Episode # 182: Why PCOS Weight Loss Feels Harder Than It Should

Hi, and welcome back to the PCOS Repair Podcast. If you feel like whatever program, plan, weight loss, fitness, or body composition-related plan you’ve followed—or are currently following—if you feel like one or two, or even the numerous ones you’ve tried in the past, have not worked or have somehow failed you, or that your body isn’t responding the way it should, then this episode is going to shed some amazing light on this situation for you.

So I want to start by saying something really clearly. I want you to hear this right from the beginning: if PCOS weight loss has been hard for you, it does not mean you aren’t trying hard enough, and it does not mean that something is permanently wrong with you.

This is really important. I want you to take a deep breath, close your eyes, and let that sink in for a second. In fact, let me say it again.

If it’s not working for you, it’s not because you aren’t trying hard enough.

Something not working for you when it comes to weight loss is not because something is permanently wrong with you or your body. It simply means that the approaches you’ve been trying, the approaches you’ve been given, do not account for what’s actually going on inside of your body, or they’re coming at it in a way that doesn’t lead to long-term success.

So today, what we’re going to talk about is why that is, what you can actually do about it physiologically, and what tends to work better for women with PCOS—including conversations around GLP-1s.

Now, you can lose weight without GLP-1s. But because they’re talked about so much right now, I want to include them in the conversation and shed some light on where they may belong and where they don’t belong. I want you to think of it more nuanced than everything being so black and white because what we hear online is often, “Nothing worked until this,” or, “This was the little missing piece.”

And while that sounds great as a buzzword, there’s, in a sense, a whole missing foundation underneath the surface. And the pieces that are missing are different depending on what plan you’re following.

So I’m a believer in, hey, let’s fix the foundation of how we’re approaching things. Then all of a sudden, the load feels lighter. And whether or not you have this root cause or that root cause, this mentality stays the same.

So let’s dive into what to do when PCOS weight loss can feel difficult and how to make it feel less heavy.

Like I said at the beginning, this is not a willpower problem.

And I think this is the piece that matters the most, and that’s why I really want you to hear this. The problem is not your lack of effort.

I have seen women struggle for years and put so much energy into losing weight. Maybe it’s the same weight over and over. Maybe they lose 20 pounds, regain it, lose that same 20 pounds again, or more or less. Sometimes they lose a little more. Sometimes they don’t get as far. But essentially, they’re trying over and over and over, and it doesn’t last.

So clearly, there is no lack of effort here.

It’s a lack of information and following plans that were not meant for a PCOS root cause situation.

With PCOS, our body’s metabolic environment is often different than what standard weight loss protocols address. When you follow generic guidance that was not designed for our hormonal landscape and it doesn’t work, it’s not a character flaw. It’s simply a mismatch in protocols.

So let me walk you through what’s really happening because I also don’t want to just chalk all of this up to, “Oh, because you have PCOS,” or “because your hormones are imbalanced.”

Because honestly, weight loss isn’t as different as people sometimes make it sound.

There’s actually a reason why even people without PCOS fail at weight loss and lose the same 20 pounds over and over and over.

So while we’re going to address root causes, we’re also going to address the mindset and lifestyle pieces so that it all starts working together synergistically, making it more doable, requiring less effort, and becoming sustainable.

Insulin resistance is extremely common with PCOS, whether or not it’s your primary root cause. It’s somewhere in there because it’s highly related to even the other root causes. It’s highly related to the stress response root cause. It’s highly related to the inflammation root cause.

So it’s in there.

Insulin is an amazing hormone. It does so many wonderful things for our body. But if it gets slightly overused, it becomes a problem. And it can very easily be addressed and shifted back toward healthy insulin levels.

So it’s a very addressable problem. We just have to be aware of it.

In some ways, insulin has been talked about so much that we’ve almost become a little deaf to it, perhaps.

But it has a significant effect on fat storage, energy availability, and hunger signals.

When insulin stays elevated, the body is essentially in storage mode more often than it needs to be. And with PCOS, we tend to already have a tendency toward low-grade insulin resistance—not necessarily where labs are concerned, but our body has more of a tendency toward it than someone without PCOS.

This doesn’t mean we need to go low carb or cut out entire food groups. That isn’t sustainable, and it isn’t necessary.

But it does mean timing, composition, and consistency of how we eat matter in specific ways beyond just generic calorie cutting.

Eating the same number of calories as someone without insulin resistance does not produce the same hormonal response.

It’s not a theory. This is physiology.

Now, short term, if both a person with PCOS and a person without PCOS cut the same amount of calories and have a similar body makeup, they will both drop pounds.

The problem is that when you have insulin issues, different signaling pathways are happening underneath the surface, and you’re fighting against them.

There’s more resistance—more cravings, more hunger issues, more of a rubber-band effect.

