2:54 – 15:18 Episode #11: How to Lose Weight With PCOS

Let me guess. Your doctor probably recommended weight loss for your PCOS, but didn’t actually tell you how to lose weight and keep it off because I know you’ve tried and it hasn’t worked. Your doctor is correct that women who lose weight have amazing improvement in their PCOS, but there is a missing link to why it’s not working. And that is exactly what we will be discussing in today’s episode of the PCOS Repair Podcast.

You’re listening to the PCOS Repair Podcast, where we explore the ins and outs of PCOS and how to repair the imbalances in your hormones naturally with a little medical help. Sprinkled in.

Hi, I’m Ashlene Korcek and with many years of medical and personal experience with polycystic Ovarian syndrome, it is my joy to watch women reverse their PCOS as they learn to nourish their body in a whole new way. With the power of our beliefs, our mindset, and our environment and the understanding of our genetics, we can heal at the root cause.

Welcome back to the PCOS Repair Podcast, where today I’m going to be sharing the secret to how to lose weight with PCOS and why it’s so hard. And of course, that missing link between struggling and long term success. So, starting on a personal note, my weight became a struggle when I was twelve years old. I had been a string bean until starting my period and finishing my last growth spurt. But then all of a sudden I started packing on the pounds. Nothing I did seemed to work and even the smell of food seemed to make the scale go up and up and up. Through unhealthy dieting habits, aka never eating, I was able to maintain my weight more or less for the next 15 years. But as I neared my third year, it became harder and harder. And it wasn’t until I battled infertility and was diagnosed with PCOS, but I finally learned what was going on with my body and I was able to lose weight and maintain it. And better yet, I was able to do it while actually eating food and enjoying it again for the first time in years. So I have my Master’s in Physician Assistant Sciences and I’m licensed to diagnose and treat patients, and I have been treating patients with PCOS and assisting them to follow a lifestyle that helps them lose weight and reverse their PCOS for many years.

But I don’t think that you should need a medical degree in order to understand how your body works. And that is why I am so excited about today’s episode. Okay, so let’s dive in. Women are often telling me that they need to lose weight, or some say that they don’t need to lose weight, they just need to fix their PCOS. Both of these groups of women share a number on the scale to justify the fact that they do or do not need to lose weight. And both these groups make me sad because on one hand, the first person feels that they need to do something, and the second person feels like they need to justify their body the way it is. As we discuss weight loss in today’s episode, I just want to put a few thoughts in place. First, unlike your doctor, I’m not going to tell you you need to lose weight. That is not the point or purpose of this episode. You do not need to lose weight. You are a valuable and amazing person just the way you are. However, just like it’s okay to like expensive shoes and purses and enjoy wearing makeup, it’s okay to not want the extra pounds or want to get rid of some extra pounds.

But your value as a person is not based on your weight or a number on the scale, nor can you wait to love yourself until you are thin. And I hope that distinction makes sense. So if you want to lose weight because you want to look different, feel different, or any other seemingly frivolous reason, then go for it. And this episode is here to help you. Basically, here’s my point. Do it for you if it’s something that you want. Otherwise, leave the sheds behind and enjoy life on your terms. And as you’ll see in this episode, you can still have PCOS health without focusing on weight loss. And now back to the topic. As promised though. So weight loss really starts by understanding the body fat, PCOS, and hormone connection. These three things your genetics, the hormones and your body composition play off of each other. Your genetics are how you respond to your environment and the degree of your hormone balance and the degree of extra weight that you’re carrying either spiral your PCOS worse or better. This is where the mainstream weight loss advice is messing you up. The way to lose weight is all about the math, right?

