Arohi (name changed), a 28-year-old professional from Delhi, consulted me after she gained 14kg in two years, despite what she described as “constant attempts at dieting”. She suffered from irregular menstrual cycles, acne outbreaks, hard-to-shed belly fat, hair loss, constant bloating, and afternoon fatigue that she found led her to reach for sweets and tea. Vital signs indicated that she had high fasting insulin levels, slightly increased testosterone levels, low vitamin D, and a mild case of hypothyroidism — all symptoms of PCOS (polycystic ovary syndrome), a hormonal disorder common in women of reproductive age, characterized by an excess of male hormones (androgens).
However, the more important point is that her weight problem was not a problem but rather a sign that her body was experiencing metabolic stress.
The real starting point: the stabilization of the internal storm
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The first change that occurred was a shift in her body’s metabolism and not in her food choice. The energy intake cycle has constantly raised her insulin levels, while rising insulin signals her ovaries to produce more male hormones, thus exacerbating the symptoms of PCOS and fat accumulation, especially in the abdomen.
Therefore, before reducing calories, we introduced the structure of blood sugar.
Her breakfast has changed from uma/poha or toast to a protein-rich dish: chilla moong with paneer or a vegetarian omelette, with sourdough or sprouts on the side. The first rule was to eat protein within 30 minutes of waking up.
Lunch and dinner were based on the 50-30-20 principle, 50% high-fiber vegetables, 30% clean protein, 20% smart carbs. Smart carbs don’t mean no carbs. And her tea did not disappear. But after breaking the fast, he turned the sugar into jaggery or date syrup in controlled portions. The goal was to add, not to remove.
Healing infections, calming hormones
PCOS is primarily an inflammatory condition, so we’ve added foods that soothe the internal environment instead of inflaming it, such as turmeric, methi water, flax, sesame seeds, mint, pumpkin, anti-inflammatory spices, and omega-rich foods. Gut health has received special attention because a sluggish bowel exacerbates hormonal chaos. A daily dose of yoghurt with seeds, variety of fiber in every meal, and hydration with electrolytes helped her reduce bloating within 10 to 12 days.
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We also corrected the most underestimated factor of imbalance, low vitamin D. No diet improves insulin sensitivity if vitamin D and magnesium are deficient. We provided the supplements along with exposure to the morning sun for 20 minutes.
Movement that works with your hormones
More sweat does not mean more fat loss. The thing is, for PCOS bodies, over-training that increases cortisol levels actually stops fat loss rather than speeds it up. We changed that to three days of strength training, 8,000 steps a day, and yoga twice a week to reduce stress hormones. What her body needs is a signal of safety, not survival.
The result is sustainable and not radical
Over the course of 12 weeks, Arohi lost 6.8kg, but the most important change was that her menstrual cycle became regular, her cravings stabilized, her acne decreased and her daily energy levels remained steady, with significant relief from her abdominal inflammation. However, the most important indicator of success is that she no longer feels that someone is fighting her.
What this case teaches us
When anyone mentions weight loss due to PCOS, the advice seems to echo: Cut back on carbs, exercise more, and lose weight. However, PCOS is not a mathematical equation where subtracting calories minus calories yields automatic results; It is an endocrine disorder in which hormones, insulin resistance, inflammation, stress physiology, sleep cycles, and even gut health influence weight response.
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Most women with PCOS are not eating “wrong,” but rather eating against a body whose internal wiring has temporarily changed.
The smartest diet strategy for PCOS is one that:
● Rebuilds insulin response before reducing calories.
● Prioritize protein and fiber before cutting portions.
● Add anti-inflammatory foods before removing joys.
● Chooses hormonal balance rather than temporary contraction.
For PCOS, fat loss is not the first trimester; Balance is. Once the body feels balanced, the weight stops resisting.
(Kathuria is a clinical nutritionist)
(Tags for translation) Managing PCOS
