Why Weight Loss with PMOS Feels So Hard

If you or a loved one lives with PMOS (polyendocrine metabolic ovarian syndrome), you're not alone.

It's a condition that may affect roughly 1 in 10 people assigned female at birth (AFAB) in Canada. However, more than half of those who live with PMOS may not even know they have it. [1]

If you live with PMOS, you may find it more difficult to lose weight. But, with the right management, you can still work towards your health goals.

In this article, we'll explain what causes PMOS and what it may mean for your weight loss journey. We'll also explore 5 simple, sustainable ways to support long-term weight management.

Article Summary:

• Polyendocrine metabolic ovarian syndrome (PMOS) is a common condition. However, if left unmanaged, it can have a significant impact on your health and wellbeing.
• People with PMOS may also find it harder to lose weight. This is largely due to the same hormonal imbalances which can trigger the condition.
• Sustainable lifestyle changes, like adopting a balanced diet, meaningful daily movement, prioritizing mental wellbeing and quality sleep, may support weight loss for those living with PMOS.

What is PMOS?

PMOS (formerly known as PCOS, or polycystic ovary syndrome) is a metabolic condition which affects people with ovaries. It can impact the regularity of your menstrual cycle, and may make it more difficult to conceive. [2]

But, if left unmanaged, PMOS may also have a wider effect on your health. It's associated with an increased risk of conditions like high blood pressure, type 2 diabetes and obesity. [1, 3]

What causes PMOS?

Unfortunately, the exact cause of PMOS is still unknown. [4] However, researchers believe that there are a few key factors:

Hormone imbalance: PMOS is often associated with a hormone imbalance, which stops your ovaries from releasing eggs regularly. [5]

People assigned female at birth (AFAB) typically have high levels of female sex hormones, like estrogen and progesterone. These are the hormones that regulate your menstrual cycle and support reproductive health. [6]

If an AFAB person has higher-than-normal levels of androgens (male hormones), it may affect their ovulation. This is because higher androgen levels can interfere with the brain signals that control ovulation, stopping eggs from releasing when they should. [4]

Insulin resistance: Many people who live with PMOS don't respond well to insulin (the hormone which keeps our blood sugar at a safe level). Their bodies often make more insulin to compensate which, in turn, increases androgen levels. This "cycle" of hormonal imbalance may be one of the reasons that PMOS can be difficult to treat. [4]

Lifestyle: Eating a diet high in processed foods and sugars may further destabilize insulin levels and worsen symptoms of PMOS. [7]

Genetics: Symptoms of PMOS tend to run in families, which suggests that the condition may also be linked to genetics. [4, 8]

What are the symptoms of PMOS?

If you live with PMOS, you may experience:

• Irregular menstrual cycles (periods). This could mean infrequent, unpredictable or completely absent periods, or particularly long, heavy and painful periods. It varies from person to person.
• Excess facial and body hair (hirsutism)
• Acne
• Female pattern baldness, or hair thinning
• Fertility challenges
• Small fluid-filled sacs that may form on the ovaries, but this isn’t present in every case of PMOS [1, 9, 10]

If you think you may be living with PMOS, speak to your clinician. They may arrange to check your blood work, to support a formal diagnosis.

How can PMOS affect weight and weight loss?

It's estimated that anywhere between 33-88% of people who live with PMOS also live with either obesity or overweight. [11] In Canada alone, obesity, type 2 diabetes and dyslipidemia (abnormal levels of fat in your blood) are 2-3 times more common in those with PMOS. [1]

But why is this? And why is it that PMOS, or PCOS weight loss can feel more difficult than weight loss without the condition?

As we've seen, PMOS is intrinsically linked to our hormone levels. And when those hormone levels are disrupted, it can significantly impact the way our bodies process energy:

Increased androgen levels: If you have higher levels of androgens, you're more likely to store weight around your belly as abdominal fat. [12] This is known by some as "PMOS or PCOS belly".

Insulin resistance: If your body's not processing insulin properly, it may store any extra sugar (glucose) as fat instead of burning it for energy. [13]

Insulin also helps to signal feelings of satiety in your brain. [14] If you're experiencing insulin resistance, you may also be more likely to experience stronger cravings, which may lead to increased calorie consumption and weight gain. [15]

Although weight loss may be more difficult with PMOS, it's not impossible. And studies have also shown the positive benefits of weight loss in those living with PMOS and obesity. In fact, weight loss of at least 5% in those with obesity has been shown to improve insulin resistance and fertility. [16] Simple but sustainable changes to daily lifestyle habits may help to manage symptoms and support longer-term health and weight loss goals.

5 ways to support weight loss

Supplements

If you live with PMOS, you may have come across PMOS/PCOS supplements. While supplements won't "treat" PMOS, and shouldn't be used as a substitute for clinical diagnosis and care, early research shows that some may support hormonal and metabolic regulation.

