Weight loss and PCOS

PCOS and weight loss with Josephine Cabrall from Fertile Ground Health Group

Weight loss improves just about every aspect of polycystic ovarian syndrome (PCOS). Whilst it is often more difficult to lose weight when you have PCOS, even modest weight reductions can have a significant impact on PCOS symptoms plus reduce the risk of developing cardiovascular disease and diabetes.

How do I know if I need to lose weight?

Being overweight, especially around the waist, causes insulin resistance (even if you don’t have PCOS) because fat cells release substances that mess with insulin sensitivity. This means that being overweight increases insulin levels even more, worsening PCOS signs and symptoms. In short, being overweight is bad news for PCOS.

Body mass index (BMI) is a good guide to determine if you are in the overweight range or the healthy weight range. You can calculate your BMI using a simple online calculator and plugging in your height and weight (there are many available).

How to get started on weight loss

It’s not so simple to just lose weight and if you have PCOS with insulin resistance, this can be even more difficult because insulin is a hormone that promotes fat storage. Both diet and exercise matter when it comes to weight loss but if you need to make changes in both areas, start with diet and once that is a routine for you work on your exercise routine – changing everything overnight is hard and you don’t want to set yourself up to fail.

When it comes to diet, head over here and get your copy of my free PCOS & Diet eBook. It outlines the dietary changes that have the most impact on weight loss for people with PCOS. If you check out the eBook but still need more help or have questions, you might need to work with a naturopath to work out the best diet for you as an individual.

What’s the best type of exercise for weight loss and PCOS?

There are two types of exercise that have been shown to be effective for PCOS and weight loss:

  1. Resistance training

Resistance training means moving your body against a resistance. The resistance can be your own body weight (e.g. push ups, planking or yoga) or equipment such as bands or weights. You can do resistance training at home if you’ve already got some experience with how to do it safely. If not, get help from a professional PT to ensure you adopt the correct posture and alignment, avoiding injury.

If you can’t afford a personal trainer, join a gym and ask the staff for assistance in getting your posture and alignment right on their equipment. If the gym is not your thing, join a strength yoga class such as Iyengar, Ashtanga or Vinyasa.

Resistance training is designed to build muscle mass. Increasing muscle mass has a positive effect on insulin resistance and boosts metabolism, meaning your resting metabolic rate is faster; you burn fat while at rest.

Research has shown resistance training can reduce androgens, waist circumference, body fat percentage and fasting blood glucose: all good things for PCOS. However, the best results come with doing a combination of resistance and aerobic exercise.

  1. Aerobic exercise

Aerobic exercise is also known as ‘cardio’ exercise and refers to any exercise that gets your heart and lungs to work faster. You breathe harder, your heart pumps faster and you work up a sweat. There are many ways to do this and lots of them are actually fun! Dancing, swimming, sex, aqua aerobics, team sports, cycling, HIIT, circuit training and jogging are just a few of them.

Beyond improving insulin resistance, aerobic exercise has many benefits. Aerobic exercise improves circulation, increases energy levels, increases endurance, reduces risk of heart disease and diabetes, reduces body fat, maintains a healthy weight, improves mood and improves sleep.

How much exercise do I need to do?

Based on the research you should do 1hr of resistance training three times weekly but you should start slowly and build up to this. On alternate days you should do 30 minutes of aerobic exercise. Have one day off per week to give your body a rest.

More is not better

If you push yourself beyond the above guidelines you run the risk of pushing your stress hormones too high, which inhibits weight loss and increases insulin.

My top 4 tips for success
  1. Get friends and family in on it

Making a time to exercise with friends or family increases your motivation and makes exercise more enjoyable. It makes you accountable for showing up. Likewise, a healthy diet, such as outlined in my PCOS & Diet eBook, is something that can be done as a family or with friends. It is a health choice that is beneficial for everyone, not just those with PCOS (if you have children they can eat the same as you, just let them eat freely of healthy carbohydrates rather than limiting their intake).

  1. Any type of exercise is better than no exercise

If all you can do today is just go for a walk then it’s better than nothing – you are still having a beneficial impact on your hormones when you exercise, even if weight loss is not achieved.

  1. Set realistic goals

If you can’t stick to a strict regime as outlined in the exercise section above, just do what you can. Any sort of increase in physical activity is better than none.

Set a goal of something you can do that is easily achievable. Once you can stick to that for 3 weeks, set a higher goal. For example, if you currently walk for 10 minutes per day, increase this to 15 minutes. Or get a pedometer and increase your daily steps by 2000 each week.