You’re pulling it back, pulling it back, pulling it back. Then as soon as you let up at all, your body wants to store again.

And so we end up setting ourselves up to fail even while feeling like we’re succeeding.

We see the scale go down, but under the surface our body becomes more stressed and more ready to store as soon as it has excess again.

And then if we have one or two meals where we lighten up because we’ve been doing so well, cravings get harder. Appetite gets stronger. It becomes harder to get back on the bandwagon.

Even if you have determination, your body went right back into storage mode.

So it can feel like your body is looking for every opportunity to work against you.

But it has nothing to do with your body being broken.

It has to do with signaling pathways and hormones.

So when it comes to stress response, PCOS, hormones, and cortisol, chronic stress—including the stress of dieting itself—elevates cortisol. Elevated cortisol creates a cascade of effects that actively work against fat loss as well.

It increases appetite. Stress wants us to have active blood sugar available, so it increases appetite, particularly for high-calorie, sugary foods.

It prompts fat storage, particularly around the midsection.

It disrupts sleep, which increases inflammation and can shut down fat burning. Poor sleep does all sorts of horrible things to us, which then further disrupts hunger hormones.

Have you ever had a night where you didn’t sleep well, and then the next day you’re wondering why everything feels harder? Your focus is harder, your energy is lower, and you’re like, okay, I kind of understand that because I’m tired. But then you wonder, why am I craving food so much more? Why am I so much more snacky?

Part of it, sometimes, we chalk up to, “Oh, I’m just not thinking as clearly, so I’m more absent-minded.” But there truly is more happening physiologically.

Your body starts looking to graze because it’s tired. It’s low energy.

Sleep disruption affects so many systems. It dysregulates our hunger hormones. It can downregulate our metabolic rate. And if it happens frequently, it can significantly impact our metabolism over time.

And here’s what this means practically speaking:

The more we restrict, the more stressed our body can become.

And the more stressed our body becomes, the harder long-term fat loss becomes.

And the cycle continues.

Now again, with the stress response PCOS root cause compared to someone without PCOS—calorie for calorie, similar body makeup—yes, you can lose weight for a while.

You can lose weight for quite a while.

Then we hit plateaus, or we see weight start creeping back up when we try to simply live comfortably again.

We can force it.

And again, this is why it’s not a willpower issue.

We can power through and make what looks like progress.

The problem is that what’s happening underneath the surface in one person compared to another sets us up for this rebound effect that feels completely outside of our control.

And we’re sitting there thinking:

“Hey… I’m not even eating that much. I didn’t even go back to eating the way I used to. Why is it all coming back? Why is all the weight coming back on?”

Okay, so then we have sleep and appetite hormones.

This one doesn’t get talked about nearly enough.

Poor sleep disrupts ghrelin and leptin.

These are the hormones that regulate hunger and satiety—how hungry we feel and how full we feel.

When these are dysregulated, you feel hungrier than you should and less satisfied than you should.

And no amount of willpower can override those signals long term.

And this isn’t about having iron willpower, right?

Part of my whole philosophy in PCOS wellness is that we live a life we love.

The idea is to thrive in a body that feels good, works the way we want it to, and allows us to actually enjoy our lives.

Now, that doesn’t mean we enjoy life by eating whatever we want, whenever we want, and never exercising or never doing healthy things for our body.

But it does mean our body has built-in resilience.

We want to fuel our body so we feel good because we want to feel good every day.

In fact, the more we learn how good it feels to treat our body well, the more we want to do that.

But we also want our body to have enough resilience where we can go on vacation and loosen up a little bit.

We don’t want to have to live in the strictest version of what I call the healing phase of PCOS forever.

We want to live more in the lifestyle phase.

Where yes, we’re caring for our body—but it feels easy.

It feels like flow.

We can go to a restaurant and choose the best option—not necessarily the ideal, perfect option under every circumstance.

Not, “I can’t eat out because I can’t eat perfectly.”

So this is where sleep and appetite hormones can play a huge role.

Because long term, we don’t want to feel like we’re ruling our health with an iron fist.

We don’t want to rely on that much willpower.

When we get enough sleep, our appetite hormones begin working with us.

When we get out of the sugar-for-energy cycle and recalibrate our cravings, appetite, and taste buds, we don’t need nearly the same amount of willpower.

Because we actually become satisfied by foods that nourish our body.

Sure—donuts, cake, chips, chips and salsa—all those things are still good.

They’re still good.

And we can enjoy them from time to time.

But we’re not so pulled toward them that everything feels difficult.

So if you’re eating well and still feeling hungry, still feeling out of control around food, sleep quality may be a really good place to look.

And honestly, it’s one of the more fun and relaxing ways to improve health, right?

Many women with PCOS are training really hard because they want accelerated results from exercise.

But if the body isn’t recovering well, more exercise can actually compound the problem.