For example, many people with PMOS have a vitamin D deficiency. A deficiency means that your body either can’t make enough of a substance naturally, or you aren’t getting enough of it through your diet. Taking supplements may support insulin metabolism and reduce androgen levels in people with a diagnosed deficiency. Omega-3 fatty acids and vitamin E may also support metabolic health, while N-acetylcysteine (NAC) may help to support hormonal balance and regularize menstrual cycles. [17]

However, there’s no evidence to suggest that taking supplements will offer any benefit if you aren’t deficient.

Diet

Making positive changes to what you eat, like swapping processed foods for fresh, balanced meals may improve insulin sensitivity and support sustainable weight loss.

One of the best dietary models for those with PMOS is the "Mediterranean diet", which balances lean proteins like chicken with healthy fats like nuts and seeds and low-GI whole grains like brown rice. This is because the nutrients typically provided in the Mediterranean diet may reduce insulin resistance and chronic inflammation. [18]

One study has even found that following the Mediterranean diet could lower the risk of developing PMOS by up to 41%. [19]

Movement

Incorporating daily movement into your routine may support weight loss and help to manage PMOS. [20] Health Canada recommends adults be active for at least 2.5 hours each week. This includes moderate-intensity activity that makes you breathe harder and your heart beat faster, as well as muscle-strengthening activities. [21]

Sleep

PMOS is strongly linked to sleep disturbances like insomnia and sleep apnea. [22] However, having good "sleep hygiene" is crucial for a healthy, functioning body, including your metabolism.

Aim for 7-9 hours sleep each night to support long-term body and brain health. [23] If you do experience a PMOS-related sleep condition, speak to your healthcare provider about the additional support available.

Mental wellbeing

While we're still learning about many elements of PMOS, what we do know is that it can also have a psychological impact. [24]

If you can, try to prioritize your mental wellbeing. Carving out space for yourself and looking after your mental health is just as important as prepping healthy meals or adding daily movement to your routine. Whether it's grabbing a quiet coffee, practicing a mindfulness exercise or speaking with a trusted person, take time for your mind.

Can I use weight loss treatments if I have PMOS?

Yes, weight loss treatment may be suitable for you if you live with PMOS and obesity. However, you'll need to check your eligibility with a registered clinician. They'll also be able to guide you on which treatments may be best for you.

Find out which treatment may be suitable for you with MedExpress.

References 

1. Grey K. Polycystic ovary syndrome (PCOS) is a big threat to women’s health, but it’s still under-recognized, under-diagnosed and under-treated – WCHRI [Internet]. WCHRI. 2025 Aug [cited 2026 Aug 6]. Available from: https://www.wchri.org/our-impact/stories/polycystic-ovary-syndrome-pcos-is-a-big-threat-to-womens-health-but-its-still-under-recognized-under-diagnosed-and-under-treated/

2. Dennett CC, Simon J. The Role of Polycystic Ovary Syndrome in Reproductive and Metabolic Health: Overview and Approaches for Treatment. Diabetes Spectrum [Internet]. 2015 May [cited 2026 Aug 11];28(2):116–20. Available from: https://spectrum.diabetesjournals.org/content/28/2/116

3. Singh S, Pal N, Shubham S, Sarma DK, Verma V, Marotta F, et al. Polycystic Ovary Syndrome: Etiology, Current Management, and Future Therapeutics. Journal of Clinical Medicine [Internet]. 2023 [cited 2026 Aug 6];12(4):1454. Available from: https://www.mdpi.com/2077-0383/12/4/1454

4. NIH. What causes PCOS? [Internet]. https://www.nichd.nih.gov/. 2022 Sept [cited 2026 Aug 10]. Available from: https://www.nichd.nih.gov/health/topics/pcos/conditioninfo/causes

5. Polycystic Ovary Syndrome (PCOS) Foundation Canada | Overview [Internet]. Pcoscanada.org. 2026 [cited 2026 Aug 10]. Available from: https://pcoscanada.org/pcos-overview

6. Reed BG, Carr BR. The normal menstrual cycle and the control of ovulation [Internet]. Nih.gov. MDText.com, Inc.; 2018 Aug [cited 2026 Aug 11]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279054/

7. Alomran S, Estrella ED, Alomran S, Estrella E. Effect of Dietary Regimen on the Development of Polycystic Ovary Syndrome: A Narrative Review. Cureus [Internet]. 2023 Oct 24 [cited 2026 Aug 11];15(10). Available from:

https://www.cureus.com/articles/174552-effect-of-dietary-regimen-on-the-development-of-polycystic-ovary-syndrome-a-narrative-review?score_article=true#

8. Khan MJ, Ullah A, Basit S. Genetic basis of polycystic ovary syndrome (PCOS): Current perspectives. The Application of Clinical Genetics [Internet]. 2019 Dec [cited 2026 Aug 10];Volume 12(12):249–60. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6935309/

9. Polycystic Ovary Syndrome (PCOS) Foundation Canada | Common Sign/Symptoms [Internet]. Pcoscanada.org. 2026 [cited 2026 Aug 10]. Available from: https://pcoscanada.org/pcos-common-features

10. World Health Organization. Polycystic ovary syndrome [Internet]. World Health Organization. 2025 [cited 2026 Aug 10]. Available from: https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndrome

