PMOS (Previously PCOS) and Obesity
Polyendocrine Metabolic Ovarian Syndrome (PMOS, previously PCOS) is a common hormonal and metabolic condition that often occurs alongside overweight or obesity. Insulin resistance is a central part of the condition and can make weight regulation more challenging.
At the same time, overweight can amplify several of the hormonal and metabolic changes that characterise PMOS. This creates a complex interaction between weight, hormones and metabolism. For women with PMOS and overweight, weight loss can contribute to improved metabolic health and relief from several symptoms associated with the condition.
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Why Are Overweight and Obesity More Common in Polyendocrine Metabolic Ovarian Syndrome (PMOS)?
PMOS and obesity often occur together and influence each other in a reciprocal way. Insulin resistance is common in PMOS and means that the body's cells respond less effectively to insulin. To compensate, the body needs to produce more insulin to keep blood sugar levels within a normal range.
Elevated insulin levels affect not only blood sugar regulation but can also stimulate the ovaries to produce androgens, a group of sex hormones that influence hair growth, acne and ovulation.
At the same time, overweight, particularly abdominal obesity, is closely linked to insulin resistance. Fat tissue is biologically active and can affect the body's hormonal and metabolic processes. As a result, overweight, insulin resistance and hormonal changes can reinforce one another, making weight regulation more challenging for many women with PMOS.
It is important to remember that PMOS also occurs in women of normal weight and that not all women with PMOS have the same degree of insulin resistance. At the same time, research shows that weight loss in women living with overweight or obesity can often improve insulin sensitivity and contribute to improvements in both hormonal and metabolic symptoms.
How Do PMOS and Obesity Affect Appetite and Hunger?
Many women with PMOS describe feeling hungry more often, feeling less satisfied after meals or experiencing increased cravings for energy-dense foods. These experiences are likely influenced by several interacting factors, including insulin resistance, hormonal changes and obesity-related changes in the body's appetite regulation.
Insulin resistance is common in PMOS and can affect the body's energy balance and metabolism. At the same time, overweight or obesity is more common among women with PMOS, which in itself can affect the body's systems for regulating hunger and satiety.
In obesity, appetite regulation can be altered through effects on several hormones and signalling pathways that control hunger, satiety and energy expenditure. As a result, many people living with obesity experience increased hunger, reduced satiety or a greater focus on food compared with people who do not have obesity. The brain's reward system may also be affected, making energy-dense foods more appealing.
Symptoms of PMOS: From Irregular Periods to Increased Hair Growth
The symptoms of Polyendocrine Metabolic Ovarian Syndrome (PMOS, previously PCOS) vary between individuals, but the most common include irregular menstruation, absent ovulation and signs of elevated androgen levels (male sex hormones). Many women seek medical care because of irregular periods, fertility problems, acne or increased hair growth.
Common symptoms of PMOS include:
- Irregular or absent menstruation
- Difficulty becoming pregnant due to absent or irregular ovulation
- Increased facial or body hair growth (hirsutism)
- Acne and oily skin
- Hair loss or thinning hair on the scalp
- Overweight or obesity
- Insulin resistance and other signs of metabolic ill health
However, PMOS does not only affect the reproductive system. Many women also experience fatigue, low energy levels, sleep difficulties or mental health concerns such as low mood and anxiety. In addition, metabolic risk factors such as elevated blood lipids, high blood pressure and an increased risk of type 2 diabetes occur more frequently in women with PMOS than in the general population.
Symptoms vary greatly between individuals and can range from mild to more significant effects on daily life. It is also important to remember that not all women with PMOS have overweight or insulin resistance.
How to Support Weight Loss
For women with PMOS and overweight or obesity, weight loss is often an important part of treatment. Even a small amount of weight loss can improve insulin sensitivity and reduce symptoms.
Three important components of treatment for weight loss are nutrition, physical activity and, when appropriate, medication.
1. Eating Habits That Support Metabolic Health
Healthy eating habits with a focus on nutrient-dense foods can contribute to better weight regulation and metabolic health.
Choose fibre-rich carbohydrates: Whole grains, legumes, vegetables and other fibre-rich foods can help increase satiety and support more stable blood sugar levels after meals.
Prioritise protein: Foods such as fish, eggs, dairy products, legumes and lean meat can help increase satiety and preserve muscle mass during weight loss.
Include healthy fats: Nuts, seeds, olive oil and oily fish are examples of foods included in many healthy dietary patterns.
2. Regular Physical Activity
Physical activity is an important part of PMOS treatment. Both cardiovascular exercise and strength training can improve insulin sensitivity and contribute to better metabolic health.
Strength training helps preserve or build muscle mass, while cardiovascular exercise can improve fitness and support cardiometabolic health. General recommendations for many people are at least 150 minutes of physical activity per week, ideally combined with muscle-strengthening activities 2–3 times per week.
3. Medical Treatment
For some women with PMOS and overweight or obesity, weight-loss medication can complement lifestyle changes. GLP-1 receptor agonists, such as semaglutide (Wegovy) and tirzepatide (Mounjaro), can support weight loss by increasing feelings of fullness and reducing appetite.
Weight loss can contribute to improvements in several hormonal and metabolic symptoms. The degree of benefit varies between individuals, and treatment should always be assessed based on the individual person's health and needs.
Nutrition, physical activity and, where appropriate, medication often provide the best results when combined as part of a long-term and sustainable treatment strategy.
Summary
PMOS (previously PCOS) is a hormonal and metabolic condition that often occurs alongside insulin resistance and overweight. For women with PMOS and overweight, weight loss can contribute to improved insulin sensitivity, better metabolic health and reduced symptoms. Nutrition, physical activity and, for some people, medical treatment can work together to create the conditions for sustainable weight loss and better long-term health.
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