According to the NHS, around 1 in 10 women suffer from polycystic ovary syndrome (PCOS). Described as a "common condition that affects how a woman's ovaries work", it's basically a reproductive hormonal imbalance that interferes with the growth and release of eggs from the ovaries, i.e. ovulation, and can cause various symptoms.
While more than half of those with PCOS don't present with any symptoms at all, others can experience a myriad, ranging from irregular periods to no periods at all, difficulty getting pregnant, oily skin or acne, and even 'PCOS belly', which is what we're here to talk about—with the help of the experts.
Lauren Johnson Reynolds aka London Wellness Coach is a Nutritional Therapist and Women's Health Speaker. She's also a PCOS expert and creator of The Complete PCOS Plan, having been diagnosed with the condition at age 14. Here, she explains all you need to know about 'PCOS belly', from what it actually is, what it looks like, and what treatments are available (should the symptom be a personal concern).
What is PCOS belly?
Though not a technical term used by doctors or health experts - rather one that has recently garnered traction online—Reynolds says that PCOS belly "refers to the excess weight that some women with PCOS experience."
She explains that it's thought to be "due to insulin resistance which is at the root of PCOS for approximately 75-80% of women." Reynolds adds that this insulin resistance causes glucose to be stored as fat around the abdomen.
Numerous studies back up Reynolds' explanation, while also adding that people with polycystic ovary syndrome are more susceptible to storing said abdominal fat. For example, one paper reported that PCOS patients "had elevated visceral adiposity," which is a larger concentration of visceral fat around the stomach and abdomen. As per Cleveland Clinic, visceral fat is the "belly fat found deep within your abdominal cavity."
Thanks to social media (especially platforms like TikTok), one search of the term 'PCOS belly' and you're immediately met with content intent on showing you how to lose it. Which, instantly attaches a negative narrative to the symptom, when in reality, we should be celebrating our bodies whatever shape or size.
So, before we continue, we must stress that losing weight is something you should only do if it's the right journey for you and your health. Not if online trends tell you to do so. But if it is something you'd like to achieve both for your physical and mental health, it's important you lose it safely.
Can PCOS change the shape of your belly?
In a nutshell, yes. Reynolds says that PCOS can cause fat to be stored around the abdomen "giving a distended appearance that can sometimes be out of proportion to the rest of the body."
She notes that this is "often referred to as an 'apple' body shape, and characteristically has a high waist to hip ratio."
Additionally, Reynolds directs us to studies that have shown that women with PCOS have an altered gut microbiome. Which, she explains, means "they may also experience GI symptoms such as bloating," a common symptom of irritable bowel syndrome (IBS).
Furthermore, this 2024 study looking at the link between PCOS and IBS firmly establishes that PCOS patients are "more prone to experience gastrointestinal (GI) disturbances such as irritable bowel syndrome (IBS)."
The paper adds: "Disordered bowel habits are typically present (i.e. constipation, diarrhea or a mix of constipation and diarrhea), as are symptoms of abdominal bloating/distension."
What does PCOS belly look like?
As described by Reynolds, 'PCOS belly' manifests in an 'apple' body shape, whereby the visceral fat is stored above the hips and around the midsection. This differs from the 'pear-shaped' figure, where any excess body fat is distributed around the thighs and hips.
Reynolds is eager to note that while not every woman with PCOS will experience weight gain around the waist or weight gain at all, they are "still at risk of other health issues associated with PCOS such as type 2 diabetes and fatty liver disease."
Does PCOS mean more belly fat?
"For many women, PCOS means that more fat is stored around the abdomen and this is due to insulin resistance," Reynolds reiterates. "When our body is resistant to insulin, it stores excess glucose as fat, primarily around the abdomen, showing up as 'PCOS belly.'"
She stresses again: "It can also result in fatty liver disease, type 2 diabetes, and cardiovascular disease for women with PCOS."
Does PCOS cause belly hair?
One side effect for some people with PCOS is an increased amount of body hair, which may also include hair on the stomach, as well as elsewhere like the face, darker arm hair, and thicker leg hair compared with someone who does not have the hormonal imbalances associated with PCOS.
Body hair is a totally normal part of life, for men, women, and non-binary people, and you should never feel under pressure to remove yours due to so-called 'beauty ideals' created by other people. It's about what makes you feel happiest and healthiest in your own skin.
If you do decide removing PCOS-related body hair is the right choice for you, it's worth looking into how to do so safely. We've a handy guide on body hair here, which may be worth a read.
Is there treatment for PCOS belly?
As we now know, insulin resistance plays a big part in PCOS belly. So, Reynolds explains that focusing on blood sugar balance is a great place to start in terms of treatment - if it's something you want to change.
"Opting for higher protein, higher fiber, and lower carb meals can be really helpful for keeping blood sugar balanced, reducing cravings, and aiding weight loss in general," she notes. Which, as we've already said, the latter should only be attempted if it's what you want want to do, and in a safe manner (e.g. by eating a balanced diet and following a healthy exercise routine.)
In regards to balancing blood sugar, Reynolds notes that your choice of breakfast foods is especially important. This is because the right foods help to replenish glucose levels and boost energy, while preventing unnecessary, unhealthy snacking throughout the day. So, she recommends a savory breakfast, such as eggs, avocado, and veggies.
Plus, "walking after meals is another great way to utilize excess glucose, making it less likely to be stored as fat," Reynolds adds. And hey, who doesn't love a bit of 'me time'? There's nothing better than taking yourself out for some fresh air with your favorite tunes or podcast to keep you company.
Finally, Reynolds notes that "because inflammation and stress are major drivers of PCOS for many," she recommends "following an anti-inflammatory diet rich in nuts, seeds, berries, oily fish, herbs, spices, and whole grains." As well as "incorporating stress reduction techniques like diaphragmatic breathing, meditation, and yoga."
This article is not intended to be a substitute for professional medical advice or diagnosis. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. And remember: if you're worried about your relationship with food and/or exercise, or are concerned about a loved one, Beat are there to help provide support and information.
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This article originally appeared on Cosmopolitan.com/uk. Minor edits have been made by the Cosmo.ph editors.
