Pcos And Weight


All over the world, 1 out of 5 to 6 women is experiencing complications related to their menstrual cycle, including infertility and irregularity. Polycystic ovary syndrome (PCOS) is a condition that affects women’s reproductive system and is estimated to affect between 5 to 15% of women globally.1 In this article, you are going to learn about the association between weight and PCOS.

What is PCOS?

Polycystic ovary syndrome is an endocrine reproductive system condition and PCOS patients develop a large number of cysts in their ovaries.1 The causes that lead to PCOS are a combination of genetic and environmental factors. Women who suffer from PCOS are usually insulin resistant, which means that they can produce insulin, but are not capable of making efficient use of it. Plus, PCOS patients usually have higher androgen levels, which are male hormones, that can cause a lack of ovulation (anovulation).1,2

As mentioned before, PCOS can lead to various health problems, like infertility.2,3 Other than this, PCOS has also been linked to depression and anxiety and increases the risk of developing the following: 

  • Type 2 diabetes
  • Gestational diabetes
  • Depression and mood swings
  • High blood pressure
  • High Cholesterol
  • Stroke
  • Sleep apnoea2,3


The symptoms of PCOS depend on the individual and can range from mild to severe. Usually, they start manifesting at the end of the teenage years and the early twenties.3

Some of the most common symptoms include:

  • irregular periods or abstinence of periods
  • weight gain
  • hair loss and hair thinning
  • difficulty getting pregnant
  • excessive hair growth
  • oily skin
  • acne3

The connection between PCOS and weight is ambiguous

Some studies suggest that morbid obesity is a risk factor for more severe PCOS, while others argue that being underweight can also be related to PCOS.

One study by Thomas et al, says that PCOS is an obesity-related condition, with between 38 to 88% of women with PCOS being overweight or obese. Additionally, they also state that a small weight loss, can lead to an improvement of PCOS.4

But how is being overweight related to PCOS?

On the one hand, the insulin resistance that can be observed in the majority of PCOS patients leads to hyperinsulinemia, which can cause weight gain. On the other hand, it seems that being overweight can be a trigger for insulin resistance and other reproductive conditions. Therefore, weight gain can be a risk factor for the development of PCOS, and at the same time, PCOS can lead to weight gain due to insulin resistance.4

Nonetheless, there are other studies that focus on what is called lean PCOS. Lean PCOS is a less frequent PCOS phenotype, where the patients present a low or normal body mass index.5 Even though these patients present normal or underweight, they still suffer from insulin resistance.6 A lot of the time, these patients are overlooked because they do not present the typical overweight symptom.   

So briefly, PCOS can be diagnosed in underweight, normal, and especially, overweight patients, but it seems that there is a lack of consensus on which is the correlation between weight and PCOS, because not all overweight patients have PCOS and not all PCOS patients have overweight. Nonetheless, it appears that PCOS can be more severe in overweight patients. 

Sudden weight gain can be a symptom of PCOS

As mentioned before, most women with PCOS usually present insulin resistance. Insulin resistance leads to hyperinsulinemia, this happens when the pancreas starts producing a higher quantity of sugar to regulate the blood sugar levels. Hyperinsulinemia can lead to weight gain and hormonal imbalance, rising androgen levels for example. The rise of the androgen levels can cause anovulation. So, if there is a sudden weight gain it’s important to keep an eye out, especially if this weight gain is accompanied by irregular periods or difficulty in getting pregnant.1


In conclusion, there seems to be a relationship between weight and PCOS, especially when talking about being overweight. Nonetheless being overweight is not always present in the diagnostic of PCOS, like in lean PCOS. This means that there is still a need to produce more studies in order to understand the relationship between PCOS, insulin resistance, and weight. If there is a sudden weight gain, this does not mean that the patient has PCOS, but there is a chance, so it is important to pay close attention to other symptoms.


  1. Ajmal N, Khan SZ, Shaikh R. Polycystic ovary syndrome (Pcos) and genetic predisposition: A review article. European Journal of Obstetrics & Gynecology and Reproductive Biology: X [Internet]. 1 de julho de 2019 [citado 9 de dezembro de 2022];3:100060.
  2. CDC. Pcos (Polycystic ovary syndrome) and diabetes [Internet]. Centers for Disease Control and Prevention. 2020 [citado 9 de dezembro de 2022].
  3. Polycystic ovary syndrome - Symptoms [Internet]. nhs.uk. 2017 [citado 9 de dezembro de 2022].
  4. Barber TM, Hanson P, Weickert MO, Franks S. Obesity and polycystic ovary syndrome: implications for pathogenesis and novel management strategies. Clin Med Insights Reprod Health [Internet]. 9 de setembro de 2019 [citado 9 de dezembro de 2022];13:1179558119874042.
  5. Toosy S, Sodi R, Pappachan JM. Lean polycystic ovary syndrome (Pcos): an evidence-based practical approach. J Diabetes Metab Disord [Internet]. 13 de novembro de 2018 [citado 9 de dezembro de 2022];17(2):277–85.
  6. Anastasiou OE, Canbay A, Fuhrer D, Reger-Tan S. Metabolic and androgen profile in underweight women with polycystic ovary syndrome. Arch Gynecol Obstet [Internet]. 1 de agosto de 2017 [citado 9 de dezembro de 2022];296(2):363–71.

Joana Carneiro

Masters of Public Health - Escola Nacional de Saúde Pública, Lisboa

Joana is a recent graduate, who has a Degree in Biomedical Sciences and a Master's Degree in Public Health. She has more than two years of experience working as a healthcare professional in both private and public settings and more than 4 years of experience working as a volunteer in a non-profit organization, helping disadvantaged communities. Joana is passionate about public health, specifically about everything related to health education, health communication and health equity.

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