PCOS Weight Loss: Why It's so Hard and What to Do- Season 3 Ep 7 An Amber a Day

Today we're covering a highly requested topic: weight loss in PCOS!  Specifically, I'm going to cover why it actually is harder to lose weight and what can be done. 

Today's discussion focuses on the interrelationship between PCOS, insulin resistance, and weight loss. You'll learn how insulin, a hormone that cues your body to store fat, can become a barrier to your weight loss journey. We're also shedding light on leptin resistance and its role in intuitive eating, which many with PCOS find challenging. 

In the latter part of our conversation, we delve into the roles of stress hormones, chronic inflammation, and insulin resistance in PCOS. Grasp how to strike a balance between activity and rest, understand the role of food sensitivities in inflammation, and realize the importance of breaking the leptin resistance cycle. 

You'll also learn why measurements and progress photos can be more effective for tracking body composition changes. 

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Transcript

Speaker 1: 0:43

Welcome back to an Amber Day. I'm your host, amber Fisher, and today is the topic of all topics we're talking about weight loss in PCOS. So first of all I just want to do a few little disclaimers. You know, because this is a sensitive topic, I feel like it's my responsibility as a trained nutrition professional to give you all the information that I know. I also like to share with you guys the information that I've sort of gathered over the years, anecdotally, and I know that weight loss is a topic that a lot of us, you know, struggle with. It's something that like we're really interested in but we also sort of feel maybe embarrassed about being interested in, or we feel like it's not okay to think about weight loss, or we feel like we're obsessed with weight loss. So it's just a tricky topic because you know, on the one hand, as a nutritionist you can dip very quickly into diet culture and I hope nothing I say today does that. I'm just going to try to lay out the facts and be honest. But on the other hand, I also don't feel like it's responsible for me to not talk about something as important to people as weight loss just because it's something that a lot of us sort of either feel that we need to do or our doctors are telling us we must do, and we do know that in some circumstances weight loss is something that will be helpful for our health. It can reduce pain and increase quality of life with energy and things like that. So there are some benefits to weight loss in certain situations. But I do also know that a lot of us with PCOS are coming from places where we have histories of disordered eating, things like that, and so talking about weight loss can be triggering. So if that's you, you may not want to tune in for this one, and that's okay, I love you still and I will see you next week. Well, next week. This year the podcast have not been coming every week, and you guys know. But next time we have a podcast I will see you. But for those of you who stick around, what we're going to talk about today is why weight loss in PCOS is difficult because you're not crazy, it is harder, why that's happening, whether the scientific reasons for that, what are the underlying sort of things going on, and we're going to talk about kind of the pillars of PCOS nutrition and lifestyle that help with weight loss and why that works, so that, ideally, my goal by the end of today's podcast is to get you to switch your mindset a bit or reframe your thinking from hyper, focusing on the weight itself and even body composition in general, and moving more towards looking at the deeper reasons why someone with PCOS struggles with weight loss. Focusing on those things Because this is off. This is root cause nutrition, right. So the goal is to get us deeply down into the body as we can, and things like weight, things like hormones, should improve with time if we can do that. Okay, so that's the goal for today.

Speaker 1: 3:55

I have the very best of intentions but again, as I said, this is a triggering topic, so bear with me, be patient with me. All right, so let's well. First of all, I want to say a couple of things before I get into everything. So couple of little updates on me and what's going on in my sphere. You guys probably know I've been taking a little bit of a break. You know my, my executive functioning is not what it used to be pre pandemic. I don't know if it's.

Speaker 1: 4:24

I had a child in late 2019, like I had a hysterectomy, so I've been through menopause. A lot has happened to me in the last four years and it's been a little hard on my brain and so that's been tough because I always used to be somebody who was like very, very, very good at remembering details. I had probably the one of the best memories of anybody that I've ever known. I think it's part of the reason why of how I got to where I am, with just knowing facts and knowledge and things about PCOS, because I just absorb stuff like a sponge and that that's not necessarily the case anymore. I still have my old knowledge and I can build new knowledge, but it's different.

Speaker 1: 5:07

You know, I forget things more. I'm just like in my day to day life I'm a little bit more forgetful, foggy, that kind of thing, and so and also a little overwhelmed, honestly. I mean, I'm running a full time practice, got to my business, I have all this social media stuff and just different things, so there's a lot of my play and I'm a mom and so I sometimes have to take a step back from from stuff that's a little too overwhelming. And social media is kind of one of the first things that just wears on me because it's the necessity of posting so often. You know it's like if I don't post often enough, then my content doesn't go anywhere and it sort of feels like what's the point of making this if nobody's going to see it? Then at the same time, you know I'm posting all the time and it's just so much, it's a lot of pressure and so sometimes I just, sometimes I just have to stop for a while. So I took some time off in July. I'm getting, I'm gearing back up and the goal is to get more organized for the fall I'm having. I hired some people to help me a little bit with organization and stuff. So we'll see, but that's the goal there.

Speaker 1: 6:25

The other thing that's going on is that Hannah Mule, who runs the conscious nutritionist, you guys know I've run a group program with her for the last little over a year. We've run, I think, four or five programs together and we work really well together, hannah and I. You know we have complimentary strengths and so we want to continue doing that. But we're going to change the format up a little bit. Hannah is announced recently that she's pregnant and so we don't have much time left before she's probably going to take some time off, obviously to maternity leave and stuff like that. So we are going to run one more program this fall, kind of a back to school, get ready for PCOS type of deal, and it's going to be a little shorter than our normal program. Our normal program is about 12 weeks, so this one we're not.

