PCOS belly fat is a common concern for both lean and overweight women living with Polycystic Ovarian Syndrome.

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PCOS may have you feeling pretty defeated. It is not your imagination! Women with PCOS experience much slower progress when it comes to managing weight. If you are consistent with the dietary and lifestyle changes I share with you here, you will not only feel more energetic and balanced, but you’ll lose your PCOS belly in a sustainable way.

What does a PCOS belly look like?

PCOS belly is not a medical condition. It’s a term describing the tendency to gain fat around your midsection disproportionately. This is a common symptom among people with PCOS of all sizes.  Even if you do not struggle with weight gain, you may notice that your abdominal area is thicker and has more visible fat than the rest of your body.

Your weight or body mass index is not the best way to assess your PCOS belly. Instead, you could use the waist-to-hip ratio (WHR) to track progress. 

What Causes PCOS Belly?

Some of the hormonal imbalances associated with PCOS, such as high cortisol, insulin resistance, and elevated androgens, cause increased fat accumulation around the waist. This can be an issue even if you are lean and do not need to lose weight. Unfortunately, carrying extra abdominal fat creates a vicious cycle of hormonal imbalances; excess belly fat will worsen insulin resistance and cause androgen levels to rise, thus making the root cause of your PCOS belly worse. 

To add to this frustrating and confusing problem, ab workouts will not reduce belly fat for two reasons-

  1. Workouts that exclusively focus on the abs do not do a very good job of addressing the hormonal issues associated with PCOS belly fat.
  2. Abdominal workouts don’t help much when it comes to losing fat because they are not the most metabolically stimulating workouts. A killer ab workout will strengthen the core but not help you shed much fat. Frustratingly, you will have nothing to show for your hard work if your strong abs are covered by a layer of stubborn fat—ugh.

How do you reduce belly fat if you have PCOS?

You can break the vicious cycle of belly fat and hormonal imbalance by committing to 3 key lifestyle changes:

  1. Follow a workout program that will help balance your hormones and burn fat. 
  2. Eat a diet designed to reduce inflammation and high blood sugar.
  3. Get 7-9 hours of good-quality sleep.

PCOS belly fat-fighting workout program in 3 steps

fighting pcos belly fat: woman meditating

Step 1: Do a full-body strength workout 3-4 times a week.

Muscle-building workouts reduce insulin resistance and help lower androgens. With their high metabolic demand, full-body strength workouts are particularly helpful for reducing body fat.

You can use free weights, machines, kettlebells, resistance bands, or suspension training to get a good full-body strength training session. A full-body workout may include some core exercises (1 or 2), but the focus should be on training the major muscle groups of the upper and lower body.

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Step 2: Finish each strength workout with a short HIIT session.

High-intensity interval Training (HIIT) is a type of cardio workout that alternates between bouts of extremely challenging, fast-paced exercise (the work interval) and bouts of low-intensity exercise (the recovery interval). Several studies like this one conducted by researchers in Norway have found that PCOS women who do High-Intensity Interval Training are able to reduce their body fat percentage overall and lose more belly fat than women who do other types of cardio.

I’ve found that my clients with stubborn belly fat get great results from doing just 10 minutes of HIIT after they finish a full body strength workout.

Step 3: Do a cortisol-fighting workout 3 times a week.

When you experience unmanaged stress, your body produces high levels of the hormone cortisol. People with chronically high cortisol levels tend to store excess fat around the abdomen, both for overweight people and for slimmer people.

Workouts that incorporate deep breathing and encourage slowing down stimulate the parasympathetic nervous system, which is responsible for reducing stress reactions. When the parasympathetic nervous system is stimulated, it produces a feeling of relaxation and calm in the mind and body. Workouts that stimulate the parasympathetic nervous system and reduce stress include yoga, Tia Chi, walking outdoors, and meditation.

3 nutrition tips for managing hormonal belly

Insulin resistance is the root cause of belly fat accumulation in women with PCOS. Eating meals that keep your blood sugar even throughout the day will improve insulin levels and curb abdominal weight gain. 

1. Add protein to every meal to reduce belly fat

Protein plays a crucial role in building lean muscle mass, keeping you full, and regulating blood sugar levels. It is well-established that higher protein diets are optimal for sustainable weight loss in all people. Furthermore, specific studies related to polycystic ovary syndrome, such as this study published in The American Society for Nutrition, suggest that protein intake is essential for PCOS weight loss.