I talk about this a lot inside the PCOS Root Cause Bootcamp and Thrive with PCOS because this one gets really tricky.

We absolutely can over-exercise.

But intense exercise itself is not the problem.

And I hope we can understand that distinction.

I can’t go into it in great detail in a short podcast episode, but the gist is this:

It’s less about workout intensity and more about how we build up to that intensity.

It’s about recovery.

It’s about increasing your body’s capacity for workouts and recovery over time.

Not jumping in at full intensity so quickly that we create burnout, injuries, or hormonal disruption.

There’s been a lot of discussion lately warning women with PCOS away from HIIT workouts.

And honestly, I have nothing against HIIT.

Lots of things raise cortisol temporarily.

That alone isn’t the issue.

The issue is when we go harder and harder simply because we can, without a strategy for progression.

We can absolutely overdo things.

But someone can overdo it by going from the couch to intense workouts.

And someone training for multiple marathons can overdo it too.

The difference is capacity.

The marathon runner built capacity slowly.

They built recovery ability.

They taught their body how to tolerate that level of stress.

So it’s less about a specific workout being “too intense,” and more about where your body is currently at.

Okay—that went a little farther than I intended because I really wanted to bust that myth.

High-intensity exercise itself isn’t bad for women with PCOS.

The way our culture often approaches it can be problematic.

And that’s a much bigger conversation for another time.

So then we get into one of the biggest misconceptions in PCOS weight loss, and that’s the idea that we need to just keep eating less and less.

This is where things can get really frustrating.

Because at first, reducing calories often works.

You cut back, you lose a few pounds, and you think, Okay, finally. I found the thing.

Then a few weeks go by.

Maybe a few months.

And then suddenly things slow down.

The scale stops moving.

You start feeling more tired.

You feel colder.

Your energy drops.

Your cravings go up.

You feel hungrier than before.

And you’re sitting there thinking:

“Wait… I’m eating less than I used to. I’m exercising more than I used to. Why isn’t this working anymore?”

And then what do we typically do?

We think:

“Okay, maybe I need to cut a little more.”

“Maybe I need to be stricter.”

“Maybe I need to remove one more thing.”

“Maybe I need to work out harder.”

And unfortunately, that often digs the hole even deeper.

Because your body is smart.

Really smart.

Your body does not view prolonged calorie restriction as a positive thing.

Your body does not know you’re trying to fit into jeans.

It doesn’t know you’re trying to get ready for a vacation.

It doesn’t know you’re trying to improve fertility.

It interprets prolonged calorie restriction as:

“Hmm… resources are becoming less available.”

“We should probably become more efficient.”

So your body adapts.

Metabolism slows.

Movement outside of intentional exercise decreases.

You may fidget less.

You may feel more tired.

You may naturally move less during the day without realizing it.

Hormones shift.

Appetite increases.

Your body starts trying to preserve itself.

And honestly, from a survival standpoint, that’s really impressive.

The problem is that from a weight loss standpoint, it can feel incredibly discouraging.

Because you’re trying harder and getting less return on your effort.

And then if we add PCOS on top of that, with insulin concerns, cortisol concerns, inflammation concerns, sleep concerns, appetite signaling concerns—all of that together—it’s easy to see why women start feeling defeated.

Not because they’re doing something wrong.

But because they’re using strategies that simply weren’t built for this hormonal environment.

And I think this is where we have to stop looking at weight loss as punishment.

We have to stop viewing it as:

“How little can I eat?”

“How much can I burn?”

“How hard can I push?”

Instead, we have to shift toward:

“How supported can I make my body?”

“How nourished can I make my body?”

“How can I create an environment where my body actually wants to let go of weight?”

Because the body is always listening.

It is constantly asking:

Do I feel safe?

Am I nourished?

Do I have enough energy?

Am I sleeping?

Am I recovering?

Am I inflamed?

Am I stressed?

And if enough of those answers improve, your body starts responding differently.

Now, does that mean the scale magically drops overnight?

No.

I wish it did.

But what often starts happening first is things like:

You notice you’re less snacky.

You’re less ravenous.

You start having fewer cravings.

You notice your energy is more stable.

You start sleeping better.

Your cycles begin improving.

You recover from workouts better.

You don’t feel quite so puffy.

You don’t feel so inflamed.

You don’t feel like your body is constantly fighting you.

And those things matter.

Because when we only focus on the scale, we miss all of the physiological changes happening underneath the surface.

And many of those changes happen before large shifts on the scale happen.

That’s why I’m always saying to pay attention to your symptoms.

Because symptoms are feedback.

Your body is constantly giving you information.

And honestly, the body often tells us it’s healing long before the scale does.

Now let’s talk about GLP-1s because I said we would.

And this is where I really want there to be nuance.