Speaker 1: 7:20

We haven't done the full planning yet, but we're looking at something shorter, probably maybe around four weeks, something like that and it's going to be more condensed but kind of like the really important information that you need. We're going to cut out some of the extra stuff that maybe isn't as important but is kind of interesting to have. We're also going to condense down how often we have meetings and so we're going to have the meetings more frequently so that you can still get a lot of the information. It's still going to come with meal plans and all that, and everybody who's done the groups has had a great experience. To my knowledge, I have a lot of positive feedback. I haven't had any negative feedback yet. Let me say that. So we've had a really good time running them and really, really enjoyed it. So we want to keep doing it.

Speaker 1: 8:07

Anyway, we're going to run this group. Since it is going to be shorter. The financial cost, the cost to enroll, is going to be a lot less than previous groups have been, so it may be a little bit more financially feasible for you. If you had wanted to join one of our groups before but felt it was too expensive for you at the time, this may be your lucky fall, so I'd love to see you If you are interested in that. We don't have any of the like, specific like. We don't have the sales page up yet or it's in very early stages of planning. So my suggestion would be to make sure that you're on my email newsletter list. You can join that by visiting my website, and then I would also say if, for some reason, you have issues there, just send an email to the podcast and Amber a day podcast at gmailcom and we can get you on the waiting list or what have you. But yeah, I would love to see some of you guys there. I love to meet podcast grilies Anyway.

Speaker 1: 9:17

So let's get into today's topic and talk a little bit about Hoyt loss in PCOS. I'm going to pull up some stuff that I made here to keep me on topic. Okay, so the reason I'm doing this podcast today is because currently on Instagram and TikTok I'm running a little PCOS myths series. So I sat down and I wrote out all the things I could think of that I hear people say sometimes and I'm just like, why are people still saying that? Like that's not true and just stuff. That kind of gets on my nerves. And I think I talked about some of my controversial opinions in the last podcast as well, if you're interested in that.

Speaker 1: 9:59

But one of the big ones that I wrote down was weight loss related, because I'm always hearing people say that it's impossible to lose weight with PCOS. It's just like you're just doomed to keep gaining weight or to at least to stay the same weight. Like it's just not even worth trying because it's totally impossible and it's PCOS is fault. Like the implication is that you have PCOS, you know, and that's just. It's just something you have and there's nothing you can do about it. And so you know, one of the things that it does is it makes you gain, gain weight, and it's like it's a very.

Speaker 1: 10:33

The concept is like blaming, the like as if you have a disease and you blame the disease. It's like a side effect of the disease that you, that you're overweight, kind of similar to to hypothyroidism, right, it's the same concept like your thyroid's not working well and that prevents your body from from managing weight properly, and so you're overweight because of your thyroid. But with PCOS there's no like magic pill or drug, you know. I mean, besides metformin, ozimpic stuff like that can be helpful, but that's another topic for another time. There's really nothing that like taking thyroid medicine can help with the thyroid. So that's the concept. There's truth and myth in that.

Speaker 1: 11:19

So if you have felt like it's impossible for you to lose weight, if you've really struggled, if it's been like you gain and gain and it seems like you gain faster than other people, there's nothing that you feel like you can do. You're not crazy. There is truth in that it does. Pcos, especially uncontrolled PCOS, makes it very difficult to lose weight, very easy to gain weight. So if you live a lifestyle where you eat a you know, weight loss friendly diet I don't know 80% of the time, but 20% of the time you don't think about that and you you know, I don't know eat whatever, then if you're more prone to storing body fat, you could store more body fat during that time and simultaneously lose less body fat during the times when you're not, when you are, you know, paying attention, leading to equilibrium right, leading to not dropping anything at all or sometimes, depending on you, know what's going on, gaining weight. So you're not crazy, it's not a weird concept Like, it's not totally untrue. I guess that's what I'm trying to say.

Speaker 1: 12:32

It absolutely is more difficult to lose weight with PCOS because of factors outside of your control. However, there are solutions to those issues. So the things that cause it to be difficult to gain, to lose weight in PCOS, they do have some nutritional solutions or some nutrition methods that are effective for improving them. So let's talk about what some of these things are today and we can, you know, go down the list of like what the underlying factor is, why it's affecting you and what you can do about it.

Speaker 1: 13:44

So the difference between someone with PCOS and someone without PCOS on a weight loss journey is that, without PCOS as a factor, you cut your calories. Your body responds by dropping body fat because it's not getting enough to eat, so it'll eat its own fat cells and that's basically how it works, right, and it works pretty well if you're pretty disciplined. And this is why so many people who have lost weight point the finger at those of us with PCOS and kind of like make it, make it, they make it our fault Because they're like well, I've done it and I've seen lots of other people do it and all they had to do is be disciplined. And you must not just not be disciplined, but if you've ever truly tried to lose weight with PCOS, you know that even if you're disciplined, you might be able to lose some weight, but you stall out like it's really. It takes a long time, goes a lot slower and it's just a really frustrating experience which does lead to less compliance with programs and things like that. Because, like, who wants to stand something? That's not working right. So the normal person without PCOS is going to just eat less. Their bodies can respond by losing weight.

