If you have recently been diagnosed with PCOS, you probably have a lot of questions regarding symptoms and treatment options. It’s also likely you’ve stumbled across a few PCOS rumours – specifically those related to body weight and its link with polycystic ovary syndrome – correct?

One such thing you may be wondering – what on earth is a “PCOS belly”? We’ll explain…

What is a PCOS belly?

PCOS belly refers to the “excess” fat held around the abdomen that sometimes (emphasis on sometimes) occurs in people with PCOS. It’s not an official term – you won’t (or, definitely shouldn’t!) hear medical professionals using it – and, quick reminder, it’s actually not an indicator of a person’s health.

Some 40-85%^1 of people with PCOS (yes, very broad) are considered – in medical terms – to be overweight. This is widely thought to be because excess body fat is associated with insulin resistance, which can lead to fat being stored around the tummy area.

Elevated levels of insulin are thought to increase the amount of “male” hormones (such as testosterone) in the body. High levels of testosterone have also been linked with weight gain and excess fat being stored around the abdomen. It’s complex, but, in short: excess fat not only potentially aids the development of PCOS, but can increase the severity of symptoms, too.

That said, not everyone with PCOS is considered overweight, and it’s very normal for people to have PCOS and be within a “healthy” weight range. However, studies^2 have shown that for those who are “overweight,” losing around 5-10% of body weight could help to reduce insulin resistance, normalise periods, and improve fertility^3.

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Identifying a PCOS Belly

Recognising a PCOS belly can be a complex task due to the variability of symptoms and its manifestation in different body types. Here we aim to guide you through the process of identifying a PCOS belly, focusing on its distinctive symptoms and the diagnostic procedures used by healthcare professionals.

Common Symptoms That Might Indicate A PCOS Belly:

• Abdominal Weight Gain: This is often the most noticeable symptom. You might find that your belly is larger and more bloated than usual, even if the rest of your body remains the same size.
• Hard to Touch: A PCOS belly typically feels hard to the touch due to the accumulation of visceral fat in the lower abdomen.
• High Waist-to-Hip Ratio: Many women with PCOS have a waist-to-hip ratio of >0.87, which is often referred to as an apple body shape.
• No Noticeable Stomach Changes: Some women with PCOS may not experience any noticeable changes in their stomach size or shape. In these cases, it's important to watch out for other symptoms of PCOS.

Risks Associated with PCOS Belly

The PCOS belly, while often seen as a physical manifestation of the condition, carries with it a host of risks that extend beyond the cosmetic. These risks, both physical and psychological, can significantly impact ones overall health and quality of life. In the following section, we delve into the health risks associated with PCOS belly.

Health Risks of PCOS

PCOS is left untreated can lead to serious health issues, including heart disease and high blood pressure. The abdominal fat associated with a PCOS belly surrounding internal organs increases these risks.

Type 2 diabetes is another major concern. PCOS can cause insulin resistance, which in turn can lead to diabetes.

Liver problems are also associated with PCOS belly. The excess fat can cause liver disorders, affecting its ability to function properly.

Fertility issues are a common problem for women with PCOS. An irregular cycle plus cysts in/on the ovaries can interfere with ovulation, making it harder to get pregnant.

Endometrial cancer risk is increased in women with PCOS. Irregular periods can lead to insufficient shedding of the endometrial lining, which can then lead to cancer.

Sleep apnea is another risk. Increased body weight and high testosterone levels in PCOS can increase the risk of obstructive sleep apnea.

Lastly, obesity is a common outcome of PCOS belly. The hormonal imbalance and insulin resistance can lead to significant weight gain.

How can I help my PCOS belly?

There are lots of lifestyle changes you can make to help with your PCOS symptoms, including weight gain. We've written a more detailed guide on natural ways to manage PCOS yourself but here are our top tips for a 'PCOS belly'.

Eat (mostly) nutritious foods

Contrary to popular belief, you do not need to adopt a diet of lettuce leaves and celery sticks to manage symptoms when you have PCOS. A balanced diet full of nutritious foods can help you to manage PCOS symptoms – and a great place to start is the Eatwell Guide.

Studies^4 have also found that a low glycaemic index (GI) diet, where wholegrains are eaten in place of refined carbohydrates, can be beneficial for people with PCOS, as it could help to reduce insulin resistance and regulate periods. The Mediterranean diet is another good option for people with PCOS.

