Women with PCOS are no fatter than the rest of the population, and being fatter makes the living with PCOS experience worse.
Being overweight or obese tends to exaggerate everything we suffer from related to having PCOS. I am very focused on minimizing the suffering high-androgen women with PCOS experience. I like the bumper-sticker Zen lesson that reminds us that pain is inevitable, but suffering is a choice. In fact, we do not have to suffer obesity. The fact so many of us do is something I want to contribute to changing. One vital element to changing our relationship to obesity is information. Here are some essentials for you to know:
The relationships between having a high androgen body and obesity are circular. Not every high androgen woman is overweight, but every woman with a high androgen body is more likely to have more visceral fat than average for females. Visceral fat, the kind we build in our abdomen, surrounding vital structures like heart, liver and kidneys, is an active endocrine organ. We owe some of the advantages of being a high androgen women to the hormones our visceral fat contributes. However, imbalances create certain hormonal states that are also common to and made worse by being overweight or obese. The great news is that all these biochemical states can be optimized- meaning we can enjoy the benefits without additional suffering due to theses tendencies of ours- when we live in our high androgen bodies the way we are optimally meant to.
Because of our collective chronic anxiety about being or becoming fat, it is important to understand that PCOS does not cause obesity. More than half of women with PCOS are in fact overweight/obese, but that’s because at this time in history we are experiencing a global epidemic of obesity. Currently in the US about 65% of adult women are overweight or obese.i In studies looking at women from many different countries, we can see that the percent of women with PCOS who are overweight/obese is essentially the same as all women in that country, meaning PCOS does not have a genetic component that requires we become overly fat. “However,” these authors conclude, “it is likely that changes in the quantity, type, and quality of dietary intake and in the degree and type of physical activity over time may have had significant influence on the prevalence of obesity among PCOS women, as they have in the general population.” ii This fact is supported by additional studies that show how the incidence of obesity rises in the subset of women with PCOS at the same rate it has risen in the general population.iii
It’s good to know that having PCOS does not mean we will inevitably become dysfunctionally fat. But this study and many others iv v, make it very clear once we have gained too much fat, it tends to be deep abdominal fat that contributes to biochemistry that worsens all the signs and symptoms of PCOS that we struggle with. It is clear that weight loss and lifestyle management offers a beneficial effect on the ovulatory and metabolic dysfunction of obese women with PCOS.
I’m sure all that is good news to each of us, but… If you are among the majority of women who have tried to lose excess fat, and keep it off long term, your happiness may be tempered with frustration abut the very real difficulty everyone has in changing our fat to lean tissue. If you are not extra fat, you may be weary of the effort you need to make to maintain a healthy weight; you may experience yourself having to be more vigilant, more consistently conscious of your behaviors and choices, than it seems like your friends do.
You are not imagining the difference! It turns out that both over weight and lean high-androgen women with PCOS behave differently than most other women- with or without PCOS- do, trying to maintain a comfortable body weight. vi vii viii
What’s clear is for a high-androgen woman with PCOS, aligning eating and other behaviors with best health practices becomes even more important than usual. We do have a genetically-based tendency to run body chemistry that causes us to have insulin resistance, higher blood sugars and thus higher-risk for cardiovascular disease and diabetes and inflammatory damage in general, when we are not living in our beautiful, strong reliable fabulous bodies they ways we should.
If you want to know how to maximize your well being and thoroughly enjoy being an UnCommon Woman, consider a personalized plan developed specifically for you ~ please do visit www.PCOSConsultations.com, and get what you need to be optimally well.
Walking with you to joy, peace and a fulfilled life,
Nan
Resources:
[i] National Center for Health Statistics. Health, United States, 2013: With Special Feature on Prescription Drugs. Hyattsville, MD. 2014.
[ii] Yildiz B, Knochenbauer E, Azziz R, Impact of Obesity on the Risk for Polycystic Ovary Syndrome, J Clin Endocrinol Metab. 2008 Jan;93(1):162-8. Epub 2007 Oct 9.
[iii] Diamanti-Kandarkis E, Kouli CR, Bergiele AT, Filandra FA, Tsianateli TC, Spina GG, Zapanti ED, Bartzis MI 1999 A survey of the polycystic ovary syndrome in the Greek island of lesbos; hormonal and metabolic profile. J Clin Endocrinol Metab 84:4006-4011
[iv] Franks S 2006 Genetic and environmental origins of obesity relevant to reproduction. Reprod Biomed Online 12:526–531
[v] Lim SS, Norman RJ, Davies MJ, Moran LJ. The Effect of Obesity on polycystic ovary syndrome: a systematic review and metaanalysis Obes Rev. 2013 Feb; 14(2):95-109
[vi] Jones GL, Hall JM, Balen AH, Ledger WL: Health-Related Quality of Life Measurement in women with PCOS: a systemic review. Hum Repro Update 2008; 14: 15-25
[vii] Komarowska H, Stangierski A, Warmuz- Stangierski I, Lodyga M, Ochmanska K, Wasko R, Wanic-Kossowska M, Ruchala M Differences in the psychological and hormonal presentation of lean and obese patients with polycystic ovary syndrome Neuro Endocrinol Lett. 2013;34(7):669-74
[viii] Yildirim B, Sabir N, Kaleli B. Relation of intra-abdominal fat distribution to metabolic disorders in nonobese patients with polycystic ovary syndrome. Fertil Steril. 2003 Jun;79(6):1358-64.
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