  1. Prioritise it

One of the excuses you might give yourself is that you simply don’t have time exercise and prepare food. This is when you need to sit down and make a list of all of the things that take up time in your life and prioritise which ones are going to make you the happiest. Chances are that being healthy is going to be near the top of your list.

Other things might have to take a back seat in preference of your health.
You might find that some things can be combined. For example, seeing friends and exercising could be rolled into one on some days. Preparing food and family time are other things that could be done together. How you shape your life is up to you but one thing is for sure: if you don’t prioritise time for weight loss, it won’t happen.

Need more help?

Losing weight can be really tough, so don’t be afraid to reach out for help if you need it. Some great choices are personal trainer or exercise physiologist, naturopath, nutritionist, osteopath, acupuncturist and psychologist or counsellor. All of these professionals can help you tailor a plan that is most effective for you as an individual and help keep you accountable and motivated along the way.

Josephine is currently offering free 10 minute consults to everyone. These sessions give both practitioner and patient the chance to see if the therapeutic relationship is a great fit, as well as to get you started on the path to feeling better, whether that be prescriptions on the day, referral for testing, or simple extras that you can incorporate to support yourself even more. 

Book in with Josephine to get started > bookings > Naturopathy > Free 10 min consult

Exercise during Pregnancy

Pregnancy and Exercise - with Osteopath Nicole Cukierman at Fertile Ground Health Group

Exercise during pregnancy should be done and is safe in a healthy, uncomplicated pregnancy. In fact, performing the recommended type and amount of physical activity during pregnancy achieves health benefits for mother and baby including reduced risk of pre-eclampsia, pregnancy induced hypertension, a reduction in instrumental delivery and unplanned caesarean section birth and may help to reduce the severity of lower back and pelvic girdle pain 

According to the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) evidence- based guidelines for physical activity in pregnant women, it is recommended that in a normal pregnancy woman participate in 150-300 minutes of moderate intensity or if previously exercising can continue 75-150 minutes of vigorous intensity exercise per week. 

This can be completed over a minimum of three days per week, however, being active every day (ideally 30 minutes per day, less if previously inactive) is encouraged and doing some physical activity is better than none. 

Training should be a combination of aerobic (brisk walking, cycling, swimming, dancing, exercise classes) and strength (body weight, light weight or resistance band) exercises and exercise intensity will vary depending how physically active you were or we not pre-pregnancy. Women who were active prior to conceiving can continue with their usual activities for as long as they feel comfortable but are advised to check with a health professional if they would like to continue with vigorous intensity or high impact sports and exercise 

 Additionally, some exercises may need to be modified as your pregnancy progresses due to biomechanical changes and pain i.e. After 16 weeks it is best to avoid exercises lying on your back. 

Exercise is not recommended in all circumstances. The following are cases in which exercise is not recommended; 
  • Incompetent cervix  
  • Ruptured membranes, preterm labour 
  • Premature labour 
  • Persistent second or third trimester bleeding  
  • Placenta previa  
  • Pre-eclampsia  
  • Evidence of intrauterine growth restriction  
  • Multiple gestation (triplets or higher number)  
  • Poorly controlled Type 1 diabetes, hypertension or thyroid disease  
  • Other serious cardiovascular, respiratory or systemic disorder  
Stop and seek advice from a health professional if you experience any of the following while being physical activity: 
  • Chest pain 
  • Persistent excessive shortness of breath – that does not resolve with rest  
  • Severe headache 
  • Persistent dizziness / feeling faint – that does not resolve with rest 
  • Regular painful uterine contractions
  • Vaginal bleeding 
  • Amniotic fluid loss 
  • Calf pain, swelling or redness 
  • Sudden swelling of the ankles, hands or face 
  • Decreased foetal movement 

 Still unsure what physical activity you can or cannot be doing during pregnancy speak with your health care provider before starting an exercising program 

*Exercise intensity ratings are based on ratings of perceived exertion on a scale of 1-10 where 1 is not moving and 10 is maximal effort. Activities in the range 3-7 indicate moderate-vigorous intensity and are considered safe and are recommended for health benefits in pregnant women. This can also be judged by the ‘talk test’ in which a conversation can be held during moderate intensity activities but difficult during vigorous activities. 

Written by Dr Nicole Cukierman, Fertility, Pregnancy and General health Osteopath at Fertile Ground Health Group.

Dr Nicole Cukierman is available for one on one consultations in person at Fertile Ground Health Group. Book in with Nicole and find out what’s possible for your situation.

References

Brown, W.J., Hayman, M, Haakstad, L.A.H., Mielke, G.I. et al. (2020). Evidence-based physical activity guidelines for pregnant women. Report for the Australian Government Department of Health. Canberra: Australian Government Department of Health.