If you have PCOS and weight loss feels harder for you than for everyone around you, you're not imagining it — and it isn't a willpower problem. On The Weigh In, nutritionist Rebecca Labaki (who lives with the condition herself) explained why PCOS is increasingly being called PMOS, and what actually helps with weight when you have it.
PCOS stands for polycystic ovary syndrome — a name that makes it sound as if it's only about ovarian cysts. That framing, Rebecca explains, is a real problem: only around 25% of women with the condition show cysts on an ultrasound. So someone gets scanned, no cysts appear, and they're told they're fine — while the condition quietly continues.
That's why the conversation is shifting toward PMOS, reflecting that it's polyendocrine (involving hormones beyond the reproductive ones), metabolic, and cardiac as well as ovarian. It's a syndrome because it's not one single thing but a basket of features. Rebecca sees the renaming as good news: better awareness means fewer people fall through the cracks after a single ultrasound.
Because it's more than cysts, the condition can show up as a cluster of symptoms, including:
If these appear together and conventional dieting keeps failing, Rebecca says it's worth looking at the whole hormonal and metabolic picture rather than just calories.
The core issue Rebecca focuses on is the interplay of cortisol and insulin. When these are dysregulated, the body becomes more prone to storing fat — especially around the belly — and to cravings and blood-sugar swings. Aggressive dieting and punishing workouts can add stress to a system that's already inflamed, which is why the usual "eat less, train harder" advice often backfires.
Rebecca's strategy centers on managing insulin and cortisol through nutrition and appropriately dosed training, rather than extreme restriction.
Manage blood sugar. Eating in a way that keeps insulin steady is the foundation. That means building meals that don't spike and crash your blood sugar.
Front-load your calories. For people with PCOS, she recommends eating the majority of calories — roughly 60 to 70% — before the sun sets, since insulin sensitivity drops in the evening. After about 6 or 7 p.m., a poorly timed meal can bring a rush of cortisol, more belly-fat storage, and more cravings.
Start the day with protein. A substantial breakfast, or around 30 grams of protein within the first 90 minutes of waking, helps set up the day.
Don't overtrain. Someone with PCOS shouldn't be doing high-intensity interval training to the point of being completely out of breath and overtaxed. Gentler, controlled training helps dampen inflammation instead of adding to it.
Be strategic with supplements. Rebecca cautions against the common pattern of stacking supplements like berberine and chromium while the underlying diet stays poor. Supplements should be matched to your needs and your blood work — not copied from social media.
Because cortisol is central, Rebecca's own morning routine leans heavily on calming the nervous system: limited screens on waking, a few minutes of meditation or prayer, time in the sun, water with a pinch of salt or electrolytes, and delaying caffeine until after breakfast. The goal is to keep the stress response from running the show.
Rebecca's parting message is worth repeating for anyone with PCOS or PMOS: don't blame yourself. If your cravings are climbing and your weight is getting more stubborn, that's biology talking, not a character flaw. Investigate the biology first, then build the plan.
Steady blood sugar starts with knowing what's on your plate. Journable makes it easy to log meals by photo or text and see your calories and macros in seconds, so front-loading protein and balancing meals becomes practical day to day. Download Journable and get started today.
Watch the full episode with Rebecca Labaki on The Weigh In: YouTube | Spotify | Apple Podcasts.
You can also connect with Rebecca on Instagram at @re.nutrify
This article is for educational purposes only and is not medical advice. Speak with a qualified healthcare professional before making changes related to medical conditions, medication, or treatment.
