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If you’ve been diagnosed with polycystic ovarian syndrome (PCOS), aka polycystic ovary syndrome, you’re quite familiar with all its signs and symptoms. Cysts on the ovaries, bloating, weight gain, random chin hairs, irregular periods, infertility, acne, and hair loss are a few examples. Those are bad enough, but one of the most aggravating PCOS symptoms for women of all ages is the dreaded “PCOS belly.”  

PCOS may affect up to 13% of women of reproductive age worldwide. Yet, the World Health Organization (WHO) says that up to 70% of women with PCOS don’t even know they have it. [1] It’s also been recently connected to thyroid conditions like Hashimoto’s. Could PCOS be the reason you can’t shed your belly fat?

What Does a PCOS Belly Look Like?

Women with PCOS tend to accumulate fat around their middles – even those at a normal, healthy weight. [2] This abdominal fat creates more of an apple-shaped body rather than the preferred pear-shaped physique. The frustrating part about PCOS belly fat is that it doesn’t always come off with weight loss. You could have a low BMI (body mass index) and still have a puffy-looking belly. 

A PCOS belly can be made up of three elements: subcutaneous fat, visceral fat, and bloating. Subcutaneous fat is the fat found directly beneath the skin. It’s that fat you can pinch with your fingers. Visceral fat is found deeper in the body, surrounding the organs in the abdominal cavity, and greatly contributing to central obesity.  

Researchers have found the adipose tissue around the bellies of PCOS patients has inflammatory molecules. [3] That’s likely why visceral fat is considered a dangerous type of fat that’s one of the risk factors for diabetes, heart disease, and stroke. Bloating can enhance the look of belly fat, making things even worse. Food allergies and/or gut dysbiosis can be behind the bloating.  

What Causes PCOS Belly?

What causes PCOS belly? Experts point to chronic inflammation, chronically high cortisol levels (stress), insulin resistance, hormonal imbalance (especially elevated male hormones), and an altered metabolism. Really, these are all interconnected.  

The chiropractic concept of the “3 T’s” describes the three categories of stressors that create an imbalance in the body:  

  • Traumas (physical stressors) 
  • Toxins (biochemical stressors) 
  • Thoughts (emotional stressors)  

These stressors can trigger the HPA axis (the stress center in the brain), leading to elevated cortisol and androgen (male hormone) release, high blood sugar, and heightened immune response. That leads to excessive insulin secretion and, ultimately, insulin resistance. Excess androgens may be converted to an estrogen called estrone, contributing to estrogen dominance 

All these things can alter metabolism and make it difficult to lose excess body fat.  

6 Tips to Get Rid of Your PCOS Belly!

While websites, blogs, and books suggest all kinds of things to address PCOS and lose the PCOS belly, there’s not one magic supplement, probiotic strain, or exercise that’s guaranteed to alleviate all symptoms of PCOS. A better strategy is to support normal insulin levels, androgen levels, and gut health with a healthy diet and lifestyle changes. [4]. Some suggested changes are outlined below: 

1 – Eliminate SUGAR (and All Inflammatory or Allergenic Foods)

PCOS is very much tied to inflammation, so it’s critical to eliminate any foods that create inflammation in your body each time you eat them. [5] Some of the worst offenders are sugar and refined carbs, which are abundant in the Standard American Diet (SAD). 

  • Sugar and Carbs – Sugar is always inflammatory to the body, and if you’re insulin-resistant, carbs will also be problematic as they can spike blood sugar. If you have trouble resisting sugar and carb cravings, consider adding an herb called Gymnema, which can support balanced blood sugar while taming the sweet tooth. [6] Getting rid of sugar is by far the most effective thing you can do to address PCOS belly fat. 
  • Gluten and Dairy – The proteins in modern grains and dairy are also tied to inflammation and allergic responses. They may also be major factors behind insulin resistance in some people. Eliminating gluten and dairy from the diet can make a noticeable difference for women with PCOS. [7][8][9] 
  • Food Allergies – You can have allergies to healthy foods! It’s not just wheat and dairy products that you have to look out for. Those are some foods everyone should consider eliminating. However, it’s also important to consider individual allergies to foods, which may or may not be the big ones listed on an elimination diet list. [10] 

At The Wellness Way, we see food allergies to such seemingly innocuous foods as lettuce, rice, and black pepper. It’s important to note very few food allergies will give you noticeable symptoms. You won’t know whether you’re having immune reactions to foods unless you test 

Chronic inflammation is associated with an increased risk of high blood pressure, cholesterol imbalance, and heart disease, so it’s crucial to get it under control. 

2 – Try a High-Protein OR Ketogenic Diet

Beyond eliminating inflammatory sugar and carbs, it’s also important to stick to a diet that’s lower in carbohydrates. A good PCOS diet is based on whole foods and focuses on healthy fats, adequate protein, and vegetables with a low glycemic load.