I mean, eat less calories than you burn, and every time that you eat enough less calories to equal a pound of fat, you’ll lose a pound, right? Wrong. This thought process had led so many so called experts recommending 1200 or less calorie diets. Things like keto, that can be helpful in certain situations for PCOS, but can also be harmful. Things like high calorie burning exercises, among other crazy diet recommendations and fads. All of these have led to further hormone imbalance and ultimately more weight gain. When it comes to PCOS, hormone balance needs to be the first thing we address. This is the missing link that is creating failure time after time after time. Perfection is not required. Removal of certain food groups is usually not necessary. Motivation is not your problem because, I mean, who would be able to stay motivated when everything they tried doesn’t work? Because they’re not understanding where to start. They’re missing that missing link. We need to stop focusing on the calories and the scale and the weight loss at first and focus on healing our body, providing nourishment, rebalancing our blood sugar, reducing inflammation, and stop stressing the body out with restriction diets.

The best place to start is to take the PCOS root cause quiz because it’s going to help you focus even more on those couple of things I just mentioned of rebalancing sugar, inflammation, stressing, all of those things. It’s going to help you focus where to start rebalancing your hormones and I will link to both the quiz as well as the two episodes below that talk more about your PCOS root causes. Your hormones don’t have to be perfect to start losing weight, but addressing the hormone connection first is vital then keeping calories in check for a slight restriction. Aim to lose no more than a pound per week is the general math that we want to work with. The actual amount of weight that you lose on the scale is irrelevant. Sometimes you’ll lose more than a pound, sometimes you won’t lose a pound, sometimes you’ll gain a pound. But overall the weight will trend down if you are addressing the hormones and your overall health over the scale. And you’re going to want to be even more careful with the restriction if you have been doing yoyo diets for years. All right, so let’s recap today’s topic because we just kind of pack a ton of information all in there very quickly.

So backing up our weight loss philosophy that we want to approach PCOS with is that you do it if you want it okay. You can focus on PCOS hormone health without having the concern of weight loss. Philosophy two, is it’s a lifestyle, not a diet. So we aren’t going on some fad diet or some huge restriction diet. We’re focusing on a healthy lifestyle that isn’t perfect, that’s nonrestrictive, that we do the best that we can at. We get better and better over time. It’s not a diet, it’s a lifestyle. Number three is to forget the perfect. I say that so many times you got to forget the perfect because if we try to do perfect, it won’t last. We can only do perfect, supposedly perfect, probably not even quite perfect. We only do it for so long before it falls apart and then we’re back to what, going back to calling ourselves a failure and eating unhealthy like that didn’t do us any good. We’d be so much better off saying I’m making progress, I’m making progress and I’m getting a little better all the time and adding more and more health to our life as compared to throwing it all out because it was too much.

And then four, we have to lose all the weight in our mind before we can lose the weight on the scale. Maybe not all of it. Maybe we just start losing the weight in our minds. I am a big believer that we will never weigh less than the baggage that we are holding on to. Our mindset, our self-talk, if we keep telling ourselves that we aren’t motivated enough, if we always fail, we failed the last time, so of course we’re going to fail this time. If we don’t provide ourselves with the self love here and now, where we are today, we can’t be who we need to be to lose the weight. Basically, we can’t hate ourselves thin, we have to love ourselves healthy and the weight loss will come with it. So that brings us back to that missing link, the PCOS weight loss formula. We have to look at the hormone balance, then we bring in some weight loss math, support and accountability and then we have our long term sustainable, healthy weight loss. Maybe to you that doesn’t sound that different from what you’ve heard from all the experts and what you’ve been trying about eating less and trying to exercise more.

But it is. So listen to it again if you need to because the subtle difference is focusing on the health of our body. Nourish your hormones, balance those hormones doesn’t have to be all the way, but get it started and then slightly reduce those calories for a trend of weight loss. It’s amazing, just balancing your blood sugar or working on balancing your blood sugar, working on reducing your inflammation. A lot of people don’t even need to watch their calories when they start to do that. But if you really do want to lose weight watching those calories or just kind of being aware of the calories, it can be helpful to get you where you want to go. And then the most fun is that as our hormones get back into balance, as that inflammation decreases, as our blood sugar improves, so does the spiral of upward success. Everything becomes easier, our cravings become less, our energy becomes better. It’s just, it all works together. And that is the body composition, hormone and PCOS genetic kind of connection there. They all work together. As we start to see improvement in one, they all get easier. So while it’s kind of alluded to it just wants to recap again to how do we balance our hormones?

