I met Reproductive Endocrinologist and highly regarded Polycystic Ovarian Syndrome expert Dr. Mark Perloe when he presented at the PCOS Challenge symposium. Before he took to the stage, the woman seated to my right turned to me and said, “My fertility doctor is speaking next. He’s really great. I had my last baby over ten years ago, but I still see him because he really gets PCOS.”
I was immediately impressed. In all my time as a PCOS patient and advocate, I had never heard a fellow cyster rave about her medical care. As Dr. Perloe gave his presentation on creating a treatment plan for PCOS, it became clear he was truly a compassionate, enthusiastic, and knowledgeable advocate for women living with PCOS.
So I sat down with Dr. Perloe to pick his brain about PCOS and weight loss, and I am eager to share what I learned with you.
Why women with PCOS have trouble with their weight
The insulin resistance that is characteristic of PCOS promotes weight gain. However, it is still unclear exactly how PCOS and insulin resistance are linked. Recent research suggests that our genetics play a role. Insulin is the hormone your body uses to deliver energy to your cells, in the form of glucose. When you are insulin resistant, normal amounts of insulin are inadequate to produce a normal response from your cells. As a result, the excess glucose that remains in the blood stream is sent to the liver. The liver converts the excess glucose into fat and stores it throughout the body. Thus, women with PCOS tend to gain weight easily.
The relationship between insulin resistance and weight gain is not easy to understand. But Dr. Perloe has made great some explainer videos on the subject that you can grab here!
The three point plan for PCOS weight loss: a low GI diet, insulin sensitizers, exercise.
Trying to lose weight with PCOS can be incredibly frustrating, like the cards are stacked against you.
Dr. Perloe won’t tell you that losing weight with PCOS is easy. For that matter, neither will I. He believes that managing your weight and health when you have PCOS takes a life-long commitment, but there is a clear and research-based approach to ensure that you look and feel you best. He is very optimistic about the following plan when it comes to weight management and PCOS:
1. A Low GI Diet
GI, or the Glycemic Index, is designed to measure how quickly a type of carbohydrate is digested and absorbed into the bloodstream. A low GI score indicates the food is digested and absorbed more slowly. Examples of low GI foods include beans, unprocessed whole grains, nuts, seeds, vegetables and, of course, foods that do not contain carbohydrates like animal proteins and oils.
The goal of a low GI is to get the majority of your calories from low-GI food so that you have a steady rise in the level of glucose in the blood, which in turn leads to a small and gentle rise in insulin.
2. Insulin Sensitizers
Insulin sensitizers, like metformin and inositol supplements, plus a low GI diet, can correct PCOS-related insulin resistance. Dr. Perloe has seen great results with both the supplement Ovasitol and generic metformin. However, you and your physician should work together to find the right dosages of metformin or inositol for you.
Dr. Perloe wants you to hit the weight room, ladies. Why? Because the majority of the glucose you ingest from food will be used by and stored in your skeletal muscle. Progressive strength training increases the size of skeletal muscle and enhances that muscles’ ability to manage glucose. Medical research has demonstrated that the adaptations created by progressive resistance training will increase insulin sensitivity and your metabolic rate (the amount of calories you burn at rest).
Don’t be a cardio queen
Dr. Perloe cautions women against doing long bouts of cardio exercise. The traditional thinking that “the more calories you burn, the better” will not serve PCOS women well. Over time, large amounts of cardio can reduce your muscle mass, thus slowing down your metabolism. Shorter, high-intensity cardio does a much better job of improving your cardiovascular health and insulin resistance.
Dr. Perloe tells his patients to do just two 20-minute, high-intensity cardio sessions a week and to strength train two or three times a week on nonconsecutive days. When you strength train, select exercises and resistance levels that challenge you and train each major muscle group once a week.
Question: Will lifting heavy weights increase your androgen levels?
I get asked this a lot, so I decided to put this question to Dr. Perloe.
The answer: No, quite the opposite. We know that insulin resistance and obesity exacerbate hyperandrogenism in women with PCOS. Strength training is a proven method of managing insulin resistance and obesity. Improved insulin sensitivity and weight reduction will ultimately improve hyperandrogenism.
Should you work out if you are trying to conceive?
Absolutely. The majority of women who follow Dr. Perloe’s three-point plan can conceive without any further fertility treatments. How cool is that? In fact, women who are physically active give birth to healthier babies. Check out the post I wrote for With Great Expectations (an excellent blog for anyone TTC) to learn more about how exercise can prepare you for motherhood.
However, once you are pregnant, you should reevaluate your exercise program and consult your OB-GYN. Dr. Perloe says expectant mothers should reduce their exercise intensity so that they can pass the talk test: you should be able to hold a conversation while exercising.
If there is one thing I took from my Sunday afternoon chat with Dr. Perloe, it’s that PCOS is not a lost cause. We have smart and compassionate advocates like Dr. Perloe and information on our side. It is our job to use the tools available to our advantage!
Would you like to hear more from Dr. Perloe? Click here to get some of Dr. Peroe’s best video tutorials sent to your inbox.
If you live in the Atlanta, Georgia area and are looking for a wonderful fertility specialist, you can get in touch with Dr. Perloe by contacting his clinic.