Low Carb, High Protein Diet (Like Atkins)

A high-protein version of a low-carbohydrate diet can be highly beneficial for women dealing with PCOS belly fat. In a 2012 study published in the American Journal of Clinical Nutrition, researchers tested the effects of a high-protein diet versus a standard protein diet in women with PCOS. After the 6-month trial, the high-protein diet led to greater reductions in body weight and waist circumference than the standard protein diet. [11 

Ketogenic Diet (Low Carb, High Fat, Moderate Protein)

Another option is to follow the increasingly popular ketogenic diet. In a 2015 study published in the Journal of Nutrition, researchers wanted to determine whether restricting carbs (vs. restricting fat) was helpful for improving body composition and metabolic health.  

At the end of the study, those who followed the low-carb diet lost more belly fat than the low-fat group. They also reduced their total body fat by 4.4% over the course of the study. Women with PCOS on a low-carb diet decreased their fasting insulin and glucose while increasing their insulin sensitivity. Their inflammation also went down. [12] 

A small clinical trial published in 2020 investigated the effects of a Mediterranean-style ketogenic diet on women with PCOS. After three months on the diet, the women had lost a significant amount of weight, including belly fat. They also lowered their blood sugar, insulin, and triglycerides and improved their hormone balance. The researchers determined that a ketogenic diet could be considered a non-pharmacological tool for treating PCOS. [13] 

A 2023 review referred to the ketogenic diet as a potential “medical prescription in women with polycystic ovary syndrome.” [14] Of course, everyone is different, and not everyone should start a ketogenic diet without support. That’s where personalized nutrition comes in.  

The healthy fats and proteins that characterize these two diets help reduce cravings, making it easier to stay on track. They also don’t add to fat accumulation as long as you’re keeping your blood sugar levels low by avoiding sugar and carbs.

3 – Activate AMPK with Herbs

AMPK (AMP-activated protein kinase) is an enzyme that plays a significant role in our cells’ energy balance. It works like a metabolic sensor in our cells, responding to changes in energy and altering our metabolism to maintain energy balance (keeping us trim and healthy). Activating it is associated with metabolic benefits like improved insulin sensitivity and better glucose control. [15] 

As we age, AMPK levels decrease, contributing to a slowed metabolism and difficulty losing weight.  

Metformin is a prescription drug used for conditions of insulin resistance, including type 2 diabetes and PCOS. It also happens to be one of the most researched AMPK activators. However, natural herbs have also been found to activate AMPK:  

  • Oregon Grape (Berberine) – Berberine is a constituent found in Oregon Grape that activates AMPK but has anti-inflammatory properties. Inflammation is closely linked to metabolic disorders. By reducing inflammation, berberine may indirectly support AMPK activation, metabolic health, and weight management in PCOS. [16][17] 
  • Japanese Knotweed (Resveratrol) – Polyphenols are known activators of AMPK, and the antioxidant resveratrol is an excellent example. [18] Japanese knotweed is the best herb source of resveratrol, which is great to include for your overall health.  
  • Nettle Leaf (Quercetin) – Quercetin is a flavonoid found in various fruits, vegetables, and herbs – including nettle leaf. Some studies suggest that quercetin can activate AMPK, both directly and by reducing inflammation. [19] 
  • Milk Thistle – Milk thistle not only activates AMPK but supports liver health, which is important for breaking down excess estrogens, so they don’t get recycled and lead to estrogen dominance. [20] 

These four herbs can activate AMPK, helping the body reduce abdominal fat storage. However, there are many other herbs that not only activate AMPK but can support blood sugar balance. Your Wellness Way clinic can guide you on which herbs may be best for your situation.

4 – Focus on Fiber

A fiber-rich diet may also help you shrink your waistline. A 2019 study found that getting enough fiber resulted in less belly and improved insulin resistance in women with PCOS. [21] 

Fiber supplements can help – especially a prebiotic fiber called inulin. Supplementing with this type of fiber may help reduce PCOS-related inflammation. In a 2023 randomized controlled trial, supplementing with inulin for about three months helped to lower inflammation in women with PCOS. [22] 

Inulin naturally occurs in many foods, including onions, garlic, asparagus, apples, and chicory root 

5 – Increase Your Physical Activity

Physical activity is part of a healthy lifestyle that reduces the risk of cardiovascular disease, mental health problems, and more. Regular exercise does more for your body than simply burning calories or increasing your heart rate. It can also improve insulin sensitivity, which is essential for PCOS. [23]

Strength training can help improve both body composition and insulin sensitivity; high-intensity exercise also activates AMPK pathways. [24][25] A 2020 review recommended that women with PCOS include vigorous aerobic exercise and resistance training to improve their insulin sensitivity and lower their excess testosterone levels. [26] 

6 – Support Your Hormones (Get Tested)

PCOS can be a complicated condition. It’s ultimately a hormonal disorder, and hormones don’t work alone. They make up a greater system called the endocrine system, which is intimately involved with all our other organ systems. The nervous system and digestive system especially impact hormone balance. After all, the human body operates like a Swiss watch, with each system affecting all the others.  

