Daily WTF: Doctors Telling Women with PCOS to Lose Weight as Their Only Medical Treatment

Leaving the gym earlier this week, I chanced to hear a call-in show where a young man was trying to figure out the best birth control for his girlfriend. He, the radio personality, and the medical expert, a certain well-known Dr. Drew, were going through as many options as possible including IUDs, shots, condoms, and the morning after pill. Even though the young man went over his allotted time, the doctor and host allowed him to keep talking and kept dispensing advice for several more minutes.

The next call was from a young woman with PCOS (Polycystic Ovary Syndrome), which is a disorder that can often result in ovarian cysts, a slower metabolism, and health complications. She called because she was worried about her PCOS. Several months ago, it has worsened, resulting in her going from a fairly regular period to one every five months that was heavy, painful, and contained a great deal of uterine lining. She also gained 40 pounds in very short order, putting her up to 220 pounds (she was 5’10”).

The second the doctor heard about her weight, he immediately interrupted her to tell her to lose the weight and wouldn’t let her explain her diet or fitness regime. He just kept insisting that she lose the weight and pretty much promised that all of her problems would go away once she did so. Then he promptly hung up on her – without telling her where to go or what to do to lose weight or any other actual medical advice.

This exchange made me absolutely livid. First, it was incredibly rude of him to refuse to listen to her, especially since he had been constantly interrupting her, claiming she couldn’t know what was in her periods and being deliberately obtuse. Second, it was incredibly rude of him just to demand that she lose weight and refuse to listen to what her actual health was like. Third, losing weight is not how you “fix” PCOS. Yes, it can alleviate some symptoms, and people with PCOS really do need to watch their weight because of how easy it is for many of them to gain it (which can cause health problems down the line), but weight gain does not cause PCOS. And, if he had listened to her in the first place, he would have learned that she had extra cysts and abruptly irregular periods before she gained weight.

Let me reiterate this: weight gain does not cause PCOS. Doctors don’t know exactly what does, though there’s some chatter about insulin production having some correlation. If this is true, this is why weight management is important – weight gain can help make you insulin resistant, which might worsen your disorder (and cause other health complications). However, not every obese woman develops PCOS while thousands of skinny and physically fit women do. Weight gain is something someone with PCOS needs to watch because of health reasons. Losing weight will not “cure” you of PCOS.

Telling women that the “cure” for their PCOS is weight loss is completely irresponsible and can prevent women from seeking actual medical treatment. It can lead to them not going to the doctor and making them ignore increased cysts, pain, or discharge. It can lead to them ignoring prediabetic symptoms and messing up their metabolism for life. It can lead to them going on dangerous and life-threatening crash diets.

So if you are a health professional, do not tell a woman with PCOS just to lose weight. Yes, if she is overweight or obese recommend dietary changes and fitness plans. Help her come up with a plan for a healthier, more active life – but do that after you have actually learned about her medical and fitness history and after talking about real treatments for PCOS.  Because she is talking to you about her PCOS, not her weight, and if you won’t address that, you’re not doing a damn bit of good.

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