Symptom Spotlight: Weight Loss Resistance

Felice Gersh, MD

Hi. I am Dr. Felice Gersh, your host for the PCOS SOS Summit. I want to share some great news. I have created a course just for women with PCOS, and I cover the six most common issues that women with PCOS face. For this particular talk that I’m giving to you right this minute, I want to talk a little bit about one of the topics, one of the modules that will be part of my course. Issues of weight. Now not all women with PCOS suffer with overweight and obesity, but 80% do. And guess what? The so-called lean women with PCOS, that doesn’t mean they’re in great shape. In fact, when they do body compositions, they find that they are not in optimal shape at all. They have a significant percentage of their body as visceral belly fat, liver fat. So even when they’re thin, it doesn’t mean their body composition and their health is optimal. So even for those women, that 20%, they still need to hear this module because you don’t want to carry excess inflammatory fat on your body. It promotes not just a feeling of, you know, low self-esteem but it is metabolically unhealthy fat and it increases your risk of many cardiometabolic illnesses. And I’m going to deal with all of that in my module on PCOS and weight. It’s all about poor quality, functioning, and abnormal distribution of fat in the body of women with PCOS, both in that 20% and the majority 80% that are actually officially overweight or obese. 

Now, women with PCOS who suffer with overweight and obese and also the thin but metabolically unhealthy with high levels of visceral and liver fat, it’s really, really hard for them to lose that weight. As you probably have already discovered. That is in large measure because they have a lot of inflammation in their body and inflammation underlies so many things now that are associated with aging. And women with PCOS actually have like a condition of accelerated aging, even though they’re young and part of aging, you probably have this knowledge in terms of mothers, fathers, and grandparents. They often become insulin-resistant and develop diabetes. In fact, in the United States today and worldwide, we have an epidemic of insulin resistance and diabetes and many of these are undiagnosed. And pre-diabetes even more so. But pre-diabetes is not pre problem. Bad things are already happening in the cardiovascular system and in the brain, in the bones, and in the joints, even when it’s so-called pre, because pre-diabetes is on the spectrum of diabetes. They should just call it earlier-stage diabetes. I hate these labels because labels give people sometimes the wrong idea. So pre-diabetes, insulin resistance, and diabetes, it’s all a spectrum and they’re all really problematic for overall health in so many ways, in that includes menstrual health, reproductive health, fertility, pregnancy-related outcomes, and longevity. So it’s a host of things that are involved in obesity and visceral excess of fat. So it’s about so many things that are so important for women with PCOS. It’s about their self-esteem. It’s about presenting themselves to the world the way they want the world to perceive them. Because we know that there is a lot of discrimination against people who are overweight and obese. So there are so many different aspects longevity, health, fertility, reproduction. So many things. 

And women have tried crash diets and pharmaceuticals. And we are going to talk about all the newest pharmaceuticals, pros and cons in my module. And I’m going to now give you the tip of the day. So I really hope that you will join me for my entire course because this one module is really enough to join me for my course. Every woman lean and heavy with PCOS needs to understand what’s happening in their body with fat metabolism, and fat distribution. What is that? What does it do and what can we as women with PCOS do to lose excess inflammatory fat, not the healthy storage fat, but the really dangerous, pro-inflammatory, visceral fat? And I have secrets that I’m going to share with how to actually shed that really dangerous, not just visually problematic, but really deep down unhealthy, visceral, fat. And here now is my Tip of the Day. Stop eating early. It turns out that you are most insulin-sensitive in the morning. In fact, I’ll talk about data showing that women with PCOS who eat more of their food for the entire day in the first half of the day have much better metabolic rates and less irregular cycles. They are more fertile and what else? They lose fat better. They just have less insulin resistance if they eat their food in the first part of the day. So what does that mean about the end of the day? It means you have to stop eating early because at the end of the day and especially into the night, you are very insulin resistant. So even if you eat the same food at night that you would have eaten in the morning, more of it is going to turn into fat. You’re going to have higher insulin resistance. So your insulin level will rise, your blood sugar will rise, and insulin, which is a vital hormone, you cannot live without it. But when you have too much of it, it promotes the production and storage of fat. So the tip of the day is to stop eating at least 3 hours before you go to sleep. Preferably earlier is better. So at the latest, except for holidays or family gatherings, I know that there are exceptions. But as a general statement, try to not eat one morsel of any caloric food you can drink. You know, herbal teas all you want, but do not have any caloric food solid or fluid after 7 p.m. But if you could push it up earlier, earlier and earlier, 6 p.m., even 5 p.m. And I’ll tell you about studies where they stopped eating at 3:30, but that’s a study, but the earlier you stop eating, the better off you will be in all aspects of your health, including your weight. So I sure hope you’ll join me for the PCOS SOS course because it is going to really transform your life.