11. Barber TM, Hanson P, Weickert MO, Franks S. Obesity and Polycystic Ovary Syndrome: Implications for Pathogenesis and Novel Management Strategies. Clinical Medicine Insights: Reproductive Health [Internet]. 2019 Jan [cited 2026 Aug 10];13(13):117955811987404. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6734597/

12. Dumesic DA, Akopians AL, Madrigal VK, Ramirez E, Margolis DJ, Sarma MK, et al. Hyperandrogenism Accompanies Increased Intra-Abdominal Fat Storage in Normal Weight Polycystic Ovary Syndrome Women. The Journal of Clinical Endocrinology & Metabolism. 2016 Nov;101(11):4178–88. Available from: https://pubmed.ncbi.nlm.nih.gov/27571186/

13. Chen Y, Liu T, Khameis F, Xie M. Exploring the underlying mechanisms of obesity and diabetes and the potential of Traditional Chinese Medicine: an overview of the literature. Frontiers in Endocrinology.

2023 Aug 1;14. Available from: https://pubmed.ncbi.nlm.nih.gov/37600709/

14. Georgios Antasouras, Antonios Dakanalis, Chrysafi M, Papadopoulou SK, Ioulia Trifonidi, Spanoudaki M, et al. Could Insulin Be a Better Regulator of Appetite/Satiety Balance and Body Weight Maintenance in Response to Glucose Exposure Compared to Sucrose Substitutes? Unraveling Current Knowledge and Searching for More Appropriate Choices. Medical Sciences [Internet]. 2024 June 6 [cited 2026 Aug 11];12(2):29–9. Available from: https://www.mdpi.com/2076-3271/12/2/29

15. Stefanaki K, Karagiannakis DS, Peppa M, Vryonidou A, Kalantaridou S, Goulis DG, et al. Food Cravings and Obesity in Women with Polycystic Ovary Syndrome: Pathophysiological and Therapeutic Considerations. Nutrients [Internet]. 2024 Jan 1 [cited 2026 Aug 11];16(7):1049. Available from: https://www.mdpi.com/2072-6643/16/7/1049

16. Rondanelli M, Perna S, Faliva M, Monteferrario F, Repaci E, Allieri F. Focus on metabolic and nutritional correlates of polycystic ovary syndrome and update on nutritional management of these critical phenomena. Archives of Gynecology and Obstetrics. 2014 Sept 9;290(6):1079–92. Available from: https://pubmed.ncbi.nlm.nih.gov/25200687/

17. Han Y, Hou Y, Han Q, Yuan X, Chen L. Dietary supplements in polycystic ovary syndrome–current evidence. Frontiers in Endocrinology [Internet]. 2024 Sept 27 [cited 2026 Aug 10];15. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11466749/#B13

18. Barrea L, Arnone A, Annunziata G, Muscogiuri G, Laudisio D, Salzano C, et al. Adherence to the Mediterranean Diet, Dietary Patterns and Body Composition in Women with Polycystic Ovary Syndrome (PCOS). Nutrients. 2019 Sept 23 [cited 2026 Aug 11];11(10):2278. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6836220/

19. Zeinab Ajorlouie, Paniz Moshkian, Baghdadi G, Amiri R, Fereshteh Biglari, Mehran Rahimlou. The association between the Mediterranean Diet and the Prime Diet Quality Score and polycystic ovary syndrome: a case control study. BMC Nutrition. 2025 Apr 16 [cited 2026 Aug 11];11(1). Available from: https://pubmed.ncbi.nlm.nih.gov/40241157/

20. Gautam R, Maan P, Jyoti A, Kumar A, Malhotra N, Arora T. The Role of Lifestyle Interventions in PCOS Management: A Systematic Review. Nutrients [Internet]. 2025 Jan 16 [cited 2026 Aug 11];17(2):310–0. Available from: https://www.mdpi.com/2072-6643/17/2/310

21. Public Health Agency of Canada. Physical Activity Tips for Adults (18-64 years) [Internet]. Canada.ca. 2018 [cited 2026 Aug 11]. Available from: https://www.canada.ca/en/public-health/services/publications/healthy-living/physical-activity-tips-adults-18-64-years.html

22. Fernandez R, Moore V, Van Ryswyk E, Varcoe T, Rodgers R, March W, et al. Sleep disturbances in women with polycystic ovary syndrome: prevalence, pathophysiology, impact and management strategies. Nature and Science of Sleep [Internet]. 2018 Feb [cited 2026 Aug 11];Volume 10(2018):45–64. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5799701/

23. National Heart, Lung, and Blood Institute. How Sleep Works - How Much Sleep Is Enough? [Internet]. www.nhlbi.nih.gov. 2022 Mar [cited 2026 Aug 11]. Available from: https://www.nhlbi.nih.gov/health/sleep/how-much-sleep

24. Dewani D, Karwade P, Mahajan KS. The Invisible Struggle: The Psychosocial Aspects of Polycystic Ovary Syndrome. Cureus [Internet]. 2023 Dec 1 [cited 2026 Aug 11];15(12). Available from: https://pubmed.ncbi.nlm.nih.gov/38288169/