Because I feel like conversations online become very black and white.

Either:

“GLP-1s are amazing and fix everything.”

Or:

“GLP-1s are terrible and nobody should take them.”

And honestly, neither approach is very helpful.

GLP-1 medications can be extremely beneficial tools.

For some women they reduce food noise.

They improve insulin sensitivity.

They decrease appetite.

They help people finally feel like they aren’t fighting themselves every second of every day.

And for some women, that can be life-changing.

But they are tools.

They are not foundations.

Because if the underlying environment doesn’t change—sleep, stress, movement, nourishment, recovery, inflammation, habits—then eventually we can run into some of the same issues.

Because if we lose weight without building a lifestyle that supports our body, what happens when the medication changes?

What happens if we come off of it?

What happens if life gets stressful?

So I’m not anti-GLP-1 at all.

I’m very pro using tools wisely.

But I think lifestyle always has to be underneath it.

Because even if someone uses a GLP-1, we still want healthy metabolism.

We still want muscle.

We still want good nutrition.

We still want sleep.

We still want recovery.

We still want stress management.

We still want a body that feels good.

Because ultimately, the goal isn’t just weight loss.

The goal is health.

The goal is energy.

The goal is fertility.

The goal is feeling vibrant in your body.

The goal is living in a body you actually enjoy living in.

And that’s different.

That’s a much bigger goal than just a number on the scale.

So where does this leave us?

If you’ve been trying really hard and feeling discouraged, I want to bring this back around to where we started.

Your body is not failing you.

You are not failing.

And if you’ve been carrying around the thought that maybe you’re just not disciplined enough, maybe you don’t have enough willpower, maybe everybody else figured out something that you somehow missed—I really want you to let that go.

Because this isn’t a character issue.

This is information.

This is physiology.

This is understanding how your body responds and learning how to create an environment that allows it to function well.

And honestly, I think that can feel really freeing.

Because if the issue isn’t that you’re broken, then suddenly there’s room for solutions.

There’s room for learning.

There’s room for adjustment.

There’s room for hope.

Instead of continuing to think:

“Why can’t I just do this?”

We can begin asking:

“What is my body asking for?”

“What signals is it responding to?”

“What environment have I created?”

“What’s working?”

“What isn’t working?”

And this is one of the reasons I focus so much on root causes.

Because when you understand your root cause, everything starts making more sense.

You stop trying random things.

You stop bouncing from protocol to protocol.

You stop seeing somebody online say, “This one thing changed my life,” and immediately thinking, Maybe that’s the missing thing.

Because honestly, maybe it isn’t.

Or maybe it is—but maybe only a small piece of it.

When you know your root cause, suddenly you have context.

You understand why your body responds the way it does.

You understand why certain approaches helped temporarily.

You understand why some things backfired.

You understand why one woman with PCOS swears by one thing and another says it made her feel terrible.

And all of that confusion starts to settle down.

Because confusion creates stress.

And stress creates more symptoms.

So even just having a framework can create relief.

Now, does this mean there won’t be trial and error?

Of course not.

We’re humans.

Our bodies change.

Our seasons of life change.

Our stress changes.

Our sleep changes.

Our schedules change.

What worked in one season may need adjustment in another.

And honestly, I’ve experienced this myself.

What my body needed in my teens was different than what it needed in my twenties.

Pregnancy was different.

Postpartum was different.

Having young kids was different.

Life changes.

And your body changes with it.

So the goal isn’t perfection.

The goal isn’t finding one magical forever answer.

The goal is learning to become fluent in your own body.

To learn how your body communicates.

To understand the signals.

To notice patterns.

To become confident enough that when symptoms pop up, you don’t panic.

You don’t immediately think:

“Everything is falling apart.”

Instead you think:

“Okay… what changed?”

“What is my body telling me?”

“What support does it need?”

And that’s a completely different place emotionally.

Because now you’re not at war with your body.

You’re working with it.

And honestly, that shift changes everything.

Because when we stop forcing and start supporting, things begin to feel lighter.

They begin to feel more sustainable.

And this whole PCOS journey becomes less about surviving and more about actually living.

So as we wrap up today, I want you to remember this:

You do not need more shame.

You do not need more restriction.

You do not need to push harder.

You do not need to punish your body.

You need understanding.

You need support.

You need clarity.

And you need a strategy that actually fits your body.

So if today’s episode felt like one of those “aha” moments, and you’re realizing there may be more going on underneath the surface than you previously understood, I highly encourage you to go take the PCOS Root Cause Quiz.

Because understanding your primary root cause gives context to all of this.

And once you understand the context, you can finally stop guessing.

You can find that linked in the show notes below.

And if you found today’s episode helpful, be sure to hit that subscribe button on whatever platform you enjoy listening on so you get notified each and every week when a new episode becomes available.

And until next time, bye for now.