Speaker 1: 15:11

Unfortunately, in PCOS we have all these conflating, confounding comorbidities, all these little factors that get in the way right. So we have the biggest issue, which is insulin resistance, but we also have something called leptin resistance that's based off of that insulin resistance. We've got stress, hormone craziness, we've got chronic inflammation and, paired with that, sometimes we don't have a good grasp of what our caloric needs are or our activity needs are, and that can impact things. So you just have more opportunities to not be aligned. Basically, with PCOS, there's more factors fighting against you than somebody who doesn't have PCOS, and that can make it very difficult and can make you want to give up, and it can make you make it very difficult for you to figure out, like, exactly what path to go down.

Speaker 1: 16:15

The other thing that I think I won't probably talk a ton about is just energy. You know a lot of us with PCOS because of these other issues, and each one of them can cause energy issues, honestly, but we tend to be a little bit more tired than the average person and that makes it hard to motivate, like you know. I mean, I relate to that so much, especially just the way my life has been the last four years where I've been doing everything the same, but also being a mom, like it's been tough to keep my energy levels high enough to focus on me at all, and so you know, having energy is kind of a precursor to like being motivated. You have to have that energy first in order to actually get up and do anything and make changes. And the frustrating thing about energy, too, is that sometimes if you get up and you move and you go like I don't know, go do some exercise or whatever you feel better after. You have more energy after, but then the feeling fades and you have to keep doing that to get that feeling and it's just that initial motivation to get up and do it. That's really, really tough and it is a little bit worse in PCOS than in your average person and so that makes it tough to motivate, right. But let's talk about some of these other factors.

Speaker 1: 17:41

So first we'll go over insulin resistance. I know I've talked a ton about this before, so if this is your first podcast here, I'll give you the basics, but I would highly recommend going backwards and listening to some of my specific insulin resistance podcasts. I have several of them. By the way, guys, I'm putting this podcast together the day before I'm going to actually post it, so I probably won't have time to do like a ton of editing like I normally do. So bear with me on the ums and the pauses. This is how I talk, but I usually edit it out so that it's not such a frustrating listening experience for you. But I'm not going to have time to do as much of that with this particular podcast, so bear with me, okay. So insulin resistance. I've done lots of topics on this before, a lot of podcasts on this before and lots of Instagram content for sure on this.

Speaker 1: 18:40

All of us with PCOS are dealing with some level of insulin resistance. This is pretty much across the board, like there's really very little evidence that folks with PCOS don't have some type of insulin resistance. What's often happening if you don't think you have insulin resistance is that it hasn't been measured properly for you. Most people's blood work that they get is like so base level. It often doesn't show PCOS insulin resistance, because PCOS insulin resistance can sometimes be in earlier stages or it can be something called hyperinsulinemia, which is where we have high insulin levels, but it doesn't necessarily affect our blood sugar. So the early stage, earlier stages of like insulin resistance are your body making enough insulin, so it's bringing your blood sugar down the way it needs to, so that on paper it looks normal, but actually it's that excessive insulin that's causing all the problems. So you know that's the issue.

Speaker 1: 19:37

Now, how it affects weight loss and weight is that insulin is a fat storage hormone. So your body, when it has a lot of extra insulin, it's going to prefer to store fat over anything else. So we know this. If you look at you know there you can look up PubMed studies on, like the insulin carbohydrate model theory of obesity, for example and this is not unique to PCOS. This is something that many different chronic health conditions deal with.

Speaker 1: 20:12

Anything that's got any sort of insulin base. You know, diabetic conditions, things like that, and a lot of obesity issues surround this sort of phenomenon, where the calories don't matter so much as the composition of the food itself, because if the food that's being consumed forces the body to make more insulin than you know your average person, then you are going to prefer to store body fat over somebody who doesn't have insulin resistance. And so what happens over time is that you know you got to eat every day, right, and so life goes on and you're making too much insulin and so you've always got this extra little bit of preference for fat storage. So if you're eating more than you need, you're going to store more than you need of body fat, and we'll get into calories in a little bit, because calories are complicated. It's not as simple as like calories and calories out like that. That's been debunked. I don't.

Speaker 1: 21:26

You know, most of the time you're going to hear that kind of information from, like personal trainers and fitness bros and stuff who don't have a deeper nutrition education. They just kind of have like a base level of like performance level nutrition education. But this has long been debunked that it's all calories and calories out. It's really not how it works, because hormones and other factors do play a role in weight composition. So we'll talk about calories in a little bit. But one thing that you should know is that they do matter some. It's not like they don't matter at all.

Speaker 1: 22:03

If you overeat, your body is going to have to do something with that material and it's going to put it into fat. So the problem with insulin resistance is that you're already prone to that. So then if you overeat, it's like you're really prone to that. Everything's amplified. Your experience of fat storage is amplified versus somebody else, and so even when you cut calories, if you're not also accounting for insulin resistance, then you're still going to struggle with your body having that insulin and wanting to store it as fat. It's like looking to store it as fat, whereas somebody else who doesn't have insulin resistance their body might not do that, and that can be a real bummer.

