It can be especially tough to lose weight when you have polycystic ovary syndrome (PCOS). What’s more, the condition can actually cause weight gain—which can make your symptoms worse.
That’s why losing weight is usually a key element of treatment plans for PCOS. Here, lifestyle change plays a big role, but medicines are often used as well.
There’s currently no cure for PCOS, but that doesn’t mean you need to suffer through your symptoms. You aren’t alone, and there are options available that might help. We’re here to tell you all about them.
Why does PCOS cause weight gain?
But first, a quick refresher on the link between PCOS and weight gain.
One of the defining features of PCOS is having too many androgens, aka “male” hormones. This can cause excess weight to build up around your middle.
Most people with PCOS also have insulin resistance , which is where your body becomes less sensitive (i.e. resistant) to the effects of insulin. That means sugar remains in your bloodstream for longer, and so its levels can be higher. If excess sugar stays around in the blood, it can be stored as fat. Excess fat can cause inflammation and make you less sensitive to insulin.
This can create a vicious cycle: gaining weight can in turn make you even less sensitive to insulin, which can then lead to more gains…and so on.
Plus, as insulin resistance gets worse, the body makes even more insulin to deal with all the extra blood sugar. This can drive up your androgen levels, which further contributes to weight gain.
Best medications for PCOS weight loss
Thinking of trying weight loss medication for PCOS? Here are the most common options.
Metformin
First up we have metformin, which can help control blood sugar and make your body more sensitive to insulin.
Studies show that it can lead to a modest, but significant, amount of weight loss. A review of ten clinical trials looking at PCOS found that metformin was linked to a 3.13kg loss in body weight over a range of weeks and months (the studies were done over different lengths of time). Some trials reported higher losses (8.7kg) while others showed no effect.
Orlistat
Orlistat is the only weight loss pill available on the NHS, and it works by reducing the amount of fat your gut absorbs from your food.
Studies have found that for people with PCOS, orlistat weight loss pills can be just as effective as metformin—and that they may have fewer side effects.
GLP-1 agonists
People with PCOS can use GLP-1 agonists , too. These medicines work by acting like GLP-1, one of your body’s natural hunger hormones. This makes you feel full and suppresses your cravings. These peptide medications are the best at improving insulin sensitivity.
And they’ve been shown to work very well. People on Saxenda might lose 7.4% of their starting weight after a year, while those on Wegovy could lose 14.9%.
Mounjaro is a GLP-1 *and* GIP receptor agonist, which means it acts like two hormones rather than one. This makes it more potent: people taking Mounjaro injections might lose 25.3% of their initial weight after at least a year.
Birth control pills
Finally, we have birth control pills. These are used to manage irregular periods on PCOS and they can also help lower your androgen levels.
What about weight loss? Birth control isn’t usually used for weight, but it has been associated with weight loss when used in combination with metformin.
Choosing the right PCOS weight loss medication
But which medication is best for you personally? That’s a decision for you and your provider to make. They should ask you about your health and medical history when making the call.
Please make sure that you only buy from qualified providers. Otherwise, there’s no guarantee that the medicine is genuine, safe or in date.
Online doctor services should be registered with the Care Quality Commission (CQC) and General Medical Council (GMC), while online providers like us need to be registered pharmacies. This information should be on their website (it’s usually in the footer).
Lifestyle changes and PCOS
Although weight loss medications can work very well, they aren’t a silver bullet. For example, GLP-1 agonists are meant to be used for at least a year, all while you exercise regularly and eat a nutritionally balanced diet. If you take them on their own, they might not be as effective.
Lifestyle change really is the cornerstone of healthy, sustainable weight loss , even when you’re taking PCOS medication for weight loss as well.
For example, did you know that not getting enough sleep can mess with your weight? It’s true—this can affect hormones that control your appetite. Plus, being exhausted can bring on all sorts of cravings for high-calorie foods.
