At PGI, women with PCOS changed their diet plan and got it under control: Here’s why a new study offers hope

Counselling: A crucial tool

Dr Walia highlights how PCOS negatively affects body image, with patients experiencing irregular periods, acne, facial hair, and weight gain. To motivate them, she records their affirmations and transformative journeys. “Seeing their progress, from underconfidence to joy, provides a psychological boost,” she says. Unlike diabetes patients, who prioritize health changes, PCOS patients often lack motivation. By combining medication with lifestyle changes, Dr Walia helps patients regain control over their health.

PGI study insights

A PGI study involving 300 women found that PCOS disproportionately affects young, well-educated women from upper-middle-class backgrounds. Most participants were under 25, and more than half were students. Another study estimates PCOS prevalence among Indian women at 3.7% to 41%, with hormonal imbalance being a key factor. The study revealed that 79% of participants were overweight, 77.1% belonged to the upper-middle class, and nearly all had poor lifestyles, eating junk food, avoiding exercise, and experiencing high stress. Around 80% were overweight or obese.

Dr Swapna Misra, Director of Obstetrics and Gynaecology, Fortis, Mohali, explains that while PCOS is a hormonal disorder, its symptoms are aggravated by poor lifestyle choices and obesity. “When obesity rises, testosterone increases and progesterone decreases, leading to irregular cycles and other symptoms,” she says.

The role of diet

Dr Vanita Jain, HOD, Obstetrics and Gynaecology, PGI, emphasizes that nutrition and PCOS are directly linked. “Losing just 5% of body weight can significantly ease symptoms, sometimes reducing the need for medication,” she states. She stresses that oral contraceptives, often prescribed, are not a long-term solution; lifestyle changes are more effective.

One patient in her mid-20s suffered from acne, thinning hair, and weight gain. Despite taking birth control pills and metformin to control blood sugar, she saw no improvement. Instead of changing medication, doctors focused on counselling, encouraging movement throughout the day, hydrating with beetroot and cucumber water, eating fibre-rich home-cooked meals, swapping sweets for fruits, having early dinners, and attending regular follow-ups. After losing 25 kg, she was able to stop medication, proving that holistic management works.

Small changes, big impact

Dr Walia starts with small dietary adjustments to prevent hunger pangs. “We make weight loss easier by incorporating seasonal vegetables, salads, seeds, nuts, sprouts, green tea, and whole grains. We also use visualization techniques, replacing cravings for chocolate with images of carrots or dates. Patients write affirmations like ‘I am happy while eating this carrot,’” she explains.

A study by PGI’s Department of Community Medicine and School of Public Health found that dietary deficiencies were the top risk factor for PCOS among girls aged 12-19, followed by unhealthy lifestyles and lack of awareness. Adolescent girls were particularly vulnerable, struggling with menstrual irregularities and cosmetic concerns like facial hair due to obesity. Dr Ishwarpreet Kaur, who worked on the study, advocates for a multidisciplinary approach rather than relying solely on medication. “We focused on portion control, avoiding processed foods, and eating local, seasonal produce. As patients lost weight and saw aesthetic improvements, incorporating exercise became easier,” she says.

Balanced breakfast: The first step

Dr Nancy Sahni, HOD of Dietetics at PGI, observes that many young women rely on processed and genetically modified foods high in preservatives. “For many, a ‘homemade’ breakfast means white bread with commercial spreads, while lunch is from a college canteen. Given their budgets, we recommend fresh, seasonal produce over imported items,” she explains.

To address this, she eliminates processed foods and sugar, introduces twice-daily salads, encourages hydration over snacking, and promotes post-meal walks. “A well-balanced diet with macronutrients, antioxidants, low glycaemic index foods, and controlled calories helps manage weight, insulin sensitivity, inflammation, and menstrual cycles,” she states.

She also implemented a “seed break” to prevent cravings. “For the first 14 days of the month, patients consume a teaspoon each of pumpkin and flaxseeds. The rest of the month, they switch to sunflower and sesame seeds. This helps balance hormones and provides satiety,” she says. According to Dr. Sahni, diet accounts for 70% of the effort, while exercise makes up the remaining 30%. When packaged like a life lesson, a holistic approach works for young women.