Why PCOS Causes Weight Gain (And What To Do When “Eating Less and Exercising More” Isn’t Working)

Why PCOS Causes Weight Gain

If you have PCOS and feel like your body gains weight easily or refuses to lose it no matter how hard you try, you are not imagining it.

PCOS weight gain is one of the most frustrating symptoms women experience because it can feel unfair. You can be eating well, exercising, “doing everything right”… and still feel like your body is working against you.

But there is a reason this happens. PCOS changes the way your hormones and metabolism function, and once you understand what is happening underneath the surface, weight management becomes less about willpower and more about strategy.

Woman on the scales

What Is PCOS and How Does It Affect the Body?

Polycystic Ovary Syndrome (PCOS) is a hormonal and metabolic condition that affects women of reproductive age. It can present with symptoms like:

• irregular or missing cycles

• acne and oily skin

• excess facial or body hair

• hair thinning

• fertility challenges

• stubborn weight gain or difficulty losing weight

While PCOS is often described as a reproductive condition, it is actually much bigger than that. PCOS impacts your hormones, blood sugar regulation, inflammation, and the way your body stores and uses energy.

Two of the biggest drivers behind PCOS weight gain are:

• insulin resistance

• androgen excess

How Hormonal Imbalance Contributes to Weight Gain

Hormones don’t just affect your period. They influence your metabolism, appetite, fat storage and energy levels.

In PCOS, androgen levels can be elevated. This can encourage the body to store more fat, especially around the abdomen. This is known as visceral fat, and it matters because it is associated with a greater risk of metabolic issues like type 2 diabetes and cardiovascular disease.

At the same time, insulin resistance is common, and it plays one of the biggest roles in weight changes.

Insulin Resistance: The Real Reason Weight Loss Can Feel Impossible

Insulin is the hormone that helps move glucose (sugar) out of the bloodstream and into the cells for energy.

With insulin resistance, the body becomes less responsive to insulin. This means glucose stays in the bloodstream longer, and the pancreas produces more insulin to try and keep blood sugar stable.

Higher insulin levels do two things that make weight loss harder:

1. They signal the body to store fat more easily

2. They make it harder to access stored fat for energy

This is why women with PCOS can feel like they gain weight faster than other people, and why traditional “calorie deficit” advice often falls flat. It doesn’t address the metabolic driver that is pushing fat storage behind the scenes.

PCOS and Appetite, Cravings, and Energy Levels

Another piece that gets missed in PCOS weight struggles is appetite regulation.

Insulin resistance can increase cravings, especially for refined carbohydrates and sugar.

Blood sugar spikes and crashes can lead to:

• cravings

• increased hunger

• snacking urges

• mood changes

• fatigue

Many women with PCOS also feel chronically tired. And when you’re exhausted, it is harder to exercise consistently, harder to meal prep, and easier to fall into quick-fix food options.

This isn’t laziness. It’s physiology.

Why Losing Weight With PCOS Can Be More Difficult

Women with PCOS often have to work differently, not harder.

The challenges include:

• a metabolic environment that supports fat storage

• stronger appetite signals and cravings

• hormonal disruptions that affect energy levels

• high stress and emotional fatigue from symptoms

• inflammation that reduces insulin sensitivity

So if weight loss feels slower for you, it does not mean you are failing. It often means your body needs a different approach that supports your hormones and metabolism first.

Practical Steps That Actually Support Weight Management in PCOS

The goal with PCOS is not extreme dieting. It is improving insulin sensitivity, reducing inflammation, supporting hormone balance and building sustainable habits.

Here are the foundations I focus on with clients:

1) Stabilise blood sugar

• eat regular meals with protein and fibre

• reduce refined carbs and added sugar

• choose whole-food carbohydrates and balance them with protein

2) Prioritise strength training

Building lean muscle improves insulin sensitivity and helps the body use glucose more efficiently.

3) Support stress and cortisol regulation

Chronic stress increases inflammation and worsens insulin resistance. Gentle, consistent stress support can be a game changer.

4) Improve sleep

Poor sleep disrupts appetite hormones and blood sugar regulation, making weight management harder even if your diet is solid.

5) Personalise your plan

PCOS is not one-size-fits-all. You want support that looks at your symptoms, blood work, cycle patterns, and lifestyle so the plan actually matches your body.

Why Weight Management Matters in PCOS

Weight management is not about being smaller. It is about improving health outcomes and reducing risk long term.

Even a modest change in weight (5–10%) can improve:

• cycle regularity

• hormone balance

• insulin sensitivity

• fertility outcomes

• inflammation levels

• 
  

But the bigger message is this: weight loss should be a side effect of metabolic healing, not punishment or restriction.

Final Thoughts

PCOS weight gain is real, and it is driven by hormone and metabolic changes that are often misunderstood.

When you stop blaming yourself and start supporting the root cause, everything shifts. Weight management becomes more achievable, your symptoms become easier to manage, and you feel more in control of your body again.

If you’re struggling with PCOS weight gain and feel like nothing works for your body, I can help you understand what is driving it and what to do next.

Book a FREE Naturopathic PCOS Assessment Call, and we’ll map out the most supportive next steps to improve insulin sensitivity, reduce inflammation, balance hormones and finally start seeing progress that feels sustainable.