The Beginning of Problems With Body Weight in Women With PCOS

Significant weight gain often results from health and personal factors. People who struggle with obesity have various life situations and health problems. However, overweight women with PCOS share stories that have many similarities. It starts from a gradual weight gain without any lifestyle changes or excessive indulgence. Then, women experience sudden feelings of hunger even after a large meal. They undergo a series of unsuccessful dieting and try to get medical help. However, many diseases result in PCOS symptoms. As a result, it delays the diagnosis. A delayed reaction to gaining weight makes maintaining good health very hard. Research shows that losing more than 10 kg without the yo-yo effect is a difficult achievement.

How Polycystic Ovarian Syndrome Contributes To Excess Body Weight?

Polycystic ovary syndrome (PCOS) is a condition of unknown cause that affects about 10% of women of their reproductive age. It does not directly lead to obesity, but it creates numerous health challenges. Common PCOS symptoms are irregular menstrual cycles, unwanted hair growth, substantial weight gain, acne, reduced fertility and metabolic syndrome: insulin resistance or high cholesterol. Obesity is a factor that further exacerbates negative health consequences, which creates a vicious circle. Metabolic and bariatric surgery is often a successful tool to fight health problems resulting from both PCOS and obesity.

Obesity is frequently observed in individuals with PCOS, and weight gain is a common symptom of the condition. Research indicates that weight gain and obesity may contribute to the development of PCOS, while the condition, in turn, can lead to increased weight gain and hinder weight loss efforts.

Several mechanisms link PCOS to excess body weight. Firstly, insulin resistance, a prevalent feature of PCOS, can lead to weight gain and difficulties in losing weight. Insulin resistance arises when the body’s cells become less responsive to insulin, resulting in elevated insulin levels in the blood and increased fat storage, particularly around the abdomen.

Secondly, hormonal imbalances in PCOS, distinguished by higher levels of androgens (male hormones) than normal, can contribute to increased fat storage and weight gain. Lastly, due to the hormonal imbalances and insulin resistance associated with PCOS, women with the condition may find it more challenging to lose weight. Nevertheless, implementing appropriate medical treatment, dietary modifications, and regular exercise can effectively address obesity in PCOS patients.

Common Struggles of PCOS Patients

Insulin Resistance

Insulin resistance is associated with PCOS but can exist without it. Insulin is a hormone that stores blood sugar (glucose). If the insulin isn’t working properly, the body starts to produce more of it, to get blood sugar into the cells. Increased insulin leads to building up fat cells and sudden feelings of hunger.

Leptin Resistance

Leptin is a hormone produced by fat cells. Its main function is to signal to the body that fat cells are properly nourished. However, an excessive number of those singles in people with obesity results in leptin resistance. The brain is no longer registering those signals, creating a pervasive and constant feeling of hunger.

The Ghrelin Imbalance

Ghrelin is a “hunger hormone” that is linked to many weight problems in females with PCOS. It’s produced by the stomach and should signal to the brain when the stomach is full. Leptin imbalance may cause sudden cravings, uncontrollable appetite and hunger even after large meals. Additionally, high levels of ghrelin slow down the metabolism.

Uncontrollable weight gain is tightly connected with hormonal imbalance, mental health factors and increased appetite.

Weight Loss Surgery

Weight loss surgery is one of the solutions offered by modern medicine to combat obesity. It’s worth noting that modern weight loss surgery doesn’t leave a patient with extensive incisions, which prolong the recovery time. Doctors operate under laparoscopy – through a small body opening, using a camera to navigate their way inside the body. It results in fastened recovery time and lower risks. Weight loss surgery is the fastest and most effective solution for patients whose body mass index (BMI) is over 35.

Types of Weight Loss Surgeries

✔️ Laparoscopic Roux-En-Y Gastric Bypass (LRYGB)

A gastric bypass is a modern weight loss surgery that helps to reduce body absorption of fats and starches – the main culprits in weight gain. The food tract is rearranged by dividing the stomach into two parts and connecting both to the small intestine. It significantly lowers the amount of food one person can eat in one sitting and improves the metabolic system.

✔️ Laparoscopic Sleeve Gastrectomy (LSG)

This type of bariatric surgery removes the part of the stomach, making it smaller and similar in shape to a tube, or a banana. A person can no longer consume large quantities of food because the stomach won’t fit them. Additionally, the part of the stomach responsible for ghrelin (hunger hormone) production is removed, which solves patients’ problems with an insatiable appetite.

✔️ Endoscopic Sleeve Gastroplasty (ESG)

Endoscopic gastric reduction or suturing is an innovative, non-surgical, completely reversible method of treating obesity that consists of decreasing the volume of the stomach with endoscopic sutures. To reduce stomach, the seams are made from the inside. This procedure in obese patients can be performed as a primary procedure for those who do not want to undergo obesity surgery or who have contraindications to surgery, or as obesity correction surgery after previous obesity surgery.

What are the Risks Associated with PCOS-Related Weight Gain?

Women with PCOS face an increased susceptibility to various issues associated with weight gain and insulin resistance, including diabetes, heart disease, sleep apnea, and uterine cancer.

PCOS also induces insulin resistance, impeding the body’s utilisation of insulin, thereby leading to the accumulation of insulin and glucose in the bloodstream. This resistance is a significant factor in weight gain among affected women.

