Can changing what I eat really help PCOS symptoms?

Many people with polycystic ovary syndrome (PCOS) are told that nutrition matters, but are rarely given a clear explanation of why. This can feel confusing and frustrating, especially when you are trying to eat well and still struggling with symptoms such as weight gain, low energy, cravings, acne, or irregular periods.

In this article, I explain why nutrition plays such an important role in PCOS, why weight loss is often discussed but not always the main goal, and what actually matters most when it comes to food and symptom improvement.

Why does nutrition play such an important role in PCOS?

Nutrition can be genuinely symptom-modifying in PCOS. Research shows that improving how and what you eat can help improve many common PCOS symptoms, including:

• Weight gain and weight management difficulties
• Irregular or absent periods
• High insulin levels and insulin resistance
• Chronic inflammation
• Acne and excess hair growth
• Fatigue and low energy

These improvements are often seen even when nutrition changes are not focused on weight loss, particularly when dietary changes are combined with medical or lifestyle support.

Is weight loss really necessary to improve PCOS symptoms?

Weight loss is often discussed in PCOS because studies show that 5–10% weight loss can improve symptoms for some people. However, this does not mean that weight loss is the only – or even the most important – goal.

Many PCOS symptoms can improve without any weight change at all, especially when insulin sensitivity, blood sugar control, and inflammation improve. This is a crucial and often overlooked point for people who feel disheartened when the scales do not move despite consistent effort.

What matters more than weight loss in PCOS?

What matters most is how your body responds to food.

Key goals include:

• Keeping blood sugar levels steady
• Improving insulin sensitivity
• Reducing chronic low-grade inflammation

When these processes improve, symptoms often improve too, regardless of what the scales say.

This is also why extreme dieting often backfires in PCOS. Skipping meals, cutting carbohydrates completely, or eating too little can:

• Worsen blood sugar swings
• Increase cravings and fatigue
• Raise stress hormones such as cortisol
• Lead to weight regain over time

A PCOS-informed approach to nutrition focuses on balance, consistency, and nourishment, not restriction.

Why does PCOS affect weight even when I’m eating normally?

Many women with PCOS feel they are “doing everything right” yet still gaining weight or struggling to lose it. A key reason for this is insulin resistance, which affects around 70–80% of people with PCOS.

When insulin resistance is present:

• More glucose is stored as fat rather than used for energy
• Appetite and cravings can feel stronger
• Fat is more likely to be stored around the abdomen

This means you may not be overeating at all – your hormonal signals are working against you.

Other contributing factors include chronic inflammation, raised cortisol, and poor or disrupted sleep, all of which make weight gain more likely and fat loss harder.

Why is losing weight often harder with PCOS?

PCOS affects multiple systems involved in fat loss at the same time:

• Insulin resistance makes stored fat harder to access
• Higher androgen levels influence fat distribution and muscle metabolism
• Metabolic rate may be lower, reducing energy expenditure at rest
• Hunger signalling can be stronger
• Fatigue can make consistent movement difficult

This helps explain why progress can feel slow or inconsistent, even when someone is making sustained lifestyle changes. These challenges reflect the metabolic features of PCOS, rather than a lack of effort.

What should I eat to support hormones and reduce inflammation?

When we talk about “balancing hormones” in PCOS, the aim is not to force hormones into perfect levels, but to support the body so hormones, especially insulin, can function more smoothly.

Many people with PCOS have ongoing low-grade inflammation, which can worsen insulin resistance and contribute to higher androgen levels.

Foods studied in PCOS include:

• Leafy green vegetables, which support blood sugar control and reduce inflammation
• Berries, rich in antioxidants that reduce inflammatory stress
• Walnuts, which some studies suggest may help reduce testosterone levels in people with PCOS
• Cinnamon, which may support insulin sensitivity and blood sugar regulation

Rather than “fixing” hormones directly, the goal is to reduce inflammation and blood sugar instability, allowing hormonal symptoms to improve naturally.

How can stabilising blood sugar support weight management?

When you eat carbohydrates, they are broken down into glucose. Insulin then helps move glucose into cells for energy. In PCOS, cells often respond poorly to insulin, leading the body to release more insulin, which promotes fat storage, cravings, fatigue, and higher testosterone levels.

Supporting blood sugar stability means:

• Choosing whole, minimally processed carbohydrates
• Being mindful of portion sizes, rather than eliminating carbs
• Avoiding repeated carbohydrate-heavy snacks
• Pairing carbohydrates with protein, fibre, and healthy fats

There are no “magic” foods. Consistency across the day matters more than perfection.

How much protein and fibre should I aim for?

Protein and fibre help slow digestion and reduce blood sugar spikes.

A practical approach includes:

• Including protein at every meal, and ideally at snacks
• Aiming for a palm-sized portion of protein at meals
• Including fibre-rich foods such as vegetables, berries, beans, whole grains, seeds, and nuts

This is not about high-protein diets or obsessive tracking. It is about avoiding meals built around carbohydrates alone.

Does meal timing matter for PCOS?

Meal timing may play a role, but it is not the most important factor.

Research suggests insulin sensitivity may be higher earlier in the day, meaning the same meal could cause a higher blood sugar response at night. However, evidence in PCOS is mixed, and individual responses vary.

What matters far more is what you eat and how balanced your meals are, rather than strict timing rules.

About this author

Ms Rania Salman is a London-based registered dietitian and nutritionist with specialist expertise in weight management, PCOS, fertility, and sustainable healthy living. With a background in Biomedical Sciences and postgraduate training in Nutrition and Dietetics, she has worked across both the NHS and private practice, supporting a wide range of clients.