It really all starts with understanding our current primary root cause, what is our body currently struggling with and what is leading to hormone imbalance in our body. So the first step is to really take that PCOS root cause quiz and then begin to address the lifestyle accordingly. Again, I will link the quiz and the episodes that correlate with the quiz in the show notes below. And as a side note, it’s important to understand too that although the hormone balance is important, the more body fat that we store on our bodies, the more we are prone to insulin resistance and inflammation. And so simply by reducing our body fat percentage we do improve our insulin sensitivity and our other hormones. And so there is a hormone body composition connection that we don’t want to ignore, but starting by forcing the weight loss further unbalances our hormones. So we really want to always have the health of our hormones in mind as we approach weight loss with PCOS. So there you have it, my friend. We have been told and recommended a backwards and counterproductive approach to weight loss, especially in regards to PCOS. Trying to lose weight as a treatment plan for PCOS is both fruitless and a frustrating endeavor because weight struggles are a symptom of hormone imbalance.

And while it does worsen the downward spiral of PCOS, trying to force that weight loss and starving yourself will only hurt your hormone balance. Now, I think I repeated myself enough times. I hope it makes sense. Comment and let me know over on Instagram if you have any other questions, because this is a topic that, although simple in some ways, rips people up day after day after day. And it’s time that we unravel all of the misguided information that we’ve been given about weight loss and go back to it being simple of eating healthy, providing our body what it needs, non restrictive, allowing ourselves indulgences along the way, and overall, creating a healthy body that is non resistant to weight loss. So the missing link is to care for and nourish your hormones. Then once you are working with your body and your health, and your body is no longer working against you, it all gets so much easier. If you found this episode helpful, be sure to subscribe, because we have some great topics coming up in the next few weeks, including the best supplements for PCOS. So make sure that you tap that subscribe button.

All right, bye for now.

Did you know that studies of PCOS epigenetics have shown that our environment can either worsen or completely reverse our PCOS symptoms? I believe that although PCOS makes us sensitive to our environment, it also makes us powerful. When we learn what our body needs and commit to providing those needs, not only do we gain back our health, but we grow in power just by showing up for ourselves. This is why I’ve created a guide for you to get started. My PCOS Fertility Meal Guide can be found in the show notes below. I want to show you how to create an environment that promotes healing while still being able to live a life that you enjoy. This guide is completely free, so go get your copy now so that you can step into the vision that you have for your life and for your health.

15:22 – 32:15 Episode #92: Weight Management and Contraception For PCOS Women

So perhaps when you saw your doctor at one point in time, you asked about the concern of gaining weight if you went on certain birth control. So in today’s episode, we are going to be reviewing some of the more recent research on PCOS contraceptives for hormones and weight gain. We’re going to be reviewing an article called weight changes among women using intramuscular Depo Medroxyprogesterone Acetate, a copper intrauterine device, or a Levonorgestrel Implant for contraceptive use. Findings from a randomized, multicenter, open-label control trial and of course, I will include the link to this research article in the show notes below. So let’s get started.

You’re listening to the PCOS repair podcast, where we explore the ins and outs of pcos and how to repair the imbalances in your hormones naturally, with a little medical help sprinkled in. Hi, I’m Ashlene Korcek, and with many years of medical and personal experience with polycystic ovarian syndrome, it is my joy to watch women reverse their pcos as they learn to nourish their body in a whole new way. With the power of our beliefs, our mindset, and our environment, and the understanding of our genetics, we can heal at the root cause.