Speaker 1: 22:50

I can just tell you right now I mean, you guys can't tell what I look like on the internet, I'm only showing you from the waist up, but I do carry my body fat in my middle. I've struggled with my weight my whole life. I've been a yo-yo'd over the years depending on what was going on, and it really wasn't until I got a good basic understanding of insulin-friendly eating that things started to really stabilize for me and I found that I'm not the thinnest person you've ever seen in your life for sure. I'm a very average size, but it's a healthy size for me and the real key is that it doesn't shift and change a ton, so I'm not gaining 40 pounds in a few months and then having to lose that and then regaining and yo-yoing and stuff. I'm stable and that's what a good understanding of insulin-friendly nutrition can do for you can help you stabilize and even if you need to drop some weight. So insulin is a fat storage hormone. Your body's going to prefer to store fat when it's got too much insulin in the system.

Speaker 1: 24:11

Insulin also throws off your hormones because it's insulin really that does a lot of the triggering of the testosterone. So insulin is kind of the trigger that tells your ovaries to make too much testosterone and then the testosterone's where a lot of your PCOS obvious symptoms come from your facial hair and hair loss and all the acne and things like that. They're oftentimes driven by that high androgen level or the high testosterone level and that's triggered by the insulin. So those things, those downstream things, those hormone imbalances, can also lead to some issues with weight maintenance and weight gain because you can start to get kind of estrogen dominant over time. I'm pretty sure there's a podcast on estrogen dominance that's too complicated to go into today, but you can get kind of estrogen dominant over time. You've got too much estrogen in your system. Your body doesn't like to let go of fat. It's like it kind of feeds the problem.

Speaker 1: 25:12

So not only is controlling insulin important for controlling weight but it's also important for controlling that excess hormone production that causes all the other PCOS symptoms. So that's the good thing and the bad thing. It's kind of a. It's a double-edged sword, because it's good in the sense that you focus on one thing. You make big changes to a whole range of things. It's bad because if you don't focus on that one thing you're not going to see much movement and unfortunately a lot of the information that you get out on the internet at large is not going to be super insulin friendly. A lot of the things that your friends and family have done to lose weight are probably not going to be super insulin friendly and they may not work well for you, and so it can be confusing.

Speaker 1: 26:03

And you know the other, the other downside of it is like you got to do something about it, but you, unfortunately, with PCOS, we have this like the burden of, of action, right, like I guess technically we could not do anything about it at all and just sort of accept it, and there are some people that do that. But if we want to feel any semblance of like just decent, then we often have to do things that other people don't have to think about. You know, let me give you my husband, for example Cool, six foot three, just a little skinny rail. He's never, ever and he's we're, we're in our mid thirties now, so he's starting to kind of, you know, start to get a little dad bod. But he's always been so thin and it really truly doesn't matter what he eats.

Speaker 1: 26:57

And we've run experiments before because I'm like I love to run experiments. Okay, so we've run experiments before where we've eaten the the the same thing, but like adjusted for our uh, bmis or whatever. So he's a little taller than me, so obviously he's metabolic rate is higher. But I used to have this body scanning. It's like professional body scanning machine that would give you a really accurate BMR. So basal metabolic rate, by the way, is what that means, which is the minimum amount of calories that your body needs to sort of function. So we'd run these experiments where we would eat according to that, but basically eat the same stuff, eat the same amount. I'm five, eight, by the way, so not too much shorter than him.

Speaker 1: 27:42

Anyway, you should have seen the craziness that ensued. I mean my body if, if I'm not just so careful with, with, kind of how I feed it, it does not respond the way you would expect. It doesn't respond according to the math, and I think that's the case for most of us with PCOS. We can run all these online calculators do my fitness pal, the weight watchers, whatever and let them tell us how much of this and how much, how many calories, we need to eat. But at the end of the day, our bodies don't work the same way as other people's bodies and if we're not accounting for those, those differences, we're not going to be very successful. So it was just funny because it would be like we'd go, we'd get like about the same thing. I'd always eat a little bit less than him, but you know essentially the same thing and I would gain weight very rapidly from you know some of this stuff and not a not a thing would happen to him. So lovely, we just love that for me. But I know you guys can relate, so that's why I tell you that personal story.

Speaker 1: 28:57

But yeah, insulin resistance is is what's going on with that? And that is a commonality across even people who don't have weight issues in PCOS. Most of them are dealing with insulin resistance as well. It's just there is kind of like there can be some genetic changes to how much fat storage your body prefers. There is a subtype of insulin resistance where they're really thin and they struggle to put on weight, but that's a topic for another time. That is not what we're here to talk about today. Okay, so that's insulin resistance, and insulin resistance can drive this other issue that I want to talk to you about, which is leptin resistance, and leptin resistance is. Leptin is a hormone that tells you what you want to eat and it's a hormone that tells you when you are full. Have you ever had any trouble with that. So I definitely have personal experience with this and also see this with my clients quite a bit.

Speaker 1: 30:00

With PCOS it can be so hard to know when you've had enough, when you haven't had enough, when you've had too much, when you've had just right. It's so hard to know intuitively from your physical body signals if you're not eating too much food or not eating enough food. Why is this? Shouldn't it be easy? Shouldn't our body just tell us oh, you're full, stop eating. That would be lovely if that was true, but unfortunately that's not what happens oftentimes in PCOS, because we're dealing with this thing called leptin resistance. This is where we get into talking about kind of the overall concept of intuitive eating, or at least how people think about intuitive eating and why it sometimes doesn't work very well for PCOS.