Testing is essential to find out what’s going on with your hormones. Here are some examples of where we might start at The Wellness Way: 

Is it a production issue? Conversion issue? Elimination issue? It could even be all three. As we always say, we don’t guess; we test! Testing helps us determine the best course of action for returning the body to balance.  

The Wellness Way Can Help

Have you been frustrated by stubborn belly fat? Do you think you might have PCOS? “You don’t know what you don’t know.” The Wellness Way is here to help you navigate the challenges of hormone imbalance and overcome the belly fat. A flat stomach is possible at any age! It’s just a matter of finding out what’s causing you to hold onto the extra fat. Contact a Wellness Way Clinic today! 

References

  1. Polycystic ovary syndrome (who.int) 
  2. PCOS is associated with increased CD11c expression and crown-like structures in adipose tissue and increased central abdominal fat depots independent of obesity – PubMed (nih.gov) 
  3. Inflammation in Polycystic Ovary Syndrome: Underpinning of insulin resistance and ovarian dysfunction – PMC (nih.gov) 
  4. Lifestyle changes in women with polycystic ovary syndrome – PubMed (nih.gov) 
  5. Controversies in the Pathogenesis, Diagnosis and Treatment of PCOS: Focus on Insulin Resistance, Inflammation, and Hyperandrogenism – PubMed (nih.gov) 
  6. Gymnema – an overview | ScienceDirect Topics 
  7. The Relationship between Intake of Dairy Products and Polycystic Ovary Syndrome in Women Who Referred to Isfahan University of Medical Science Clinics in 2013 – PMC (nih.gov) 
  8. Dairy Consumption and Insulin Resistance: The Role of Body Fat, Physical Activity, and Energy Intake – PMC (nih.gov) 
  9. Possible Prevention of Diabetes with a Gluten-Free Diet – PubMed (nih.gov) 
  10. 2165-7904-2-112_948.pdf (nordiclabs.com) 
  11. Effects of increased dietary protein-to-carbohydrate ratios in women with polycystic ovary syndrome – PubMed (nih.gov) 
  12. A lower-carbohydrate, higher-fat diet reduces abdominal and intermuscular fat and increases insulin sensitivity in adults at risk of type 2 diabetes – PubMed (nih.gov) 
  13. Effects of a ketogenic diet in overweight women with polycystic ovary syndrome – PubMed (nih.gov) 
  14. Ketogenic Diet as Medical Prescription in Women with Polycystic Ovary Syndrome (PCOS) – PMC (nih.gov) 
  15. Regulation and function of AMPK in physiology and diseases – PMC (nih.gov) 
  16. The effect of berberine supplementation on obesity parameters, inflammation and liver function enzymes: A systematic review and meta-analysis of randomized controlled trials – PubMed (nih.gov) 
  17. The Effect of Berberine on Polycystic Ovary Syndrome Patients with Insulin Resistance (PCOS-IR): A Meta-Analysis and Systematic Review – PubMed (nih.gov) 
  18. Polyphenols stimulate AMP-activated protein kinase, lower lipids, and inhibit accelerated atherosclerosis in diabetic LDL receptor-deficient mice – PubMed (nih.gov) 
  19. Quercetin and polycystic ovary syndrome – PubMed (nih.gov) 
  20. Silymarin Suppresses Cellular Inflammation By Inducing Reparative Stress Signaling – PubMed (nih.gov) 
  21. Dietary intake, body composition and metabolic parameters in women with polycystic ovary syndrome – PubMed (nih.gov) 
  22. Effects of inulin-type fructans with different degrees of polymerization on inflammation, oxidative stress and endothelial dysfunction in women with polycystic ovary syndrome: A randomized, double-blind, placebo-controlled trial – PubMed (nih.gov) 
  23. Exercise and insulin sensitivity: a review – PubMed (nih.gov) 
  24. Progressive resistance training in polycystic ovary syndrome: can pumping iron improve clinical outcomes? – PubMed (nih.gov) 
  25. Effect of exercise intensity on skeletal muscle AMPK signaling in humans – PubMed (nih.gov) 
  26. A Systematic Review of the Effects of Exercise on Hormones in Women with Polycystic Ovary Syndrome – PubMed (nih.gov) 

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Disclaimer: This content is for educational purposes only. It’s not intended as a substitute for the advice provided by your Wellness Way clinic or personal physician, especially if currently taking prescription or over-the-counter medications. Pregnant women, in particular, should seek the advice of a physician before trying any herb or supplement listed on this website. Always speak with your individual clinic before adding any medication, herb, or nutritional supplement to your health protocol. Information and statements regarding dietary supplements have not been evaluated by the FDA and are not intended to diagnose, treat, cure, or prevent any disease.

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