The Role of Anti-Inflammatory Foods in PCOS Management

In managing PCOS belly, an anti-inflammatory diet can also play a significant role. This diet is designed to reduce inflammation, a major player in PCOS. It's a fact that inflammation can worsen PCOS symptoms, making it crucial to incorporate anti-inflammatory foods into your diet.

So, what does an anti-inflammatory diet look like? It's a colourful mix of foods known for their inflammation-fighting properties. These include nuts, berries, leafy green vegetables, and seeds. Natural sweeteners like maple syrup can also be included, along with beans, lentils, and whole grains.

Be mindful that no one diet will suit everybody, and that the aforementioned diets are simply guides for getting started. It’s also worth noting that women with PCOS tend to be low on certain vitamins and minerals, such as magnesium, zinc, and iron, so be sure to consult your GP or get advice from a dietitian or nutritionist before making any big diet adjustments – regardless of whether you want to lose weight or not.

Managing PCOS belly isn't just about what you eat. It's about creating a balanced, nutritious diet that supports overall health. Incorporating anti-inflammatory foods is just one piece of the puzzle. It's also essential to maintain a healthy lifestyle, including regular exercise and stress management.

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Move your body - The Role of Exercise in Managing PCOS Belly

Exercise is a powerful tool in the fight against PCOS belly. It's not just about burning calories or losing weight, it's about managing the underlying causes of this condition. Regular physical activity can help regulate insulin levels, a key factor in PCOS, and reduce the risk of developing related health issues.

However, it's not just about hitting the gym or running marathons. The type of exercise you choose can have a significant impact on your PCOS management. It's about finding the right balance and routine that suits your lifestyle and health goals. The role of exercise in managing PCOS belly is multifaceted and crucial to overall health and wellbeing.

Movement is so much more than simply a tool for fat loss, however, If you are looking to lose weight, exercise can help you achieve a calorie deficit.

In one study^5, which saw 45 people with PCOS complete weight training sessions 3 times a week, participants experienced fat loss around the abdomen and increased lean body mass. And that’s not all – they also experienced a reduction in testosterone and blood sugar levels, too.

A separate study^6 which looked at exercise therapy for PCOS, reported that consistent moderate exercise is also linked with improved ovulation in people with PCOS. The best part, though? The study found that fat loss and improvements in ovulation were not dependant on any specific exercise type, frequency or session duration. That said – Public Health guidelines advise 30 minutes of moderate exercise 5 days a week and strength training twice a week.

The Impact of Exercise on Insulin Resistance

Exercise plays a crucial role in managing PCOS belly, particularly due to its impact on insulin resistance. Insulin resistance is a common symptom of PCOS, and it's a condition where the body's cells become less responsive to the insulin hormone. This can lead to higher levels of insulin in the blood, which can exacerbate PCOS symptoms and contribute to weight gain.

Regular exercise can help to combat insulin resistance. It does this by increasing the body's sensitivity to insulin, which means your cells can use glucose more effectively. This can help to lower blood insulin levels, which in turn can help to manage PCOS symptoms and promote weight loss.

Different types of exercise can have different impacts on insulin resistance. Aerobic exercise, such as running or cycling, can be particularly effective at improving insulin sensitivity. This is because it uses large muscle groups and increases heart rate, which can help to burn off excess glucose in the blood.

On the other hand, resistance training can also be beneficial. It helps to build muscle mass, which can improve metabolic rate and help to control blood sugar levels. This can be particularly useful for women with PCOS, as it can help to manage weight and reduce the risk of developing type 2 diabetes.

So, what’s the best exercise for people with PCOS? The kind that you enjoy, and that feels good for your body. Movement is so beneficial for your wellbeing – it can boost your mood and improve your mental wellbeing (not to mention it can reduce your risk of illnesses such as stroke, coronary heart disease, and cancer) – so try to steer clear of solely associating it with fat loss.

Get quality sleep - How Sleep Affects PCOS

Good quality sleep is invaluable for mental wellbeing. It also improves immunity and acts as a mood-booster – it has even been linked with a reduced risk of developing illnesses such as heart disease.

PCOS is associated with sleep disturbances, such as sleep apnea, and disturbed sleep is linked with weight gain^7 (as tiredness from lack of sleep can result in decreased physical activity and a change in eating habits).

Sleep is a critical factor in managing PCOS. When you don't get enough sleep, your body's insulin resistance increases. This means your body isn't as effective at using insulin, which can lead to higher levels of insulin in your bloodstream. High insulin levels can exacerbate PCOS symptoms, including weight gain, particularly in the belly area.