Speaker 1: 30:50

Because if we're only listening to hunger cues to tell us when we're done eating or when we've had enough, oftentimes in PCOS our hunger cues are warped. We won't be able to figure out the right equilibrium with that. We have to use other cues to know when we are full or not full. That's because of leptin resistance. When we have leptin resistance, it's similar to insulin resistance. Our body doesn't listen to the signal from leptin. It's not listening to that signal that's saying I'm full, it's resistant to it. So the body is making more leptin and then, over time, you start to get this warped, like your brain's, like I don't know how much leptin we need to cue us, that we need to stop eating. The way it plays out practically in your day-to-day life is just. You probably will feel full slightly later than someone who doesn't have leptin resistance, but that can build up over time, because, if I like to use the example of cheesecake factory, this is where my leptin resistance comes out.

Speaker 1: 32:06

I love the cheesecake factory. This is my theory on cheesecake factory. It's like the most American restaurant. I think people talk about burgers, fries. I mean they have burgers and fries, but the cheesecake factory is America. It's just so over the top. It looks like Disney World. The menu is so insane. It's America guys. Anyway, the cheesecake pieces are like the size of your head.

Speaker 1: 32:39

You go to cheesecake factory, and person without leptin resistance will probably get maybe halfway through a piece of that cheesecake and be like nope, cannot keep going, I'm getting sick, I feel physically ill. Someone with leptin resistance, though, won't get that cue right away. They may get three quarters of the way full. They may eat the whole piece of cheesecake and only afterwards would they feel like, oh my gosh, I really feel nauseous, I feel sick, I ate too much.

Speaker 1: 33:10

Whatever that's what leptin resistance does is it slows down your reaction to those cues. You don't know when you've had enough or when you haven't had enough. That is so difficult when it comes to weight loss, especially if you're trying to do it in an intuitive way, because we hear all the time that it's not mentally healthy it's a count and to count carbs or count calories or this or that, or have too much structure, because that can be triggering emotionally, mentally. On the same token, if we don't do that and we have leptin resistance, sometimes we really struggle and we end up gaining weight without really intending to, because we don't know what's too much, what's not enough. It can be really really tough. My solution to that, to leptin resistance, is a combination of factors.

Speaker 1: 34:05

I think it's helpful for folks with PCOS to have, if possible, a professional create a structure for them at the beginning. I don't have my clients count calories and count carbs, but I do that for them when I create a meal plan for them and I give them a template, basically, of how many servings a day do I want them to have this category, that category? I break it down across categories where I've already done the math of this is how many carbs-ish a day I want this person having. This is how much protein I want them having. This is how many calories I want them having. All that kind of stuff I just incorporated into that structure of telling them how many portions they have the structure of saying I know I need to eat this many portions of meat, I need to eat this many portions of vegetables, I need to eat this many portions of grains, and this is how I'm going to spread them out throughout the day, because Amber doesn't want me having all of them at one meal or whatever. That's the specificity that I get into with them. But their experience of it is, if they follow it, they just know I'm eating this portion of this, this portion of that and at the end of the day it's going to add up to what is ideal for the body.

Speaker 1: 35:25

If that's possible for you, I think that's really really helpful at the beginning because you just may need an outside objective perspective to tell you you can do that work on your own. You can figure that stuff out on your own. There are enough free tools online to do that. But it gets a little complicated if you don't have the training and how to do macros and how to figure out how many calories you need and all that kind of stuff. I do cover all of that in a good amount of depth in both of my courses. So if you're new to PCOS and you're new to eating for PCOS and for the root cause, you would probably like PCOS Foundations my course first, because that's kind of my intro to PCOS course.

Speaker 1: 36:17

It's not surface level information, it goes deep. I want to say it's got five or six hour long video modules on specific PCOS topics so you get a lot of information. But it's kind of a four week meal plan, like the meal plans, organized to kind of help you start understanding portions a little bit better and it's a good place to start and I only charge $49 for it. So it's a good value if you're just getting started. But if you are beyond that a little bit and you've been doing PCOS nutrition for a while and you want to get even deeper with it, there's a big weight loss section in functional PCOS, which is like my kind of more intense in depth course. So if those interest you and you want a little bit of a little bit of that information but you're not ready to hire somebody to do it, then check them out.

Speaker 1: 37:18

But I think it's helpful at the beginning to have a bit of a structure so that your brain can get used to that structure, because over time if you kind of eat like this, similar portions and amounts of stuff, you start to get used to it and you start to expect it and that's kind of like you know, this is what I eat, right. So that's helpful at the beginning. And the other thing that I find helpful is accounting for the PCOS pillars of nutrition first, which we're going to get into, and then pairing calories on top of that. So insulin resistance is the first pillar, right. And if we eat a diet that's friendly for insulin resistance and we pair in appropriate amounts of calories based on calculating your basal metabolic rate and all that stuff, the pair of those two things can be very effective for weight loss. But it has to be together, Because if you're just doing calories, it may work for you for a while but it's probably not going to work as fast as it could and blah, blah, blah. So how do we eat well for insulin resistance. How do we support that?