Being stressed can hamper your progress as well. When levels of the stress hormone cortisol are high, it can make you crave comfort foods while also encouraging weight to build up around your stomach.
Natural supplements for PCOS weight loss
What about supplements? Your main option here is inositol, a form of sugar that’s naturally found in your body. More importantly: it can improve insulin sensitivity in people with PCOS.
Studies have shown that inositol can reduce weight, too. In one analysis of eight clinical trials, one type of inositol (myoinositol) led to a 0.71 decline in BMI for people with PCOS. It also significantly lowered androgens and blood sugar levels compared to placebo.
Others include:
- L-cartinine. This plays a role in how the body uses glucose and is sometimes used to support weight loss. In one study , the average BMI of people with PCOS dropped from 28.28 to 26.82 after taking L-cartinine daily for three months.
- N-acetylcysteine (NAC). Used as both a supplement and medication, NAC has shown reductions in BMI that are comparable to those on metformin.
- Insulin. This supplement has been found to improve the gut microbiome and decrease inflammation.
More research is needed to prove the effectiveness of these supplements in PCOS management, but the data we have so far looks promising.
Support for your weight loss journey
We know how disheartening it can be to put in your best effort but not see the results you want, especially when you’re up against the challenges of losing weight with PCOS.
If you can relate to that—we see you. And again, we want to remind you that you’re not alone: there’s help and support out there for you.
For example, our clinicians and expert coaches can work with you to create a personalised treatment plan that includes weight loss medication and lifestyle guidance. We’ll help you build a routine you can stick to and will be right there with you at every step.
Fill out this short form to see if you’re eligible for the programme. Our clinicians will review and come back to you right away.
PCOS weight loss medication: FAQs
Can you lose weight with PCOS without medication?
Absolutely—making healthy lifestyle changes is a core aspect of PCOS treatment. Though because of how difficult the condition sometimes makes it to lose weight, it can be tough to get the results you want. That’s why medication is often used as well.
Will my dosage be different if I have PCOS?
There’s no specific advice around using weight loss injections with PCOS. Your provider will tell you which dose to take, but you’ll follow the typical dosing schedule: starting on the lowest strength and gradually increasing it so your body can get used to the medicine.
Do PCOS weight loss medications have long-term effects?
For weight loss injections, long-term effects are rare. But they can happen—for example, less than 1% of people on Saxenda might experience an inflamed pancreas (pancreatitis). With metformin , long-term use can lead to a vitamin B12 deficiency.
¹Abdalla, Mohammed Altigani, et al. “Impact of Metformin on the Clinical and Metabolic Parameters of Women with Polycystic Ovary syndrome: a Systematic Review and Meta-analysis of Randomised Controlled Trials.” Therapeutic Advances in Endocrinology and Metabolism
, vol. 13, 2022:20420188221127142 https://pmc.ncbi.nlm.nih.gov/articles/PMC9548689/#bibr41-20420188221127142.
²Arrone, Louis J, et al. “Continued Treatment with Tirzepatide for Maintenance of Weight Reduction in Adults with Obesity.” JAMA, vol. 331, no. 1, 2023:38-48. https://pmc.ncbi.nlm.nih.gov/articles/PMC10714284/.
³Attia, Ghalia M, et al. “Role of Metformin in Polycystic Ovary Syndrome (PCOS)-related Infertility.” Cureus, vol. 15, no. 8, 2023:e44493 https://pmc.ncbi.nlm.nih.gov/articles/PMC10544455/.
⁴Dumesic, Daniel A, et al. “Scientific Statement on the Diagnostic Criteria, Epidemiology, Pathophysiology, and Molecular Genetics of Polycystic Ovary Syndrome.” Endocrine Reviews, vol. 36, issue 5, 2015:487-525 https://academic.oup.com/edrv/article/36/5/487/2354671.
⁵Greer, Stephanie M, et al. “The Impact of Sleep Deprivation on Food Desire in the Human Brain.” Nature Communications, vol. 4, 2013:2259 https://www.nature.com/articles/ncomms3259.
