What is PCOS Belly: What It Looks Like, How to Treat It, and How a Dietitian Can Help

Polycystic ovary syndrome (PCOS) is a hormonal disorder that affects many women of childbearing age. It is often characterized by irregular periods, ovarian cysts, infertility, acne, and hormonal imbalances. One of the key drivers behind PCOS and its associated challenges, including the development of PCOS belly, is insulin resistance.

Insulin resistance occurs when the body's cells become less responsive to the effects of insulin, a hormone produced by the pancreas that helps regulate blood sugar levels. This can cause elevated blood sugar levels as well as hormonal imbalances, including high levels of male hormones such as testosterone. As a result, it may be more difficult to maintain a healthy weight.

What is PCOS Belly? 

If you have PCOS, you may find it harder to lose weight or maintain a healthy weight. This is because insulin resistance promotes the storage of fat, particularly around the abdomen. This accumulation of fat around your midsection is often referred to as “PCOS belly”. 

PCOS belly vs. endo belly

While both PCOS belly and endo belly involve abdominal discomfort and bloating, they stem from different underlying conditions. It's important to understand the differences in order to properly address each symptom. 

PCOS belly is linked to PCOS and driven by hormonal balances that increase the storage of lower abdominal (belly) fat.

Endo belly is linked to a condition called endometriosis and driven by inflammation and bloating in the abdominal area. Discomfort is typically in the lower abdomen, but can radiate to the lower back and pelvic regions. 

What does PCOS belly look like?

PCOS belly is characterized by excess fat accumulation around the abdominal area, often resulting in a distinctive body shape commonly referred to as an “apple shape.” Some people feel as though their abdomen feels larger in proportion to the rest of their body. 

Other signs of PCOS 

Beyond the visible accumulation of abdominal fat, there are additional signs and symptoms associated with PCOS. Irregular periods are a hallmark sign of PCOS and are linked to the hormonal imbalances that also contribute to belly fat.

Alongside the symptoms mentioned above, ovarian cysts, acne, hirsutism (excess hair growth), and thinning hair on the scalp are common symptoms of PCOS.

What is the PCOS Belly shape? 

PCOS belly is often described as an apple shape, with excess fat stored above the hips at the midsection. This body shape differs from a “pear-shaped” body, where fat tends to accumulate around the hips and thighs. 

PCOS and belly fat

Many women with PCOS find that they gain weight in their midsection. This is often due to hormonal imbalances caused by the condition.

PCOS apple belly

Those with PCOS may feel that they have an apple shape because of fat accumulation around the midsection. This is associated with visceral fat or fat that accumulates deep in the abdominal cavity and around the organs, whereas the pear shape is associated with subcutaneous fat at the surface of the skin.

It is important to note that an apple shape pattern of fat accumulation around the stomach is linked to a higher risk of heart disease and diabetes.

PCOS apron belly 

“Apron belly”, or pannus stomach, is a term used to describe a large flap of excess abdominal fat that can hang down. While there are different potential causes, weight gain due to PCOS may cause this appearance. 

Those who experience visible changes in their body due to PCOS may feel negative emotions about their appearance. Please remember that you are not alone and there are tools that can help, including the PCOS Awareness Association and PCOS Challenge.

How can you address PCOS belly? 

Managing and reducing PCOS belly involves a comprehensive approach that addresses the underlying hormonal imbalances, insulin resistance, and metabolic disturbances characteristic of PCOS. Here are some strategies to help alleviate PCOS belly:

PCOS Eating Plan

Following a PCOS eating plan can help with weight management and the appearance of PCOS belly. However, it’s important to remember that every person is different and there is no “one-size-fits-all” plan. 

In general, a well-balanced eating plan that is high in fiber can help regulate blood sugar levels. You should emphasize nutrient-dense foods and minimize intake of processed foods, sugary snacks, and refined carbohydrates, which can exacerbate insulin resistance and contribute to abdominal fat accumulation. An eating plan rich in omega-3 fatty acid sources, like salmon, may have anti-inflammatory benefits.

Physical Activity

Engaging in regular physical activity, including aerobic exercise and strength training, can help improve insulin sensitivity and reduce abdominal fat. In general, it is recommended to aim for at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity per week, along with muscle-strengthening activities on two or more days per week. Always speak with your medical team before starting a new exercise routine or making changes to your current routine. 

Medications

In certain cases, your healthcare provider may prescribe medications to address specific symptoms or underlying hormonal imbalances associated with PCOS. Oral contraceptives are often prescribed to help regulate menstrual cycles and reduce androgen levels. Metformin, a medication commonly used to treat type 2 diabetes, may also be prescribed to improve insulin sensitivity and promote weight loss in individuals with PCOS.

How a dietitian can help address symptoms of PCOS

If you have PCOS and are looking for guidance, a Season dietitian can help! We can match you with a registered dietitian (RD) who will work with you to create a personalized plan that addresses your health concerns. 

Your Season dietitian can create a comprehensive nutrition plan with your goals in mind, whether that’s managing blood sugar levels, working toward a healthy weight, or helping with hormone imbalances. 

If you have PCOS and have been frustrated or overwhelmed trying to manage your condition on your own, consider working with one of our expert dietitians. We can’t wait to meet you!