To ensure you’re eating enough protein, include a portion of lean protein into each meal. To determine the right serving size, aim for a portion similar in size to the palm of your hand.
Listed below are some recommended sources of lean protein:

  • Eggs
  • Chicken
  • Turkey
  • Pork Loin
  • Grass-Fed Beef
  • Wild-Caught Fish
  • Vegan (soy-free) Protein Powder
  • Collagen Protein Powder
  • Organic Tofu and Tempeh (for vegans)

2. Prevent blood sugar spikes with high-fiber carbs 

There is a strong emphasis on reducing carbohydrates when dealing with PCOS. Research supports this, showing that transitioning from a high-carb diet to a moderate or low-carb diet can aid in weight loss and improve ovulation and insulin sensitivity.

However, simply cutting carbs entirely will not provide a long-term solution. While you may initially shed pounds. Low energy levels, increased cravings for sugary foods, and disrupted hormones can lead to binge eating and weight regain.

Rather than eliminating carbs altogether, aim to include a serving of high-fiber, low-GI carbohydrates in each meal. Combining healthy carbs with protein can help you:

– Prevent energy crashes caused by blood sugar drops 
– Reduce cravings for carbs
– Achieve sustainable weight loss 
– Support a healthy gut by consuming fiber 

Some of the best carbs for a nutritious PCOS diet are:

  • Fruit
  • Yams
  • Sweet Potatoes
  • White Potatoes
  • Squash
  • Root Vegetables
  • Beans
  • Quinoa
  • Oats
  • Black Bean, Chickpea, or Lentil Pasta
  • Bulgar
  • Barley
  • Sprouted Grain Bread

A diet with moderate carbohydrates is an easy-to-follow and effective option for most people with polycystic ovary syndrome. If you are following these guidelines and feel that you are not getting a good result, take a closer look at your portions. A serving size of healthy carbs will fit into your cupped hand. Go ahead and spoon some cooked rice out into your cupped hand- I bet it is less than you typically put on a dinner plate! 

3. Cook with healthy fats to fight inflammation.

Including healthy fats in your diet will add flavor to your meal and combat PCOS symptoms. Using Healthy fats for cooking will serve two important purposes:

  1. Omega 3 fatty acids have been shown to lower testosterone in women with PCOS. High testosterone levels are the cause of pesky symptoms like belly fat, acne, and hirsutism. A diet higher in Omega-3 fats could help you normalize your hormones.
  2. Eating high amounts of hydrogenated oils, trans fats, and omega-6 fats found in processed foods puts you at risk for heart disease. All women with polycystic ovarian syndrome are at a higher risk of developing heart disease. So, it is wise to avoid inflammatory fat sources.

Sleep deprivation makes hormonal imbalances and weight gain worse.

Sleep Deprivation triggers weight gain.

Ghrelin, known as the “hunger hormone,” rises when there is a lack of sleep, causing an increase in hunger and a desire for high-calorie foods. Conversely, leptin, the hormone that signals fullness, decreases with insufficient sleep, making it difficult to feel full after eating. This hormonal disruption can lead to overeating and make it extremely difficult to lose weight with PCOS.

Sleep impacts insulin sensitivity.

According to a study published in the Diabetes Journal, individuals with sleep issues commonly experience insulin resistance. Since insulin resistance is a root cause of PCOS belly, high-quality sleep is essential. Sleep deprivation can lead to the body continuously trying to regulate blood sugar levels, impacting the body’s stress response. Problems with sugar production can result in fatigue and difficulties falling asleep, complicating both PCOS and sleep problems.

Poor sleep spikes cortisol

Persistent lack of sleep causes further hormonal disorder by elevating cortisol levels, which are associated with increased inflammation and more severe symptoms of PCOS over time.

Sleep aids in recovery.

A good night’s rest can aid the body in recovering to its normal state after a workout. Regular exercise is one of the best ways to treat PCOS belly, as it has been proven to enhance insulin sensitivity and lower androgens. If you follow my PCOS belly fat workout guidelines,  getting enough sleep is critcal for proper recovery and good results.

4 Sleep tips for managing PCOS belly

1. Establish a regular sleep routine:

Maintaining a consistent bedtime and wake-up time can help regulate your body’s hormone levels and improve overall sleep quality. Try to go to bed and wake up at the same time every day, even on weekends, to support your body’s natural rhythms.