⁶Greff, Dorina, et al. “Inositol is an Effective and Safe Treatment in Polycystic Ovary Syndrome: a Systematic Review and Meta-analysis of Randomised Clinical Trials.” Reproductive Biology and Endocrinology, vol. 21, no. 10, 2023 https://rbej.biomedcentral.com/articles/10.1186/s12958-023-01055-z.
⁷Kumar, Pratap, and Arora, Shweta. “Orlistat in Polycystic Ovarian Syndrome Reduces Weight with Improvement in Lipid Profile and Pregnancy Rates.” Journal of Human Reproductive Sciences, vol. 7, no. 4, 2014:255-261 https://pmc.ncbi.nlm.nih.gov/articles/PMC4296399/.
⁸Kumar, Rupal, et al. “Obesity and Stress: a Contingent Paralysis.” International Journal of Preventative Medicine, vol 13, 2022:95 https://pmc.ncbi.nlm.nih.gov/articles/PMC9362746/.
⁹Liu, Jiajun, et al. “The Effects of N-acetylcysteine Supplement on Metabolic Parameters in Women with Polycystic Ovary Syndrome: a Systematic Review and Meta-analysis.” Frontiers in Nutrition, vol. 10, 2023:1209614 https://pmc.ncbi.nlm.nih.gov/articles/PMC10573309/.
¹⁰Minthami, Sharon P, et al. “The Effectiveness of Myo-inositol in Women with Polycystic Ovary Syndrome: A Prospective Clinical Study.” Cureus, vol. 16, no. 2, 2024:e53951 https://pmc.ncbi.nlm.nih.gov/articles/PMC10926319/.
¹¹National Health Service. “Side Effects of Metformin.” NHS, 2022 https://www.nhs.uk/medicines/metformin/side-effects-of-metformin/ Accessed 20 Feb. 2025.
¹²National Institute for Health and Care Excellence. “Polycystic Ovary Syndrome. Scenario: Management of Polycystic Ovary Syndrome in Adults.” NICE, 2024 https://cks.nice.org.uk/topics/polycystic-ovary-syndrome/management/management-adults/ Accessed 20 Feb. 2025.
¹³Salehpour, Saghar, et al. “Effects of L-carnitine on Polycystic Ovary Syndrome.” JBRA Assisted Reproduction, vol. 23, no. 4, 2019:392-395 https://pmc.ncbi.nlm.nih.gov/articles/PMC6798588/.
¹⁴Sanches de Melo, Anderson, et al. “Hormonal Contraception in Women with Polycystic Ovary Syndrome: Choices, Challenges, and Noncontraceptive Benefits.” Open Access Journal of Contraception, vol. 8, 2017:13-23. https://pmc.ncbi.nlm.nih.gov/articles/PMC5774551/#b61-oajc-8-013.
¹⁵“Saxenda: Full prescribing information.” FDA, 2024 https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/206321s016lbl.pdf Accessed 20 Feb. 2025.
¹⁶Spritzer, Poli Mara. “Contraception for Women with Polycystic Ovary Syndrome: Dealing With a Complex Condition.” Revista Brasileira de Ginecologia e Obstetrícia, vol. 44, no. 4, 2022:325-326 https://pmc.ncbi.nlm.nih.gov/articles/PMC9948050/.
¹⁷Wilding, John P.H., et al. “Once-weekly Semaglutide in Adults with Overweight or Obesity.” The New England Journal of Medicine, vol. 384, no. 11, 2021:989-1002 https://www.nejm.org/doi/full/10.1056/NEJMoa2032183.
¹⁸Zhao, Han, et al. “Insulin Resistance in Polycystic Ovary Syndrome Across Various Tissues: An Updated Review of Pathogenesis, Evaluation, and Treatment.” Journal of Ovarian Research, vol. 16, no. 9, 2023 https://ovarianresearch.biomedcentral.com/articles/10.1186/s13048-022-01091-0
