IN FOCUS: Why PCOS Makes Weight Loss So Hard. Insulin Resistance, Diet & What Actually Works

You’re doing everything right. And still gaining weight.This is one of the most frustrating and misunderstood parts of PCOS.In this conversation, Dr Bassel Wattar explains why weight loss in PCOS isn’t simply about calories, discipline, or willpower, but about underlying metabolic and hormonal dysfunction.What emerges is a much more nuanced picture, one that challenges the advice many women are still being given.Key takeaways:* Weight gain in PCOS is often driven by insulin resistance and metabolic inflexibility, not lack of effort* Standard calorie restriction alone is often ineffective. What you eat matters as much as how much* Lower glycaemic approaches, intermittent fasting, and structured dietary strategies may offer better results* Some women will require additional support, including metformin or GLP-1 medications, as part of a broader plan* Even without weight loss, dietary changes can improve symptoms such as cycle irregularity and acne* PCOS is not one-size-fits-all: treatment must be personalised to the individualDr Bassel Wattar is an Associate Professor in Reproductive Medicine whose work focuses on metabolic dysfunction and fertility outcomes in women with PCOS. His approach centres on personalised, physiology-led care.If weight isn’t just about calories… what does that mean for how we approach women’s health?I’d love to hear your experience. Has this been your story too? This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thewomanshandbook.substack.com