Why people with PCOS tend to gain more weight around their belly than anywhere else (2024)

What does PCOS belly look like?

Simply put, PCOS belly occurs when there is excess fat accumulating and getting stored in the abdominal region, Daoud says.

So, you'll likely notice that the rest of your body, like your limbs, will stay relatively stable in size, Daoud says.

Ultimately, the buildup of fat around the midsection will result in what's known as an "apple-shaped" body.

What causes PCOS belly?

The main causes of PCOS belly are hormonal fluctuations and insulin resistance, says Dr. Shahin Ghadir, a board-certified OB-GYN and reproductive endocrinologist at the Southern California Reproductive Center.

"The reason that the abdominal area begins to gain more weight than other areas of the body is that the insulin resistance increases adipose tissue, which has a tendency to grow for most people in the abdominal area before growing in other areas," Ghadir says.

Furthermore, there is a vicious cycle that occurs with insulin resistance and hyperandrogenism — which is the body making too many male hormones.

Daoud says when the body is in a state of insulin resistance, it makes hyperandrogenism worse. The hyperandrogenism stimulates fat accumulation in the body, particularly in the midsection, and ultimately, having more fat in the body worsens insulin resistance, and the cycle keeps feeding itself, she says.

Together, this leads to weight gain, especially in the belly. The ongoing cycle can make it really difficult to get rid of this fat, as it continues to accumulate in the midsection.

How to treat PCOS belly

There is no singular quick fix or treatment for PCOS belly.

"PCOS belly is merely a symptom of PCOS, and you can't spot reduce fat," Daoud says. Therefore, she says it's necessary to address the PCOS itself as a whole to manage the condition.

If you are overweight, overall weight loss can help. Diet and exercise are two of the most effective and important ways to control and improve the symptoms of PCOS — including PCOS belly, Ghadir says.

While you might see specific PCOS exercises or diets advertised, Daoud says the simple key to weight loss with PCOS is to be in a caloric deficit where you burn more calories than you consume.

Working with a nutritionist can help you determine a diet that works best for your individual situation and ideal daily calorie intake. As you lose weight overall, you will lose fat from your belly, too.

Furthermore, to treat PCOS as a whole and address other symptoms such as hair thinning, excess facial and body hair, and infrequent and unpredictable periods, your doctor may prescribe anti-androgen medications or hormonal birth control, says Daoud. However, these are not prescribed specifically for weight loss.

For the best results, Daoud says you should work with a team of specialists who can work together to holistically manage your PCOS — such as a primary care doctor, OB-GYN, endocrinologist, and nutritionist. By addressing all aspects that play into your PCOS, you can achieve better symptom relief.

Insider's takeaway

PCOS belly refers to the accumulation of fat around the belly of someone who has PCOS. This is due to hormonal imbalance and insulin resistance. The fat will tend to build up on the belly specifically rather than the rest of the body.

There isn't an easy fast fix for PCOS belly. Ultimately, if you want to get rid of a PCOS belly, the best course of action is to holistically manage your PCOS and engage in healthy lifestyle changes involving diet and exercise. Work with a team of doctors to determine the treatment plan that works best for you.