Welcome back to the PCOS Repair podcast, where today we’re going to be diving into the topic of birth control and weight gain. So one of the questions that women often have when deciding to go on birth control, especially when they don’t need the birth control, but they’re thinking about incorporating it to help them alleviate PCOS symptoms. A question that I know when I was working in clinic, this would come up a lot and I know this is a question that I hear the women I work with asking a lot as well and that is, does birth control cause weight gain? I mean, this is like an old, old question, hearing this debate among women, even when I was a child, does birth control cause weight gain? So the research was limited on this, and the doctor’s response was, no, birth control does not cause weight gain. So in this research article that’s more recent, we are going to look at some of the findings of what happened when women with PCOS were given birth control that is progesterone only. So the Depo shot was one of the forms that was studied in this research and then also the implant, the depo shot, pretty straightforward, is a shot, you take it every three months and the implant, I think there’s a couple on the market, I could be wrong, I know there was a new one coming out right about the time that I transitioned out of primary care and women’s health and so I don’t remember exactly how many were on the market. They have varying lengths of time, but basically a little tablet is inserted under the skin, very simple procedure and then to remove it, it’s almost like popping a pimple, like a little tiny slit, and you just kind of pop out the implant once it’s done being used, and then put a new one in, in the close proximity of where that one was placed and it just kind of lives under the skin and slowly releases hormone. So these two were studied against the copper IUD. So the copper IUD is a non hormone contraceptive. Okay? So that’s important to recognize and then these were, interestingly, these were actually PCOS women that were being studied in this research and so that’s also very pertinent to the podcast here and why I want to review this.

Okay, so the other thing I think that’s really important to just clarify before we dive into this particular research article is that progesterone only contraceptive is something that’s a little bit newer. So we’ve had the pill for a long time, and then there’s other estrogen based options. So estrogen based birth control, or combination birth control that contains estrogen in it can come with a whole risk of side effects. So women that smoke, women that are prone to clotting, these are all things that can be a contraindication to prescribing those forms of birth control and so, unfortunately, women with pcos oftentimes have some of these things that give us a little bit of concern for giving them estrogen and so because of that, we jump to progesterone only and so ones that are really high dose progesterone, such as the shot and the implant, is what is being studied here. In this article, I do also want to note that there is the progesterone based IUD, which is not the one that they’re studying here in this article. In this article, they’re talking about the copper, which has no hormones, the progesterone based IUD, such as the Skyla or the Mirena IUD, they tend to release a lot lower dose of progesterone and I have seen and personally been on those ones. I had two different rounds of being on the Mirena IUD. I have worked with a lot of women who have been on those and who have had the shot and have experienced what we’re going to be talking about in this research article, but did okay on the Mirena, so I do want to start this off by saying this is not at all saying that contraceptives are bad. There is a time and place. If I hadn’t had contraceptives, I may have had a very difficult time getting through grad school, and so there’s a time and place for things. Okay. However, it’s important to be really well informed. To me, I think that women really deserve to be well informed about what they are choosing when it comes to contraceptives, especially when we have PCOS, our body is just more sensitive to our environment to begin with, and contraceptives are a fairly big player in our environment if we choose to go on them, so we want to choose them wisely.

Okay, so on to the research article. So progestin only hormonal contraceptives, which in this article are referred to as POCs, not to be confused with PCOS, but POCs, progestin only contraceptives have become a cornerstone of family planning, offering various formulations such as injectables, implants, and intrauterine, IUD. So these are the Skyla and the Mirena like we talked about, as well as oral contraceptives, which you may have heard referred to as the mini pill, which is often given to women. Historically, it was really reserved for women who were nursing. So right after you had a baby, if you wanted to make sure you weren’t going to get pregnant right away again, you could take the mini pill, because the progestin only pill in a low dose didn’t affect the milk supply as birth control would. Interestingly though, that has started to become something that is used for women regardless of if they just had a baby or not, if they’re having certain symptoms of breakthrough bleeding or different kinds of period symptoms. There are reasons why doctors are prescribing the mini pill other than to postpartum women.