Speaker 1: 38:34

The biggest things with insulin resistance are making sure that you are eating a low glycemic diet. So if you go and Google, like glycemic load, glycemic index of foods, you'll see charts with rankings of what the glycemic index or the glycemic load is of these foods, and there's a difference between index and load. Glycemic load is the score based on what you would probably eat, like what a typical portion size is, whereas glycemic index is based all around just the original. I think the first thing that they ever glycemic index was like a slice of white bread or something. So you look at the glycemic index versus load of carrots, for example, and glycemic index of carrots is really high, but the glycemic load is pretty low because most people are not going to eat however many grams of carrots at one time. They're probably going to eat a different amount because of the fiber Anyway. So glycemic load is a little bit more accurate. So I recommend that one, but glycemic index can be helpful too. Anyway, if you look up charts on that, you can find scores and rankings for different foods that can help give you an idea of what foods to prioritize. So prioritize the lower index foods and what foods to limit higher index foods.

Speaker 1: 40:05

That's a great place to start. Another great place to start is with a Mediterranean diet. That's got good positive research for PCOS and it's a great starter diet. I have a podcast on how to do it for PCOS as well. The other things to consider are increasing your fiber amount and increasing your protein amount. Fiber is gonna have a lot of benefits for your health, but the main one for insulin resistance is that it slows down digestion and the slower you digest stuff, the less insulin you need to pump out at any one time. So it helps with that. Protein does the same. Fiber and protein also fill you up faster and keep you full longer, and that prevents overeating. So the more protein, the better, the more fiber, the better. Protein needs are very different across people, but I generally say like try to aim for about 30 grams at each meal. Sometimes that's hard to do at breakfast, but other meals it seems to be pretty doable. Generally like around 100 grams a day tends to be good amount for weight loss, but again it's different person to person.

Speaker 1: 41:18

And then balanced activity levels. I mean you're not probably gonna get too far working on insulin resistance if you're not increasing your activity. And there was a time when I was very pro only strength training and like light walking and no cardio whatsoever. My opinions on that have shifted a little bit because I have seen that like if there's a type of cardio that you really love, that really makes you happy, and you can do that kind of cardio regularly, that does really tend to help with insulin resistance. So a good example would be I've been taking salsa lessons for a while now and it's cardio, it's pure cardio. There's not a bit of strength going on with it, but it's so fun. It relieves stress because it's fun and I enjoy it. It keeps me motivated and I keep going and it has helped with my insulin levels, my insulin resistance. So choosing some strength exercises is probably the most important because those are going to impact your insulin resistance longer term. More muscle mass helps with insulin resistance and having enough strength training in your life will improve your insulin resistance like 72 hours, I think, after a strength training exercise or strength training day. So it helps longer term with the way that you process insulin.

Speaker 1: 42:52

But having daily cardio is also important, and so if you're just getting started, walking is great, but also consider looking into something that maybe you've always been a little scared to do, but it's always something fun. Like that's dance for me. I've always wanted to do it, but been a little nervous too, because I don't want to embarrass myself. But you never know, until you try, if you're going to be good at something, and sometimes when you get involved in some sort of community, it keeps you a lot more motivated. I've found that to be true for myself when it comes to pole. You guys know I've been doing pole dance for the last two years I'm at a high intermediate, almost advanced level now solely because I made friends at the studio and it was fun to go because of those people. I mean, I like doing it too, but I don't know that I would have been motivated to continue if I hadn't felt like I was part of a community and that there was something to strive for. And same thing with dance. It's like I'm building a community, there are levels that you work up to and it's fun. So see if you can find something like that.

Speaker 1: 44:08

Exercise doesn't have to be just like this horrible thing that you just hate doing and unfortunately a lot of stuff even at like the gym, even classes at the gym and different things like that. It can be kind of unmotivating. The other thing that's worked really well for me long term is I hired a personal trainer and I've been seeing her once a week for the last five years, so that helps as well. I don't love going, but I feel guilty. My guilt keeps me going, so guilt can be a good motivator too, guys. Anyway, balance activity levels are really key for insulin and so whatever sounds better to you at the beginning like changing your diet, changing your activities pick one, start there, then kind of incorporate more Diet-wise carbohydrates, especially simple carbohydrates that don't have a lot of fiber, so pasta, potatoes, bread, that kind of thing. It is worth limiting them, especially if your insulin resistance is not in the best place. You may find that you need to limit them a little bit more at the beginning to kind of get things moving. But those are my general recommendations. Like I said, I have some more specific podcasts that go more in depth on insulin, and same thing with the next two pillars. So we've talked about insulin resistance, we've talked about leptin resistance.

Speaker 1: 45:33

Let's talk a little bit about stress and how that impacts your weight. So those of us with PCOS tend to have higher than normal levels of stress hormones, particularly cortisol. And just like insulin, cortisol is a little bit of a. It's not that it's a fat storage hormone, but we do tend to store more fat in our bellies when we have a lot of cortisol, and so that contributes to the sort of like PCOS apple shape sort of thing which a lot of us get really frustrated with.

Speaker 1: 46:09

Right, with stress hormones, the major issue with those is that they can make us more insulin resistant. So what happens is when we produce a lot of stress hormone, it tends to cause our body to surge out some sugar. So we store sugar in our muscles and our liver. We keep that there for a rainy day, like we keep that there for it's a primal thing. Let's say we're getting chased. Right, we need to pump out some sugar to get our body some energy so that we can run. That's the concept. Well, in our modern world, of course, we don't necessarily need to run from our stressful triggers, but we do get a lot of stress triggers and our brain doesn't really know the difference, and so we'll be pumping out sugar. And guess what happens? When we pump out sugar, we're going to pump out insulin as well, right? So we get this sort of thing where we get stressed, our blood sugar spikes and then we make more insulin and that contributes to that whole insulin fat storage thing that we talked about before. So that's the major issue in having high stress hormones. It kind of increases that resistance.

