Is PCOS belly a thing?

Polycystic ovary syndrome (PCOS) is a common hormone disorder that affects women of reproductive age. One of the most bothersome symptoms for many women with PCOS is weight gain and inability to lose weight, especially around the belly area. This has led many to wonder: is PCOS belly a real thing?

Table of Contents

What causes belly fat in PCOS?

There are several factors that contribute to increased belly fat in women with PCOS:

Insulin resistance – Up to 80% of women with PCOS have some degree of insulin resistance, which makes it harder for the body to control blood sugar levels. To compensate, the body produces more insulin, which promotes fat storage, especially around the belly.
Inflammation – Women with PCOS tend to have higher levels of inflammation, which has been linked to abdominal obesity. Inflammation causes cortisol levels to rise, and cortisol triggers fat storage in the belly area.
Hormone imbalance – PCOS involves excess androgens (male hormones), which tend to promote abdominal fat deposition. Estrogen deficiency seen in some PCOS patients also encourages visceral fat accumulation.

Genetics – Research suggests there may be gene variants more common in women with PCOS that make them prone to carrying weight in their mid-section.

These underlying metabolic and hormonal imbalances all converge to make it extremely difficult for women with PCOS to lose belly fat.

What does PCOS belly look like?

Women with PCOS often describe their belly as looking ‘pregnant’ or ‘bloated.’ Here are three hallmark features of PCOS belly:

Abdominal bloating – Many women with PCOS experience frequent bloating and a ‘puffy’ belly, even if they haven’t gained much overall weight.
Protruding lower belly – Fat storage tends to accumulate mostly around the lower abdominal area below the belly button, causing the lower belly to protrude out.
Absence of waist definition – Due to increased visceral fat, the waistline becomes less defined and straight, giving an ‘apple’ body shape.

Does every woman with PCOS have belly fat?

No, increased belly fat and weight gain are not experienced by every woman with PCOS. Estimates vary, but about:

50-60% of women with PCOS are overweight or obese.
30% have a normal, healthy body mass index (BMI).

10-20% are underweight.

So while abdominal obesity is extremely common, it doesn’t impact all PCOS patients. Lean or thin women with PCOS tend to have less severe metabolic abnormalities.

What health risks are linked to PCOS belly fat?

Carrying extra weight around the middle section is tied to a number of health complications. Potential risks associated with belly fat in PCOS include:

Type 2 diabetes – Up to 10 times higher risk than women without PCOS.
Metabolic syndrome – A cluster of risk factors like high blood pressure, glucose and triglycerides.
Heart disease and stroke – Number one cause of death in PCOS.

Sleep apnea – Caused by fat buildup around the neck and upper body.
Cancer – Higher risks of endometrial, ovarian and breast cancer.
Infertility – Increased abdominal fat disrupts reproductive hormone balance.

Given the health implications, targeting abdominal fat loss should be a top priority for overweight women with PCOS.

Can you get rid of PCOS belly?

There is no cure yet for PCOS, but the good news is that the symptoms like excess belly fat can be managed and reduced with lifestyle strategies and treatment.

Diet Tips

Cut back refined carbs – Reduce bread, pasta, cereals, sugary foods which spike blood sugar and insulin.

Up protein intake – Eat lean protein at every meal to increase satiety and prevent insulin spikes.
Choose complex carbs – Focus on vegetables, fruits, legumes, whole grains which digest more slowly.
Drink more water – Stay hydrated to prevent bloating and fluid retention.

Exercise Tips

Combine cardio and strength training – Aerobic exercise and strength training helps burn belly fat and build lean muscle mass.
Target the core – Include crunches, planks, rotational exercises to tone abdominal muscles.
Reduce sitting time – Take standing or walking breaks throughout the day.

Medical Treatment

Metformin – Insulin-sensitizing drug that reduces belly fat while regulating menstrual cycles.
Anti-androgens – Block male hormones like testosterone linked to abdominal obesity.
Oral contraceptives – Birth control pills can help balance reproductive hormones.

Conclusion

PCOS belly refers to the abdominal weight gain and bloating experienced by many women with polycystic ovary syndrome. A combination of hormonal, metabolic and genetic factors drives fat storage around the lower belly in PCOS. While challenging, implementing lifestyle changes and medical treatment can help women with PCOS lose belly fat and reduce related health risks.