Obesity rates are rising globally, and many researchers are asking why. Could diet, environmental chemicals, or genetics play a role? Certain health conditions may also contribute — including polycystic ovary syndrome (PCOS), which has a strong link to obesity.

PCOS is a hormone-related condition that can affect how the body uses insulin, how the menstrual cycle works, and whether ovulation (the monthly release of an egg) happens. This condition can also make it easier to gain weight and harder to lose it. In this article, we’ll explore how PCOS and obesity are connected and what you can do to manage both.

Although “obese” is a medical term used when someone has a body mass index (BMI) over 30, this number — based only on height and weight — doesn’t always reflect a person’s health. BMI also doesn’t take into account differences in age, sex, gender, or racial and ethnic backgrounds.

What Is PCOS?

According to the Journal of Obesity & Metabolic Syndrome, PCOS affects 10 percent to 13 percent of women, often starting during the teen years. This disorder causes the body to produce too many androgens — a group of sex hormones that include testosterone.

High androgen levels can stop ovulation and block the hormonal signals that trigger a menstrual period. As a result, people with PCOS often have irregular or no periods and may also have trouble getting pregnant.

Health Impacts of PCOS

People with PCOS tend to have an increased risk of obesity and other health conditions such as:

• Type 2 diabetes
• Obstructive sleep apnea (a condition that causes breathing to stop and start repeatedly during sleep)
• High cholesterol
• High blood pressure
• Endometrial cancer (cancer of the lining of the uterus)

PCOS can also affect mental health. Changes in appearance, such as hair loss, weight gain, and hirsutism (excess hair), may lead to low self-esteem, anxiety, or depression.

Does Obesity Cause PCOS?

According to a 2022 study in the British Medical Bulletin, 38 percent to 88 percent of women with PCOS are living with obesity or are overweight. Does this strong link mean that obesity can cause PCOS or vice versa? The answer is complex. Obesity and weight gain are risk factors for PCOS — they increase the chance of developing it, but they don’t directly cause it. Similarly, not everyone with PCOS has obesity.

How Are PCOS and Obesity Linked?

PCOS is closely tied to insulin resistance, which can make it harder to lose weight. Insulin resistance means the body’s cells don’t respond well to insulin, a hormone that helps move glucose (blood sugar) into cells so it can be used for energy.

When glucose stays in the bloodstream, the body makes more insulin to manage the extra sugar. Insulin can lead to weight gain because the excess sugar is stored as fat. Higher insulin levels also raise hormones like testosterone, creating a cycle that’s hard to break.

Researchers don’t fully understand why many people with PCOS develop insulin resistance, but the reason may be related to genes, higher testosterone levels, or changes in how cells send and receive signals.

Obesity can worsen insulin resistance because fat cells don’t respond to insulin as well as muscle cells do. This can further raise insulin and testosterone levels, leading to symptoms such as irregular periods and fertility problems.

Although PCOS and obesity can make each other’s effects stronger, one condition doesn’t necessarily cause the other. Many people with PCOS don’t have obesity, and not everyone with obesity has PCOS. This suggests that other factors, such as genetics, also play important roles in both conditions.

How Are PCOS and Obesity Managed?

Losing weight can help improve both PCOS and obesity, but it’s not easy — especially for people with PCOS. Hormonal changes, emotional health challenges, and physical symptoms can make it tougher to stick with healthy habits.

Your healthcare provider may recommend both lifestyle changes and medical treatment options to help manage PCOS and obesity.

Physical Activity

Increased physical activity is a common treatment for both obesity and PCOS. Regular exercise may help:

• Support weight loss and long-term weight management
• Reduce body fat
• Decrease insulin, glucose, and androgen levels
• Manage blood pressure and cholesterol
• Boost mood and mental well-being
• Improve menstrual regularity and ovulation
• Lessen insulin resistance

If you find it hard to be physically active, talk with your healthcare provider or a mental health specialist. They can help you find ways to get moving that work with your lifestyle and health needs.

Surgery

For some people, lifestyle changes alone may not be enough to manage obesity and PCOS. Depending on your BMI and obesity class, your doctor may talk to you about bariatric (weight loss) surgery. This type of procedure reduces your stomach size to limit how much food you eat. However, surgery also comes with risks that should be carefully reviewed with your healthcare provider.

Medications

Certain medications can help manage PCOS symptoms and support weight loss. Some examples include:

• Diabetes medications — These can lower blood sugar, improve insulin resistance, and help with weight loss.
• Hormonal treatments — Birth control pills containing estrogen and progestin may help regulate periods and reduce PCOS symptoms such as acne and facial hair.
• Ovulation medications — These may help release eggs from the ovaries, but they carry some risks and must be used under close medical supervision.

If you’re thinking about treatment for obesity or PCOS, consider seeing an endocrinologist. This type of doctor, who specializes in hormones and caring for the endocrine system, may be particularly helpful as you explore safe, effective treatment options.

Find Your Team

MyObesityTeam is the social network for people with obesity and their loved ones. On MyObesityTeam, more than 57,000 members come together to ask questions, give advice, and share their stories with others who understand life with obesity.

Have you been diagnosed with PCOS and obesity? What steps have you taken to manage these conditions together? Share your experience in the comments below, or start a conversation by posting on your Activities page.