Having polycystic ovary syndrome (PCOS) can affect a lot of different areas of your life. Among other things, PCOS can impact your weight, and a lot of questions come up about the best way to manage PCOS weight gain via your diet. One frequently searched query? Whether the keto diet is a good eating method to help manage PCOS weight gain and other symptoms.
Before we get into that, it’s important to go over some PCOS basics. PCOS is a health condition caused by an imbalance of reproductive hormones, according to the U.S. Department of Health & Human Services’ Office on Women’s Health (OWH). This hormone imbalance causes problems in the ovaries, which make an egg that’s released each month as part of your menstrual cycle. When you have PCOS, the egg might not develop the way it should, or it might not be released during ovulation, according to the OWH.
PCOS can cause a range of symptoms, including irregular periods, infertility, excess hair growth, severe acne, and weight gain, per the American College of Obstetricians and Gynecologists (ACOG). As many as four in five women with PCOS deal with weight issues in conjunction with the condition, ACOG says.
PCOS may be managed with medical interventions like hormonal birth control pills. But lifestyle management, like losing even a little weight, may also help alleviate symptoms, according to ACOG.
And that’s where the keto diet question comes up a lot. Here’s what you need to know about how the keto diet can impact PCOS symptoms.
Is following the keto diet beneficial if you have PCOS?
There’s a lot to dig into here. People with PCOS often deal with insulin resistance, according to the Centers for Disease Control and Prevention (CDC). This means that the body can make insulin, which helps blood sugar enter the body's cells to provide energy, but can’t use it effectively. Insulin resistance increases the risk of developing type 2 diabetes. Insulin resistance can also lead to patches of thickened, velvety, darkened skin, a condition known as acanthosis nigricans, and this commonly occurs with PCOS, per ACOG.
So, how does the keto diet factor in here? The keto diet is an eating plan that focuses on minimizing your carbs and increasing your fat intake to get your body to use fat as a form of energy. People on the keto diet usually have no more than 50 grams of carbs a day, but some keto fans aim to have no more than 20 grams a day.
As you may (or may not) know, carbs convert into glucose (sugar) in the body, and insulin is needed to take that sugar to your cells for energy. Limiting your carb intake—like you would on the keto diet—can help relieve the insulin resistance that can occur as a result of having PCOS, but likely only for the short term, says Scott Keatley, RD, of Keatley Medical Nutrition Therapy. However, building lean body mass (read: muscle) and losing weight will help your body manage insulin resistance over the long term, he says.
There is some evidence that suggests a keto diet in particular can help women with PCOS lose weight and manage symptoms. A small study published in the Journal of Translational Medicine in early 2020 had 14 medically overweight women with PCOS undergo a keto diet. After 12 weeks on the diet, the researchers found that the women had a “significant reduction in body weight,” the study states, losing an average of 20 pounds and experiencing a reduction in BMI. They also had a decrease in their glucose and insulin blood levels, along with a decrease in the amount of testosterone circulating in their blood. “Our results suggest that a keto diet may be considered as a valuable non-pharmacological treatment for PCOS,” the study authors concluded.
While a keto diet could help women with PCOS lose weight, it may have even more of an impact than a number on the scale, says Jessica Shepherd, MD, an ob-gyn in Texas. “Reducing weight and insulin levels can help some women resume normal ovulation and improved fertility,” Dr. Shepherd notes—other side effects of PCOS.
ACOG specifically says that weight loss alone may help regulate your period if you have PCOS, noting that this is true even if you lose a small amount of weight. Weight loss also has been found to improve cholesterol and insulin levels, and relieve symptoms like excess hair growth and acne, ACOG says.
But given that weight loss alone can lead to improvement in PCOS symptoms, it’s hard to say how much losing weight specifically with keto will make an added impact, says Taraneh Shirazian, MD, an ob-gyn with NYU Langone Health. “Weight loss will help a woman with PCOS better metabolize her blood sugar—that’s what it boils down to,” she says. “And better metabolism of your blood sugar will theoretically help you ovulate. If you both lose weight so that your body is better able to have better cycles, and are on a diet like keto where your blood sugar is reduced and you keep those levels low, you can lose weight and potentially ovulate.”
In general, though, “Weight loss and a good, healthy diet is key in managing PCOS,” says Christine Greves, MD, a board-certified ob-gyn at the Winnie Palmer Hospital for Women and Babies in Orlando, Florida.
Factoring in all of that, Dr. Shirazian says that considering keto when you have PCOS is “probably a good idea.”
What about other low-carb eating plans for PCOS—also a good idea?
Yup, there’s a chance they can help, too. Low-carb plans tend to focus on low-glycemic foods (that is, foods that are absorbed and metabolized at a slower rate, and cause a slower rise in blood sugar and insulin levels), and that’s a good thing, Dr. Shepherd says. “Low-glycemic foods will help to maintain stable levels of blood insulin, thus improving the body’s utilization of glucose,” she explains.
Plenty of women with PCOS have lost weight on a low-carb diet. Lisa Hasselbeck previously shared with WH how she lost 118 pounds on a keto, and that her weight loss helped her manage symptoms of her PCOS.
Madi Wilson said she lost about 100 pounds on a low-carb diet after she was diagnosed with PCOS. And Jen Wagner says she lost 100 pounds of excess weight due to PCOS on a keto diet and modified low-carb diet.
In general, Dr. Shirazian says, “A low-glucose, low-carb diet should help women with PCOS.”
Is it safe to try keto for PCOS?
Technically, you could jump on the keto train on your own to see how it impacts your PCOS and weight. But experts say it’s not a bad idea to speak to a medical professional before diving in. “Every woman with PCOS should touch base with their doctor, just in case they have issues,” Dr. Shirazian says.
Consulting a nutritionist, if you can, can help you figure out any nutritional deficiencies you might be experiencing, and how to find the right diet that can help you meet your goals, Dr. Shepherd adds. It may be that a keto diet or other low-carb diet would be a good fit for you, or they may recommend something you haven’t even thought of.
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