PCOS? You can lose weight, you’re not trying hard enough.

Molly writes:

First and foremost, I want to thank you for bringing this issue to light. It is such a relief not only to know that I am not the only person to have experienced less than satisfying care from a physician because of my weight, but that someone is finally speaking up about it.
I’ve been heavy for most of my life. I didn’t do anything to bring it on, it just happened. I was teased and bullied almost constantly at school, criticized and singled-out at home. Every mouthful was analyzed and I simply cannot remember a time when my size and diet was not THE focus of my life.
A few years ago I was diagnosed with Poly Cystic Ovarian Syndrome, a disease which, amongst other things, disrupts the body’s ability to efficiently process insulin, making it very easy to gain weight, but extremely difficult to slim down. I am currently taking several medications to help regulate my metabolism, I eat a balanced, low fat diet and exercise regularly. However, I am still obese (250lbs).
The taunts and insults continue to come, most of which I attribute to ignorance. However, it is a great deal more difficult to ignore the dismissive and less-than-ideal treatment I’ve received from highly educated doctors on account of my size. In fact, I have recently changed internists because I no longer felt comfortable in my doctor’s presence.
Dr. B. was dismissive of my complaints and often told me that I would feel better once I lost the weight. She never once acknowledged the difficulties PCOS women have with weight loss, neither did she ever seem to believe that I could lead a healthy, active lifestyle and still be overweight. I felt I had to be on the defensive at all times. Dr. B. would roll her eyes, exhale sharply and tell me I obviously wasn’t really trying.
I acknowledge that obesity does make me more susceptible to certain medical problems, however, I refuse to be treated as though I am engaging in a foolish, risky lifestyle. I did not choose obesity, I am doing everything I can to be healthy and I deserve to be respected. I know that I am heavy. I’ve been aware of the fact almost every second of my life. I DO NOT need it pointed out and emphasized at all times.

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11 Comments

  1. O.C.

     /  July 31, 2009

    Absolutely, Molly.

    I remember clearly a very frustrating discussion with an endocrinologist in which he diagrammed PCOS, with weight gain as a symptom. He then told me that the treatment would be for me to lose weight.

    But you just said that weight gain is a symptom, I said. How is removing a symptom going to treat my condition, assuming that it’s even possible?

    He just shrugged.

    Telling a woman with PCOS to lose weight in order to treat her PCOS is like telling a person with psoriasis to just get rid of all of that scaly skin and they’ll feel better. Telling a person with chicken pox to just get rid of those itchy blisters and they’ll feel better. Total nonsense and the very essence of blaming the victim.

    Reply
  2. Megan

     /  July 31, 2009

    I like your analogies, O.C.! Like telling a person with the flu to stop throwing up and they’ll feel better. I’ll be thinking of more all evening, haha.

    As another woman with PCOS, I know how hard it is to lose weight! I’m sorry you’ve had a rough time, Molly. I would never have believed doctors could act like this (rolling their eyes, telling someone they’re not trying hard enough – that’s just awful)! I hope you can find a doctor that will treat you with respect.

    Reply
  3. Tal

     /  August 1, 2009

    Ugh. I’ve SO been there. Part of the problem is that there are some PCOS patients who have seen symptoms decrease after they’ve lost weight, and therefore some doctors seem to think it’s the weight loss that’s treating the PCOS, instead of treatment helping with the weight loss AND the other symptoms.

    FWIW, I know there’s considerable research out there right now trying to determine not just why our cells resist insulin (thus making us tired and hungry all the time, because those cells aren’t getting the glucose they need), but why we have a problem converting stored fat to glucose. (The last I heard, they think it’s a liver enzyme or something like that.

    But good luck, of course, on finding doctors–outside of REs who specialize in PCOS–who know anything at all about current research on the disease. Millions of them even still think it’s just a bleed-or-breed issue that has nothing to do with metabolism at all. Ugh!

    Reply
  4. Kristen

     /  August 1, 2009

    I really appreciate you posting this! It’s been hard for me to find a PCOS-related space that isn’t overwhelmingly fat-hatred based. I haven’t had to deal with doctors who scoff at me so much, but more people just not understanding PCOS or taking it seriously as a health concern beyond it making you fat. Which people seem to regard as more of an excuse rather than a symptom that I didn’t elect by sitting on my fat ass. I’m highly frustrated by the lack of treatment options apart from weight loss and birth control pills. I sometimes feel that the reason that so little understanding or research related to PCOS exists has to do with a combination of misogyny and sizism. We’re fat women – what do they care about us so long as they don’t have to look at us? Perhaps that’s an overstatement, but after years and years without any answers, what conclusion can we come to?

    I really hope that you can find a new doctor who isn’t a tool, and who takes your health seriously. Beyond telling you that the only way to stop being fat is to stop being fat. You certainly deserve to be treated with respect and understanding.

