g/daily) and for the first time in two years, my 2-hour fasting BS was 107. Also, the fact that I am not bone tired is wonderful. Correlation between carbs and energy levels? It seems that some people can eat a high amount and be okay, but I am assuming it's different for those of us with PCOS and/or diabetes/insulin resistance?

rita27ny

l

Dragonwolf

Going to egg whites was a personal preference over a dietary one, but if it's more beneficial then I will suck it up and do more egg/egg white blending.

Ah, ok. Taste preferences are a different matter, just so you're not just eating egg whites "because it's healthier." :drinker: Might be worth trying different recipes to see if you can find something that uses the whole egg that you like (deviled eggs are awesome!) if you're worried about getting enough of the nutrients found in eggs.