Additionally, PCOS can impact fertility, and weight gain aggravates fertility-related challenges. Women with PCOS also face an elevated risk of uterine cancer, with weight gain further compounding this risk. Several mechanisms contribute to the cycle of PCOS development and weight gain, hindering effective weight loss efforts.

What Can I Do to Lose Weight If I Have Polycystic Ovary Syndrome?

For individuals with PCOS, achieving weight loss may appear challenging; however, even a modest reduction of approximately 5% in body weight can yield significant improvements in insulin resistance, hormone levels, menstrual cycles, fertility, and overall quality of life. Here are some valuable tips for weight management in PCOS:

Reduce carb intake: Lowering carbohydrate consumption can enhance insulin sensitivity, crucial for managing PCOS-related insulin resistance.

Increase fibre intake: Incorporating ample fibre into the diet aids in stabilising blood sugar levels and promoting a sense of fullness.

Consume adequate protein: A sufficient protein intake can help curb cravings and promote satiety, facilitating weight loss efforts.

Embrace healthy fats: Opt for healthy fats found in nuts, seeds, and avocados, as they contribute to a feeling of fullness and reduce inflammation.

Include fermented foods in your diet: Adding fermented foods like curd and kefir can improve gut health and reduce inflammation, benefiting individuals with PCOS.

Practise mindful eating: Paying close attention to hunger and fullness cues, along with adopting slow and distraction-free eating habits, can aid in weight management.

Limit processed foods: Minimise consumption of processed foods that often contain added sugars and unhealthy fats, resulting in an increase in insulin resistance and inflammation.

Engage in regular exercise: Regular physical activity not only supports weight loss but also improves insulin sensitivity, making it vital for PCOS management.

Prioritise sufficient sleep: Adequate sleep is essential for hormone regulation and reducing cravings for unhealthy foods.

Consider cognitive behaviour therapy (CBT): CBT can be beneficial in identifying and altering negative thoughts and behaviours related to food and exercise.

Explore low-carb or Mediterranean diets: Research suggests that these diets may be particularly effective for weight loss in individuals with PCOS.

Reason for Weight Gain During PCOS

Some factors that contribute to weight gain during PCOS could include:

Insulin resistance: In PCOS, the body’s ability to utilise insulin becomes impaired, resulting in insulin resistance. Consequently, insulin and glucose levels accumulate in the bloodstream, potentially fostering weight gain.

Hormonal imbalance: PCOS is characterised by elevated levels of androgens, male hormones, which can lead to weight gain, especially around the abdominal region.

Changes in energy expenditure: Research indicates that alterations in energy expenditure may play a role in weight gain among women with PCOS. Factors like reduced physical activity or shifts in metabolism could contribute to this phenomenon.

Mental health: Women with PCOS may also experience mental health challenges, such as depression or anxiety, which could contribute to weight gain in this population.

Which Bariatric Surgery Is Best For PCOS?

Only a doctor specialising in weight-loss surgeries can make such a decision. All cases should be assessed individually. Nevertheless, gastric banding (LAGB) is the least effective in weight loss, with gastric sleeve and gastric bypass surgery having similar results. It’s worth noting that weight loss surgeries are an effective tool to achieve weight loss for the majority of patients.

Bariatric surgery emerges as a viable and effective approach for achieving weight loss in women with PCOS, with various types showing promising results in alleviating PCOS symptoms. Among the most commonly mentioned procedures are Gastric Bypass, renowned for its slightly superior efficacy in reducing excess weight compared to other bariatric surgeries, while also improving insulin resistance, a prevalent PCOS symptom.

Similarly, Sleeve Gastrectomy has demonstrated effectiveness in enhancing insulin resistance and facilitating weight loss for women with PCOS. Additionally, Metabolic Surgery, encompassing gastric bypass, sleeve gastrectomy, and gastric banding, exhibits positive effects on PCOS symptoms, such as ameliorating abnormal menstruation, hirsutism, fertility, and associated metabolic issues.

It is important to recognize that bariatric surgery is not a one-size-fits-all solution, and the most suitable procedure for an individual relies on factors like overall health, weight, and specific PCOS symptoms. Thus, seeking personalized advice and management strategies from healthcare professionals is crucial before considering bariatric surgery.

The Reason Behind Numerous Success Stories

Anyone who has experienced months and years of unsuccessful dieting knows how exhausting it is. Gastric sleeve surgery changes this pattern. In the first month after the surgery, patients tend to rapidly lose weight. It’s crucial to regain their positive body image and stay motivated to maintain healthy lifestyle modifications. Patients who see the results of their work stay in a good emotional state and are determined to stay on the right path.

Significant weight loss has also other benefits. In patients with PCOS, it helps to stabilise the hormonal imbalance. Research shows that it’s easier to rebuild insulin sensitivity and maintain good levels of hormones like LH, FSH and progesterone, and androgen. It not only improves women’s health but also increases their fertility.

Does Gastric Sleeve Mess With Hormones?

Some patients are concerned about such interference in the natural hormone system. Those concerns are not justified by science. Bariatric surgery helps to treat hormonal imbalance and has only positive effects on the general functioning of hormones. Obesity’s the biggest factor causing hormonal imbalance.