    Reply
  5. O.C.

     /  August 1, 2009

    You know, reading this discussion makes me wonder. We’ve all been told that PCOS makes it hard to lose weight. But if we look at the larger medical research on weight, it’s pretty much impossible for anybody at all to lose weight and keep it off! Is this really a symptom of PCOS? Or were doctors looking at the weight of women with PCOS more closely and noticing it wasn’t coming off, while assuming that people without the condition were doing just fine?

    Maybe PCOS weight is NOT any different from anyone else’s weight?

    As for finding a good doctor, I’ve found that if you can find a GYN or endocrinologist at a teaching hospital you can then look him or her up on pubmed.gov to see what PCOS research they’ve published. That should give you an idea of their expertise and their perspective on the condition. If you’re not near a teaching hospital, check out soulcysters.com for doctor recommendations.

    Reply
  6. I got really pissed off at an endocrinologist I saw in Singapore who told me to lose weight. So I asked him to tell me how. He said diet and exercise. I said already failed. He shrugged and I asked him what advice would he give a skinny woman. He said diet and exercise. Then he suggested WLS and I asked would it cure PCOS (knowing that it wouldn’t) and he said maybe. Yeah like I’m going to have a really serious surgery on the grounds that it might cure my non fatal disease. I told him that he was full of shit and walked out. Never went back.

    I just don’t put up with treatment like that anymore. I’m fat. It’s just a descriptor. Since I’ve reclaimed it for myself, I am never upset, embarrassed or ashamed. It’s totally worth it.

    Reply
  7. littlem

     /  August 1, 2009

    What do they call someone who graduates from med school (and completes residency) with a “D” average?

    “Doctor.”

    Hang in there.

    Reply
  8. MargB

     /  August 2, 2009

    This is just from my own experience and may not work for others with insulin resistance (the part of PCOS that makes it very easy to gain weight and very hard to ever lose it). But it’s worth mentioning if you are one of the lucky ones it works for.

    I have been fat for years and going to the gym and exercising for years. I always amaze instructors, etc how fit I am. As an overweight woman I was encouraged to do lots of cardio to burn more calories. It did great things for my heart but I never lost weight. Then a nurse-educator who was the first to actually identify my main issue (insulin resistance) suggested I try doing light weight-resistance training rather than just cardio. Within 4 months my insulin levels had reverted to very healthy normal levels. I’m still fat but I have heaps more energy. Apparently the light weight-resistant thing is something that has been known for years to help older people (65-plus) avoid diabetes but none of those specialist doctors ever thought to try it with younger women with PCOS and related conditions. A disclaimer – I was one of about 15 women in the program and had the best results; some of the women with particularly bad PCOS saw very little change. But even they thought it was worthwhile, if only to meet other women who were going through the same thing.

    Reply
  9. Amy

     /  August 3, 2009

    I have PCOS, and its been a real struggle to even get a doctor to acknowledge that its a real disaese. My gynae told me not to worry about it, and that the treatment was the pill. My GP told me not to worry about it, and that I should try to lose weight. It was only when I saw an endocrinologist of my own accord that someone has started to treat this properly, and actually look into various medications that might be needed. Its so frustrating!!

    I’ve found this site: http://www.soulcysters.net to be really helpful. Avoid the Diet forums unless you’re looking for that kind of thing, but the rest of the forums can be extremely helpful, and the ladies are very supportive.

    MargB – I have also heard that strength training is especially good for PCOS/Insulin resistance. I split my gym workouts into half cardio and half strength training – although i don’t keep it too light!

    Reply
  10. “I am doing everything I can to be healthy and I deserve to be respected.”

    You deserve to be respected. Period. I think we all deserve respect whether or not we meet some doctor’s or nutritionist’s idea of how to live.

    As a holistic health educator, I believe that it is important not to fall into the trap of healthism, the idea that unless we are 100% perfect at exercising, balancing nutrition, etc. we don’t deserve respect. Bottom line: Fat is NOT a moral issue.

    Reply
  11. Kaylee

     /  September 12, 2012

    I have been losing and gaining weight since the age of 14. I got my period late (at 17) and my weight went up and down a few times since. I was diagnosed with pcos at 23. Before my diagnoses i always had irregular periods but blood tests never showed anything unusual until my pcos popped up. I’m 24 now and I’m trying to lose 10-15 more KGs. To date I’ve shaved 8 KGs in about 4- 5 weeks. I’ve never had problems losing weight it the past. My body tends to lose weight very easily when I do things right. Does pcos necessarily mean my weight loss attempts this time round will be any different/more difficult ? I’m only concerned that because of my size, I should be seeing bigger numbers coming off weekly. Althought I am also doing weights which may be adding muscle mass.

    Reply

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