Speaker 1: 47:28

So it is key especially if you are going to start a whole new exercise program and things like that it is key to also balance it. That's why I say balanced activity, because you can overdo it. You can do way too much, and with PCOS sometimes it's hard to find the balance of what's not enough, what's too much. But generally boot camp type situations are not ideal. They tend to be really stressful. Anything where you're having to wake up at the absolute crack of dawn or like before dawn, that can be too hard on your adrenals. Some of us don't have the option right. So I know some of you have to work long hours and you don't have the option to do anything but exercise before work. In that case I would be judicious about how many days a week we're doing that right and not do it every day.

Speaker 1: 48:24

But sleep is so important. Sleep is almost just as important as activity for balancing insulin, because if you're not getting enough sleep you will be more prone to overeating the next day. It makes you crave sugar and then it's going to also contribute to that sort of cycle with insular resistance. And so getting enough sleep, balancing out your life with enough rest, having firmer boundaries, is something a lot of us struggle with, but that can help a lot. And then mindfulness. There are some good research that shows that mindfulness whatever type of mindfulness you want to do can be helpful for PCOS and kind of reduce inflammation, make insulin resistance better. It's really interesting.

Speaker 1: 49:13

Try practicing being where your feet are. That's a new thing that I'm working on. Be where your feet are. So you know, we're always kind of in our mind right, daydreaming Often another world, thinking about the past, thinking about the future. Instead, every time you catch yourself doing that, try to be present here in the moment. Be where your feet are. What a daydreaming thing it is. The stress-friendly lifestyle is like tough to talk about in just a few minutes because it's it gets really deep into like psychology and you may need to see a therapist right To help if you've got like trauma history and things that can make us more prone to those stress spikes. So there's a lot to it. I'll refer you to some of my Adrenal podcast episodes to learn more about that.

Speaker 1: 50:05

If we go full keto and join the Gladiator Bootcamp program, that may help for the first month or two we may lose some weight, but long-term we're going to develop probably a really awful weight loss resistance from that, because that's going to be a recipe for a yo-yo. Every time you yo-yo it seems to get more difficult on your metabolism. So avoid doing that. Avoid pushing yourself too hard. It's really all about balance. The other thing I will say with this, especially if you're kind of like getting motivated to do new things, is balance. Is Balance is really dependent on where you're starting from.

Speaker 1: 51:00

So if you don't exercise at all, please don't force yourself to go five days a week. You won't stick with that long term. Maybe you will, but most people won't stick with that long term because it's just it's too much too soon. Go where you are and build from there. So if you're not active at all, maybe try working on one thing at a time, whether it's it's frequency of movement or it's time of movement right. So you go three days a week for 20 minutes, or you go five days a week for 10 minutes or something like that. You know however you want to do it, but it's just about starting small and building and don't be discouraged that you have to do that. That is really the key to long term success. So that's how stress impacts things. Now inflammation impacts things by also making insulin worse. It can make stress hormones worse. So then we call comes back to the insulin. Right, but chronic inflammation is also, I think, connected to weight loss resistance, particularly so.

Speaker 1: 52:16

I've had situations where I've had people on a really very well aligned diet, like it should have worked, but they were eating a lot of a food that they were sensitive to and they weren't losing weight, even though everything else was aligned. And this is like coming you know professional nutritionist plan which, to be fair, like I'm not always 100% on the money like nutrition is a practice, it's a, it's a, it's an art and a science. So I'm not always perfect, but, you know, sometimes I'm like, okay, what's going on here? And it's it's ended up being one of two things either the person has insomnia, doesn't sleep enough I've seen that before or they have a food sensitivity, and so oftentimes it's dairy or it's eggs, because those are things that we tend to eat more of when we're on, like any sort of weight loss plan. Dairy because it's delicious, but it doesn't Supposedly won't impact our insulin that much, right, and it makes our kind of lower caloric food taste better. And eggs because they're an easy breakfast right, and so it's an easy entire protein, like it's better than having pancakes or whatever. So, but those are common food allergens and that's not to say that just because you have PCOS, you shouldn't eat those foods. Go back and listen to my like should you be gluten and dairy free with PCOS podcast? So I'll give you a little insight. But you know they are more foods that we are more likely to be sensitive to if we have a food sensitivity. So if you find that you're relying a lot on a certain food category, particularly those two, rethink that maybe if you, if you feel like you've got everything else aligned, because what could be happening is that that could be triggering some inflammation and then the inflammation makes your body resistant.

Speaker 1: 54:10

I always tell people that it's kind of like the concept of your body needs to feel safe to let go of weight because weight is a safety mechanism. Well, fat is a safety mechanism. So body fat is your body's way of preparing for potential starvation for winter. You know your body is a very primal system. So when your PCOS body wants to prefer to hold on to body fat, it's trying to protect you, it's not trying to harm you, hurt you. And that mentality shift if you can make that shift from being angry at your body to understanding that your body is doing its best with its limited resources to protect you, it can really help a lot. Because it can be so discouraging when you think that your body is like against you, but because your body wants to keep you safe. If your body is chronically inflamed, you know it can be like do we have an infection? Like something? We need the fat. Because if we don't have the fat, then what are we going to do? Right? And so it can resist letting go of weight even though you know you're you're eating low calorie or you're eating low carb or whatever. So that's how that can work.