2. Create a relaxing bedtime routine:

Engaging in calming activities before bed, such as reading a book, taking a warm bath, or practicing deep breathing exercises, can help reduce stress and promote better sleep. Stress can exacerbate PCOS symptoms, so finding ways to unwind before bed is essential for managing your condition.

3. Limit screen time before bed:

The blue light emitted from screens can disrupt your body’s production of melatonin, a hormone that regulates sleep. To help improve your sleep quality, try to avoid using electronic devices at least an hour before bedtime. Instead, opt for relaxing activities that can help prepare your body for restful sleep.

4. Take a magnesium supplement before bed:

Magnesium makes a neurotransmitter called GABA, which helps you sleep. I have personally seen an incredible transformation in the quality of my sleep just by taking magnesium. In addition to helping you sleep, magnesium can improve insulin sensitivity. My favorite magnesium is BioOptmizers Magnesium Breakthrough. I’m obsessed with Magnesium Breakthrough because this formula improved my sleep more than any other supplement I have tried. I love it!! Support my free content by using this affiliate link to order Magnesium Breakthrough.

Bonus: Supplements that improve insulin resistance

Three supplements have been proven to reduce insulin resistance in PCOS. This is especially good news if you have tried Metformin but have not tolerated it well. If belly fat is a concern for you, definitely discuss these supplements with your healthcare provider.


I encourage every person with PCOS to try supplementing with a blend of 2000 mg of Myo-inositol and 50 mg of D-chiro-inositol twice daily. Myo and d-chiro-inositol are two of the most researched supplements for treating PCOS. They are quite effective at correcting insulin resistance, balancing sex hormones, and reducing anxiety in PCOS. One of the most exciting benefits of taking Ovasitol for me was a significant reduction in sugar cravings!

I recommend the brand Ovasitol because it is a cost-effective way to get both types of inositol at a pharmaceutical grade. You can buy the Ovasitol from THERALOGIX and use the Provider Referral Code 130269 to get a discount.

N-Acetyl Cysteine (NAC)

If, after taking Ovasitol for 90 days, you still have trouble taming your spiking and falling blood sugar, managing belly weight gain, or dealing with a fatty liver or high cholesterol, you may want to try taking both NAC and Inositol. NAC is an antioxidant and amino acid. Studies have shown that NAC improves insulin sensitivity, lowers total testosterone, reduces bad cholesterol, and enhances fertility in PCOS patients. The recommended dosage of NAC to improve insulin levels is 1.6-3 grams/day. You may benefit from the higher end of the dose range if you have a high BMI. 


Berberine helps women with PCOS lower testosterone, improve fertility, and resolve metabolic complications like insulin resistance, fatty liver, and high cholesterol. Berberine is also helpful in improving gut health and can aid in weight loss. Any Berberine that is independently tested by an organization like NSP, GMP, or Consumer Labs is a good choice. The therapeutic dosage of berberine to improve insulin and other proven health benefits based on published studies is 500 mg, 3 times each day (similar to that of metformin dosing).  Berberine is generally well-tolerated but can potentially interact with certain prescription medications.

The lowdown

Don’t let hormonal imbalances associated with PCOS bring you down! High cortisol, insulin resistance, and elevated androgens can lead to stubborn belly fat that even lean individuals struggle with. It’s a tough cycle, but you have the power to break it.

Take charge of your health by making three important lifestyle changes:
– Stick to a workout routine that targets hormonal balance and fat burning.
– Adopt a diet focused on reducing inflammation and controlling blood sugar levels.
– Prioritize 7-9 hours of quality sleep each night.

You have the ability to overcome PCOS belly fat and reclaim control of your body and health!

Freebie Alert! Sign up to get my DIY strength training guide. I made this guide so you can create a strength training workout that will help eliminate PCOS belly fat.

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Erika Portrait

Hi! I'm Erika.

I’m a certified Personal Trainer and Nutrition Coach. I also happen to have Polycystic Ovarian Syndrome. I help guide guide women living with PCOS toward a lifestyle that gets their symptoms under control so that they have the time, energy, and confidence to thrive. My tips, plans, programs, and guides cover all the information I wish I had when I was first diagnosed.

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