However, there have been many concerns regarding potential weight gain, and although this question has historically been met with the answer of no birth control does not cause weight gain, this question has lingered especially in regions where POCs, so again, progesterone only contraceptives, notably the injectables and the implants, have been prevalent and so what we’re seeing is that although the response of no birth control doesn’t cause weight gain, we’ve seen this to be incorrect in women that are receiving these types of birth control. Understanding the impact of these contraceptive methods on weight is crucial for the informed decision making of the patient. This study delves into the intricate relationship presenting nuanced analysis between the expansive evidence of contraceptives options and the findings that we have for women, especially those with PCOS.

So, as we dive into this research article, I do want to give a little background and a little bit of limitations of this research. The landscape of evidence surrounding the effects of POCs on weight has been characterized by gaps and uncertainties. The previous Cochrane systematic reviews acknowledges that the insufficiency of data to determine the influence of POCs on weight conclusively. The challenge here is that previous studies have not necessarily had an absence of hormonal comparison group and so it’s difficult to compare large enough groups of women who are on progestin only hormones versus those who aren’t taking any hormones, because when we’re looking at who’s taking medications, oftentimes we’re just looking at side effects of the medication and the efficacy of the medication, not comparing it to a group who’s not taking the medication, lack of randomization. So when it comes to choices of birth control in the medical world, we tend to choose it based on demographic, and so we tend to use these long acting, progesterone based birth control options for people that are going to have a hard time constantly taking a pill or using more frequently dosed forms of birth control, women who maybe are of lower socioeconomic status, women who are younger, women who have reason that they shouldn’t be on estrogen. So there’s specific groupings that we are recommending these type of birth control to as a medical community and so it’s difficult to have a randomization of are we seeing these results only because we are giving this medication primarily to this group of people, or is this medication, this contraceptive, the reason why we’re seeing these results? So that’s where the lack of randomization comes in.

And then the third limitation of these studies is the suboptimal continuation rates. We are working with human beings, and we’re not going to force someone to continue with something that they don’t feel like is working for them. So when a woman feels like she’s starting to gain weight on a contraceptive, chances are she’s not going to continue with it and so our ability to get statistically significant evidence can be difficult and it leaves that critical question of whether or not the contraceptive is the problem, whether or not this is a long term issue, or whether women gain a few pounds and then it levels out is a little bit difficult to analyze and this question has been a bit left unanswered. So, recognizing these limitations that this study adopts a rigorous approach to provide a more comprehensive understanding of weight dynamics associated with different contraceptive methods.

So the methods used in this study to unravel this question about weight and specific contraceptives was that they randomly assigned participants to one of three categories and this is really important because, again, like we mentioned before, one of the limitations was there wasn’t any randomization that certain groups tend to be prescribed certain types of contraceptives more frequently than other groups, because there’s reasons why we have a go to in the medical community for why this one’s being a good fit for an individual and so in this study, we randomized everybody and we assigned participant pins to either one of these three groups.

One group was given every three months, the depo shot. Okay. The next group was given the progesterone implant, and the next group was given the copper IUD. So those three groups were the three groups that people were randomly assigned to, which provided us a unique opportunity for a comparative analysis and the study design was to have follow up extending out to at least 18 months, which also allowed for exploration of weight changes over time, because a lot of times women will change their birth control choices or their contraceptive choices, or they’ll not come back for follow up and so if something’s working for someone, a lot of times we lose that continuity of care and we don’t get the insight into what’s going on for the individual in several months and so this study gave us the unique opportunity to both compare these three different types of contraceptives, as well as to see the comparison over time.