Moreover, lack of sleep can disrupt your hormonal balance. This can lead to an increase in the production of cortisol, the stress hormone, which can further worsen PCOS symptoms.

Additionally, insufficient sleep can affect your overall health and daily activity levels. It can make you feel less energetic during the day and can also impact your eating habits, leading to unhealthy food choices and overeating, which can contribute to weight gain.

To improve your sleep quality, start by designing your own bedtime routine. Switch devices off an hour or so before bed, do your skincare, journal, meditate, read a book – whatever helps you wind down and drift off. Sticking to the same bed and wake-up time, whilst boring-sounding, can help get you into a good routine, too. Aim for 8 hours – or as close to – of kip every night.

Minimise stress

It’s impossible to avoid stress altogether, however, it’s important to manage it. Studies^8 have shown that chronic stress can actually worsen insulin resistance and increase symptom severity, so minimising stress truly is a priority when you have PCOS.

Try to prioritise rest and set boundaries to maintain peace, and make time for stress-relieving activities, such as exercise, making art, cooking, meditating – whatever floats your boat, regularly throughout the week.

Stress Management Techniques for PCOS

• Start by identifying your stress triggers. This could be work, relationships, or even PCOS itself. Once you know what's causing your stress, you can take steps to manage it.
• Practice mindfulness and meditation:These techniques can help you stay calm and focused, reducing your stress levels.
• Engage in regular physical activity: Exercise is a great stress reliever and can also help manage PCOS symptoms.
• Connect with loved ones: Spending time with people who care about you can help reduce feelings of stress and isolation.
• Prioritise self-care: This includes eating a healthy diet, getting enough sleep, and taking time for activities you enjoy.
• Consider seeking professional help: If stress is becoming overwhelming, a mental health professional can provide strategies to manage it effectively.

Remember, it's okay to ask for help. You don't have to manage stress alone. Reach out to support groups or health professionals for assistance.

Ask for help

Managing PCOS can be incredibly difficult and massively distressing at times. If you have concerns about your weight or any of your symptoms, please discuss them with a professional who can guide you on the best next steps or refer you to someone else for more specialised help.

Frequently Asked Questions about PCOS Belly

Navigating the complexities of PCOS belly can often lead to a multitude of questions. This section aims to address some of the most frequently asked questions about PCOS belly, providing you with the knowledge you need to better understand this condition. From understanding the possibility of having a flat stomach with PCOS to the potential consequences of leaving PCOS untreated, we delve into the details.

We also explore the impact of weight loss on PCOS, shedding light on whether it can help alleviate the condition. So, let's dive in and tackle these queries one by one.

Can I have a flat stomach with PCOS?

Yes, you can have a flat stomach even if you have PCOS. PCOS belly is not a universal symptom, and it can vary from person to person. Some women with PCOS may have a larger, bloated belly, while others may not see any noticeable change in their stomach size. It's crucial to remember that PCOS is a complex condition, and its symptoms can manifest differently in different people. So, even if you have a flat stomach, you might still have PCOS if you're experiencing other symptoms like irregular periods, excessive hair growth, or difficulty getting pregnant. Always consult with a healthcare professional if you suspect you might have PCOS.

What happens if PCOS is left untreated?

If PCOS is left untreated, it's like leaving a small fire unattended in a forest; it can lead to a full-blown wildfire. In the case of PCOS, this "wildfire" can manifest as serious health issues.

PCOS can lead to insulin resistance, which is a major stepping stone towards type 2 diabetes. It's like your body's cells stop listening to insulin, the hormone that tells them to take in sugar from your blood.

This can also cause weight gain, especially around the belly, leading to what's known as a 'PCOS belly'. It's like your body is storing fat in the wrong places.

Moreover, PCOS can interfere with your fertility. It's like a roadblock on the path to pregnancy, making it harder for you to conceive.

And let's not forget the risk of endometrial cancer. Because of irregular periods, the lining of your womb doesn't shed as it should, which can increase the risk of cancer.

Lastly, it can lead to sleep problems, which is like having a noisy neighbour that keeps you up at night, affecting your overall health.

So, it's crucial to manage PCOS, or else it can lead to these and other health problems.

Can PCOS go away with weight loss?

In simple terms, PCOS is a hormonal disorder that can't be completely cured. However, weight loss can significantly help manage the symptoms. It's like having a messy room. You can't make the mess disappear magically, but cleaning up can make the room much more comfortable and functional.

