The best way to lose weight when you have PCOS

According to the National Institutes of Health, up to 20 percent of women in the U.S. have PCOS, a condition characterized by an imbalance of reproductive hormones-too many androgens, or "male hormones" in particular.

In addition to creating problems in a woman's ovaries (like issues with egg development and release), the higher levels of androgens also up the odds of weight gain around the waist-launching a vicious cycle. Abdominal fat decreases responsiveness to insulin, a hormone that helps your body process sugar, making you likely to gain even more weight.

“Some people with PCOS complain they have a hard time losing weight no matter what they do,” says Daniel Dumesic, M.D., division chief of reproductive endocrinology and infertility at UCLA, who also specializes in PCOS.

Oh, and it gets worse: When the average woman wakes up in the morning, she immediately starts burning fat for energy until she eats again. Women with PCOS, however, don't burn fat first thing because they're programmed to save it instead, says Dumesic. (Those pesky androgens are linked to insulin resistance, which can cause you to store more fat instead of burning it.)

So, yes, shedding any extra pounds is especially tricky when you have PCOS, but it isn’t impossible-as long as you arm yourself with the right info. Here are a few ways to make weight loss with PCOS a little less soul-crushing.

Try a low-carb diet on for size

It should be said that no one diet is the magic fix for women with PCOS-and that the type of diet you choose is less important than whether you're able to stick with it long-term. “There’s no evidence that one diet is better than another, so compliance is critical,” says Dumesic.

That said low-carb diets tend to work well for women with PCOS, because they tend to be insulin-resistant. “Lowering carb content lowers insulin levels, which can help with weight loss,” says Caroline Apovian, M.D., an endocrinologist, weight-loss researcher, and director of the Center for Nutrition and Weight Management at Boston Medical Center.

That means you'll have to up your protein; Apovian suggests a diet with 1.5 grams of protein per kilogram of your ideal body weight-about 90 grams of protein a day if your goal is 130 pounds (or about 60 kilograms). Feel free to eat as many non-starchy veggies as you want (leafy greens, green beans, and carrots are all on the menu) and two to four servings of fresh fruit, but make sure to skip the juice.

At the beginning, Apovian suggests eliminating grains entirely. If you need carbs to keep up your diet, you can add back up to two servings a day (one slice of whole grain bread, one cup of oats, one cup of brown rice, one cup of whole-wheat pasta, etc.).

"Women with PCOS need an average of 400 fewer calories a day than women who don't have PCOS."

If you still have trouble losing or at least maintaining weight following a low-carb diet, you may need to work with a doctor to adjust your calorie intake, says Lori B. Sweeney, M.D., an endocrinologist and associate professor of medicine at Virginia Commonwealth University Health System.

"Women with PCOS need an average of 400 fewer calories a day than women who don't have PCOS-and any excess calories go to fat storage," she previously told Women's Health. But that's not free range to start slashing cals-a doctor can help you figure out how to cut back in a healthy way.

Exercise first, eat later

Exercising right before a meal can help rev your metabolism so you end up storing more carbs as energy than fat, according to Sweeney. And exercising on the regular trains your body to use up extra glucose stores in your body, which can help keep your insulin levels down, says Maria Horstmann, a National Academy of Sports Medicine-certified trainer who specializes in working with women who have PCOS.

Horstmann previously told Women's Health that women with PCOS should focus on high-intensity interval training, which utilizes short, intense bursts of energy, while Apovian and Dumesic both recommend any type of cardio that gets your heart rate up.

While you're at it, add in more strength training to your workouts too. Because muscles use glucose for energy, building more muscle can only improve insulin sensitivity and metabolic health, says Dumesic.

If youve got sleep issues, dont ignore them

One common side effect of PCOS is sleep apnea, which disrupts sleep. Lack of sleep causes weight to go up because it messes with hormones controlling hunger and fullness, says Apovian. Try to get at least seven hours of shuteye per night, and talk to your doctor if you think you might be suffering from sleep apnea.

Your doctor might sign you up for a sleep study to confirm that you have sleep apnea and, if you do, prescribe a continuous positive airway pressure device (CPAP), a mask you’ll wear while you sleep that gently blows air into your airway to keep it open.

Try to find an A+ support system

Women with PCOS are more likely to have depression and anxiety, says Dumesic, which can make it even harder to lose weight. (It's tough to work up the motivation to prepare healthy meals and work out if you're feeling happy, let alone if you're depressed.) If you think you might have symptoms of either, check in with a mental health professional. “It’s important to have a good support system. You have to get your mindset aligned with your goals to accomplish weight loss,” he says

If youre still struggling, ask your doctor about other medication options.

Metformin, a medication used to regulate glucose levels and insulin sensitivity, can be prescribed if you're still having trouble keeping your weight in check or are prediabetic. “By better regulating sugar, it subtly affects your appetite and can help with weight loss, although not everyone loses weight,” says Dumesic. Metformin decreases the amount of sugar you absorb from foods and increases your sensitivity to insulin, to help keep your appetite in check.

Other, more powerful drugs made specifically for weight loss may help too, if diet and exercise aren't working. Many of these weight-loss drugs, like a medication called Saxenda, are particularly well-suited for women with PCOS, since they're prescribed to people with higher levels of abdominal fat, says Dumesic.

But keep in mind, these drugs are typically a last resort. "“They’re very strong medications. They have to be given under doctor supervision and are recommended for only six months at a time,” says Dumesic. They also come with a whole slew of side effects like nausea and diarrhea, and can be very dangerous for an unborn baby if you accidentally conceive while taking it.