Alright, so what did this study find in the weight disparities between these different forms of birth control? So, first of all, it’s important to acknowledge that all three groups, the depo shot, the implant, as well as the non hormonal IUD, the copper IUD, they all exhibited a mean weight increase, but the magnitude varied significantly. So this is important because all women’s weight goes up and down, right? So it’s important to realize that just because we gained weight, there’s so many factors that lead to weight gain, it’s not just contraceptives. So we needed to rule out that piece of the population overall is probably going to gain some weight. So we can take that non hormonal based IUD group and use their weight increase as kind of a way to level the playing field of what amount of uptick in weight would be normal to consider in a regular population, where contraceptives is not part of the equation. So the three month depo shot users faced the highest weight gain, which may not be surprising to you if you know anyone who has taken the depo shot or if you yourself have taken the depo shot. So they faced the highest weight gain, whereas women that were using the implant versus the copper IUD experienced comparatively much lower increase in weight, but the other finding that this study wants to emphasize is that not all women in any one of the group had the same results. So it is really important for women to have very personalized counseling and decision making and being informed with the research about these type of side effects that come with each type of birth control, because there is lifestyle considerations, there are so many different things to consider, that it doesn’t make one of these necessarily wrong or bad but it is worth noting, especially for women with PCOS, where weight can be a significant factor in root cause health, which we talked about in previous episodes, but that maybe the depo shot and the risk of gaining weight on it, although not all participants gained weight on this particular method, may be a consideration to choose others or be ready to quit it if you’re noticing that your weight is rising. So, of note, not all responses were the same amongst all women in each group, but we did see a significantly statistical increase of weight in the women that had the depo shot.

So, in conclusion, the research really stands as a significant contribution to the understanding of weight dynamics associated with different contraceptive methods. I think that it’s fair to say, as we’ve all suspected, as women, that birth control can definitely have an effect on our weight. What each type of birth control’s effect will be and how it will affect each individual unique person definitely has a ton of variability and so it’s not across the board that it will make you gain weight, for some women, they do great while they’re on birth control, other women do not but I think that it needs to be understood that it’s not correct to say that birth control will not make you gain weight. It’s definitely been shown in research now that there is a potential for certain types to definitely have an increased chance of weight gain and so by navigating this complex landscape of progesterone only hormonal birth control and their impact on weight, this study provides valuable insights for both healthcare providers and for women and that’s why I wanted to share it with you here on the PCOS repair podcast, because this newfound knowledge facilitates informed decision making in reproductive health, allowing women to weigh in on the benefits and potential side effects as they make a decision on what contraceptives and if they want to include contraceptives in their family planning methods and the more information we have, the better.

So there you have it. I think that it’s really important to understand that what we have long suspected has been shown in research that certain birth control methods definitely can lead to increased weight and I would love to hear in my Insta messages this week over on Instagram, you can find me @Nourishedtohealthy. I would love to hear if you have had an experience or know somebody that has had an experience with, you know, we hear research, and I think that it’s kind of, in some ways frustrating, in some ways interesting and amusing but I think when it comes to weight, nothing’s really amusing about this but I think it’s a little bit interesting how women have been experiencing this for a long time and reporting this back to their physicians who have continually said, oh, no, birth control does not cause weight gain and then here we finally have a study that proves the opposite and so I wanted to share this with you, I think it’s very validating for women who have had this experience to not feel like they were crazy or doing anything wrong but indeed, certain birth control does give us a higher tendency, a higher risk of weight gain and so if you have had this experience, I’d love to hear about it in my instant messages this week so that you can feel seen and heard and share your story because it’s through hearing what’s going on with other women that we finally see the places in which we may need to do further research and exploration in the medical community.

So with that, I hope you enjoyed this research review. I think they’re very helpful for us to keep aware of what’s going on in the research world. More and more studies about PCOS are becoming available, and I think that that is just amazing, because when I was going through school, there was very few resources and very few studies about PCOS beyond just the very basics of diagnosis and some very limited management of the disorder. So with that, I will sign off for now and until next week. Bye for now.