When you lose weight, your body becomes better at using insulin, which can help balance your hormone levels. This can lead to improvements in PCOS symptoms like irregular periods and excess hair growth. It's like turning on a fan in a hot room. The fan doesn't change the weather outside, but it can make the room feel cooler and more comfortable.

So, while weight loss can't make PCOS disappear, it can make living with the condition a lot easier. Think of it as a powerful tool in your toolbox for managing PCOS. It may not fix everything, but it can make a big difference.

Final Thoughts on Managing PCOS Belly

In conclusion, managing a PCOS belly requires a comprehensive approach that includes dietary changes, regular exercise, and stress management. It's essential to remember that each person's experience with PCOS is unique, and what works for one may not work for another. Therefore, it's crucial to adopt a personalised approach towards managing this condition.

While it may seem daunting at first, remember that small, consistent lifestyle changes can make a significant difference over time. It's not about achieving perfection but about making progress towards better health.

Finally, always consult with a doctor or healthcare professional before making any significant changes to your diet or exercise routine. They can provide you with the necessary guidance and support to ensure your journey towards managing your PCOS belly is safe and effective. Remember, you're not alone in this journey, and there are resources and support available to help you navigate through it.

References:

1. Alvarez-Blasco F, Botella-Carretero JI, San Millán JL, Escobar-Morreale HF. Prevalence and characteristics of the polycystic ovary syndrome in overweight and obese women. Arch Intern Med. 2006 Oct 23;166(19):2081-6. doi: 10.1001/archinte.166.19.2081. PMID: 17060537.

2. Magkos F, Fraterrigo G, Yoshino J, Luecking C, Kirbach K, Kelly SC, de Las Fuentes L, He S, Okunade AL, Patterson BW, Klein S. Effects of Moderate and Subsequent Progressive Weight Loss on Metabolic Function and Adipose Tissue Biology in Humans with Obesity. Cell Metab. 2016 Apr 12;23(4):591-601. doi: 10.1016/j.cmet.2016.02.005. Epub 2016 Feb 22. PMID: 26916363; PMCID: PMC4833627.

3. Legro RS, Dodson WC, Kunselman AR, Stetter CM, Kris-Etherton PM, Williams NI, Gnatuk CL, Estes SJ, Allison KC, Sarwer DB, Diamond MP, Schlaff WD, Casson PR, Christman GM, Barnhart KT, Bates GW, Usadi R, Lucidi S, Baker V, Zhang H, Eisenberg E, Coutifaris C, Dokras A. Benefit of Delayed Fertility Therapy With Preconception Weight Loss Over Immediate Therapy in Obese Women With PCOS. J Clin Endocrinol Metab. 2016 Jul;101(7):2658-66. doi: 10.1210/jc.2016-1659. Epub 2016 May 12. PMID: 27172435; PMCID: PMC4929837.

4. Manta A, Paschou SA, Isari G, Mavroeidi I, Kalantaridou S, Peppa M. Glycemic Index and Glycemic Load Estimates in the Dietary Approach of Polycystic Ovary Syndrome. Nutrients. 2023 Aug 7;15(15):3483. doi: 10.3390/nu15153483. PMID: 37571420; PMCID: PMC10421037.

5. Kogure GS, Miranda-Furtado CL, Silva RC, Melo AS, Ferriani RA, De Sá MF, Dos Reis RM. Resistance Exercise Impacts Lean Muscle Mass in Women with Polycystic Ovary Syndrome. Med Sci Sports Exerc. 2016 Apr;48(4):589-98. doi: 10.1249/MSS.0000000000000822. PMID: 26587847.

6. Cheryce L. Harrison, Catherine B. Lombard, Lisa J. Moran, Helena J. Teede, Exercise therapy in polycystic ovary syndrome: a systematic review, Human Reproduction Update, Volume 17, Issue 2, March-April 2011, Pages 171–183, https://doi.org/10.1093/humupd/dmq045

7. Beccuti G, Pannain S. Sleep and obesity. Curr Opin Clin Nutr Metab Care. 2011 Jul;14(4):402-12. doi: 10.1097/MCO.0b013e3283479109. PMID: 21659802; PMCID: PMC3632337.

8. Yan YX, Xiao HB, Wang SS, Zhao J, He Y, Wang W, Dong J. Investigation of the Relationship Between Chronic Stress and Insulin Resistance in a Chinese Population. J Epidemiol. 2016 Jul 5;26(7):355-60. doi: 10.2188/jea.JE20150183. Epub 2016 Jan 30. PMID: 26830350; PMCID: PMC4919480.

References