Lifestyle and Weight Loss For Teens

Ep 43. Why is it hard for girls with PCOS to lose weight?

• Dr Jenny Gourgari

Share episode

Is it normal for a 15 year old to have PCOS?

In this episode I talk about insulin resistance and the impact of weight loss on menstrual regularity in teenage girls with PCOS. 

Ornstein RM, Copperman NM, Jacobson MS. Effect of weight loss on menstrual function in adolescents with polycystic ovary syndrome. J Pediatr Adolesc Gynecol. 2011 Jun;24(3):161-5. doi: 10.1016/j.jpag.2011.01.002. Epub 2011 Mar 21. PMID: 21419674.

If you're wondering…
❓ Why are teens hungry all the time during puberty?
❓ Why are teens craving sugar all the time?
❓ Why teens feel so tired—even when they sleep?

You’re not alone—and it’s not your fault.

Hormones play a HUGE role in how teens gain weight, feel energy, manage emotions, and grow.

Dr Gourgari is a certified pediatric endocrinologist, obesity medicine specialist and health coach for teens.

Each week, she break down how puberty hormones work—and how simple habits like eating better, sleeping more, and moving your body can help you feel better, stronger, and more confident.

We’ll talk about things like:
🥗 Are smoothies really healthy?
🍞 Are carbs bad for weight loss in teens?
💪 And how to stop emotional eating before it takes over your day.

Whether you’re a teen ready to make a change—or a parent looking to support your child the right way—this podcast is for you.

🎁 Want to jump in right now?
Grab your free guide: 30 Healthy, High-Protein Recipes for Teens at lifestyleforteens.com/recipes

Speaker 1:

This is the Lifestyle and Weight Loss for Teens podcast. If you're a mom and want to help your child who is struggling to lose weight, you are in the right place. If you are looking for healthy lifestyle tips, dr Gorgery is here to help you understand the science around safe weight loss in teens and children, because what works for adult weight loss is not always the best for children. This podcast is for educational purposes only. Dr Gorgory does not provide medical, psychological or nutrition therapy advice. You should not use this information to diagnose or treat any health problems without consulting your own medical practitioner and now your host, dr Jenny Gorgery.

Speaker 2:

Hello, welcome to another episode of the Lifestyle and Weight Loss for Teens podcast. This is Dr Jenny Gorgery and I'm here today for another episode that I wanted to focus on the difficulties that teenage girls that have PCOS or polycystic ovary syndrome have with their weight, and one of the main reasons that this happens in girls that have PCOS or polycystic ovarian syndrome is because they have very high insulin resistance. Now we know that insulin resistance in girls with PCOS is part of the syndrome, and one of the medications that is given to these girls to improve their periods because often girls with PCOS don't have regular periods is metformin. So metformin is a medication that is used to improve the insulin resistance. However, as I have mentioned in this podcast, there are natural ways that teenagers can do to improve their insulin resistance, and this rule also applies to girls that have polycystic ovarian syndrome. Now, there was the great study that was done in teenage girls that have polycystic ovarian syndrome. With natural ways, by addressing their weight really, and giving them different diets, they try to improve their insulin resistance by eating better, getting to a healthier weight, and then look and see what happens to their periods, because that is the main problem in teenage girls that have polycystic ovary syndromes. They don't have regular periods teenage girls that have polycystic ovary syndromes. They don't have regular periods. So I wanted to talk about this because it is another example of how important is hormonal regulation, how important is weight management, particularly in teenagers that can have signs of insulin resistance, and one group of teenagers that have very high insulin resistance is also teenage girls that have polycystic ovary syndrome.

Speaker 2:

So the title of this manuscript is Effect of Weight Loss on Menstrual Function in Adolescents with Polycystic Ovary Syndrome. It was done at Penn State Children's Hospital in Pennsylvania. Leading author is Dr Roland Ornstein. So what the researchers did in this study is they asked 24 girls that they were between the ages of 12 to 22 years of age, that they have a history of that, they have a diagnosis of polycystic ovary syndrome and they had an unhealthy weight. Their body mass index was above the 85th percentile. And then, if you don't know what body mass index is, I encourage you to go back and listen to episode one of this podcast, where I explain what is an unhealthy BMI and how you can figure out how much weight a teenager needs to lose to be in a healthy weight.

Speaker 2:

But in this particular study, they asked teenage girls that had unhealthy weight or the BMI was above the 85th percentile to participate in the study, and they divide them into different groups according to different dietary plans. So the first group of teenage girls that have PCOS was instructed to follow a low-carbohydrate diet and the second group was instructed to follow a low-fat diet and they wanted to see what would happen at the end of the study. This was a three-month study. What would happen at the end of the study in terms of the effect of their weight, their BMI, and also what would happen in terms of their irregular periods, because that, as I said, is one of the main functions that is a problem in girls with PCOS they have irregular periods. That is a problem in girls with PCOS they have irregular periods. So for the girls that they were instructed to get on the low-fat diet, the instruction was to have no more than 40 grams of fat per day, with five servings of starch per day, and they could eat as much fat-free dairy foods, fruits, vegetables for 12 weeks, and a serving of starch was defined as having 15 grams of carbohydrates. They also gave them multivitamins and they told them to have extra fiber if they have problems with constipation. Now the other group, that was the low carb group. They were instructed to have only 20 grams of carbohydrates in the beginning, for the first couple of weeks, and they could have as much fat or protein as they wanted, and then, from weeks three through weeks 12, they asked them to have a little more carbohydrates. They could eat 40 grams of carbohydrate and they added additional low glycemic index foods, which is foods that don't increase too much insulin, such as nuts, fruits and whole grains. And all of them were instructed again to have at least 50 ounces per day of water and again they were given extra multivitamins and fiber if they have issues with constipation.