Speaker 1: 55:34

Also, the bacteria in your gut play a big role in how insulin sensitive you are. So the bacteria in your gut play, I mean, they're just hugely important for, like everything Gosh, there's so many things I could go into on the gut that I just won't even touch because it's like such a complex, beautiful system. But it does play a big role in your hunger signals and cues how insulin sensitive you are. Like the gut is really the center of all of it. I think the guts even more central than the insulin responses. So when we want to get into like genetics and the reasons why our genes are expressing a certain way, we go back to the gut more because we can change things a little bit more from there.

Speaker 1: 56:19

So we have to make sure that our digestion is in a good spot, because that's a good general indicator that our gut is in a good place. Not always it's not 100%, but and we need to also think about doing things that are going to lower inflammation. So that would mean more unprocessed foods, eating more fiber too, because that's going to feed good gut bacteria. More omega threes, which are they come from, like fatty fish, like salmon. Those are very anti inflammatory. And then less advanced location in products, ages, which are. You know when you, when you cook like meat or something and you caramelize it and it gets like so delicious and like caramelized on top, that's an AGE. So trying to avoid that as much as possible. You know, baking steaming things more often can be helpful and but mostly try to work on your food sensitivities if you think you've got them, because if, if you have really poor digestion, you're pretty sure you've got food sensitivities, you're like lactose intolerant, whatever.

Speaker 1: 57:28

You probably need to do a lot more focus on your gut health than you do even on your insulin Not always, but that's what I've seen. So those are the three sort of pillars of a nutrition PCOS nutrition, healthy lifestyle and if we work on those, then anything that we do with calories and activity should work the way nature intended. So there are read some research studies that show, you know, they did some experiments to see if, like the PCOS metabolism was truly slower than the average person's metabolism. Like, is it actually a metabolism thing? And it's not. Our metabolism functions the same as somebody else's, but it's these other confounding factors that make it seem like our metabolism is so slow because they're forcing us to hold on a more weight and things like that. So if we can deal with these three pillars and make sure that those are on point, then any work we do with calories should function a lot more like the math says it does.

Speaker 1: 58:39

So if my fitness pal tells you that you need to eat 1500 calories to lose a pound a week, or whatever, then it should work If you're eating an insulin friendly diet and inflammation friendly diet and you're getting enough sleep and stress reduction. Now, I know that's a tall order, okay, so I didn't say it was going to be easy, but that's what has to happen in order for this to really work out for you. Now, there are always going to be exceptions to this rule. There are folks with PCOS who go on crash diets or have success with this thing or carnivore or that thing. You know. There there's always going to be outliers, and that's because everybody's different, but long term, I believe you're going to have the most success just focusing on your nutrition quality and pairing your quantities with that.

Speaker 1: 59:40

Some advice that I would give you on calories, though, is avoid going too low for too long. 1200 is usually my lowest that I'll go. There are some exceptions to that, like if a person is really, really petite, but you really want to aim to lose about a pound a week, and I think that's. The other thing that I really want to stress is that expectations are often really unrealistic about what a healthy weight loss looks like. Like we generally want to lose more than a pound a week. I mean, you know, I know how it is who wants to just lose one pound a week. That's boring, especially because the way that weight loss works is that it doesn't show up on the scale every week. Right, even though we might be losing a pound a week, it may not show up on the scale when we weigh in every week, so we could feel very defeated. But that's really the healthiest way to lose weight, though. That's the way where your body can adjust.

Speaker 1: 1:00:42

You store a lot of waste products and things in the fat cells, so when the fat cells kind of, you know, start letting go of stuff it's got to be processed through your liver. You know it can be kind of overwhelming for your body. So take it slow. The more weight you have to lose, the faster you can go, but as time goes on and you get within, you know, maybe 30 pounds, if you're whatever your goal is, then it's got to slow down. Be patient with yourself.

Speaker 1: 1:01:14

Like I said, the scale is not always a great indicator of actual fat loss. So the final thing that I will tell you is to have more than one method of measurement. Whenever I am trying to lose body fat or I'm working with a client, I'm taking weight, although infrequently, usually like no more than once a week, sometimes less, but I'm taking measurements weekly and I'm taking progress photos. And I think measurements and progress photos actually are so much more effective for seeing changes because you can get like a little like a pic, collage, the app, but you can like put them side by side, blow them up to the same size and see the changes and at the end of the day, right, it's not really about what we actually weigh on the scale, it's about what we want our body composition to look like. So why does the scale number matter? If you're gaining weight because you've been increasing your strength training or whatever, that may also be a factor. So, especially if you plan to start doing more strength training, I highly recommend I don't know, I don't even weigh myself on the scale anymore like just measurements and progress photos, because once you start gaining muscle in any significant way, it can really throw things off All right. So I think, hopefully that was helpful.

Speaker 1: 1:02:49

I think I'm going to close it up for the day because we've already gone for a long time, but I want to mention that there is a form you can fill out with questions for the podcast, and so if this triggered any questions for you, please feel free to reach out. I am currently taking like anything that where, if you just give me a little background on your story, I've been reading people's, you know different stories and then giving them advice. I'm doing like an advice podcast every few episodes or so. So submit your questions, okay, and thank you for being here. Don't forget to leave us a rating. If you never have, okay, we'll call it a day now, goodbye.