Speaker 2:

So the whole study was about three months, 12 weeks. So the whole study was about three months, 12 weeks, and during this study they also met with a dietician every two weeks that would give them recommendations and they would talk about their diets. During the study they would do also diet histories. They would ask them what they eat, they would write them down and of course they would also measure clinical findings, like they would measure their blood pressure, they would ask them about their periods, they would do their weight and things like that. So what did they found At the end of the three-month periods.

Speaker 2:

There were a total of 24 adolescents that participated in this study, 12 and 12. So it was a relatively small study. However, they found that actually both groups of teenage girls with PCOS whether they were following the low carbohydrate plan or whether they were following the low fat diet both of them had significant improvements in their weight. They have significant improvements in their insulin resistance and they have significant improvements in their belly fat, and the actual weight that they lost during this program was, as a group, on average, 6.5% weight loss. So they started on an average weight of 209 pounds plus minus 41 pounds and then, after the modification in their diet, they had decreased their weight to an average of 195 pounds plus minus 39 pounds. So this was a significant change, and the average body mass index used to be 35.7 plus minus six and it dropped to 32.9 plus minus 5.8. So really and the most striking, also at the end of the study is that they had improved in their menstrual function. These girls improved over the 12 weeks.

Speaker 2:

75% had periods during the course of this study and some of them eight of them had some degree of irregularity, which basically gives a very important message that, first of all, if it is possible, for girls that have PCOS and have high insulin resistance, it is possible to get to a healthier weight. Possible to get to a healthier weight. Number two even if you don't get to a healthy weight, even if you lose some percentage of that weight not necessarily all the weight that you need to lose, even if you lose in this particular study they lost 6%, but on average we know that if you lose even 5% of your current weight, that is significant improvement. That is so significant that can make your periods come back without any medications and that is because they improve their insulin resistance insulin resistance. Number three that is also an important point is it doesn't matter whether you are having a low carbohydrate or a low fat diet. As long as you are consistent with the dietary plan that works for you and you're getting the results you're getting into a healthier weight then that is important. That is great in terms of improving your insulin resistance, because if your overall weight improves, if your overall fat distribution in your body improves, then your insulin resistance is going to improve. Then you are going to get better cycles and you're also going to get less belly fat, regardless of whether it is a low fat or a low carbohydrate diet. This was a great study and this was only with 12 weeks of dietary plan. Imagine if you can continue doing that and you can even get to a healthier weight. How most likely there's going to be more regularity in terms of the periods, there's going to be even greater improvement in the weight. There's even going to be greater improvement in the insulin resistance.

Speaker 2:

If you are a mom who has a teenager girl that has polycystic ovarian syndrome, don't think that it is not possible to lose weight because of that. And it is a syndrome. It is not something that is not reversible. Like teenage girls can get back to regular menses by improving their insulin resistance. Of course, there are other things that are associated with polycystic ovary syndrome. They can have high testosterone, they can have acne, they can have extra hair, et cetera, and, as I mentioned, this is not medical advice. So, first of all, go and talk to your doctor. Go and talk to your endocrinologist, pediatric endocrinologist, about the specific problem of your child, if your child has PCOS.

Speaker 2:

Again, this podcast episode is not meant to give any medical advice.

Speaker 2:

However, it is education about the importance of getting into unhealthy weight to improve insulin resistance. That is true for all teenagers and even so, it is also true for girls that have PCOS. I hope this was helpful and giving some inspiration for you to get into the healthy habits that can improve your insulin resistance. Get into the healthy habits that can improve your insulin resistance and therefore you can regulate your periods with natural ways. If you don't want to get into any medications, or maybe you do need to get in medication, you can do it in addition to your medications, because that can enhance the effect of the medications that you are getting. That's all I had for you for today. If you found this helpful, feel free to share it with your friends and family and if you want to stay in touch with me, you can subscribe to get my weekly newsletter. You can go to lifestyleforteenscom forward slash newsletter and we'll be in touch and always feel free to reach out to me with any questions or topics you'd like me to talk about. Take care.

Speaker 1:

If you enjoyed listening to this podcast, I invite you to come check out the Lyft program. It's Dr Gorgeri's 12-week coaching program for teens and their moms, where we take all this information, we apply it to your daily life and we work together so your teenager learns how to create a healthy lifestyle so they can feel happier, more confident, less stressed and love their body again. Visit the website at lifestyleforteenscom and click on the Work With Me and free resources to learn more about this program and get free help to start this journey right away. Thanks for tuning in and we'll catch you in the next episode of Lifestyle and Weight Loss for Teens.