PCOS and weight loss

So those with PCOS will know that sometimes weight loss can be a struggle. So I’ve come across some research that I thought I’d share to try and provide you with some practical steps to hopefully make it a little easier.
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There is evidence in some of a reduced metabolic rate. A study (Georgeopoulos et al, 2009) showed that whilst the control group had a BMR of 1,868 those with PCOS without Insulin resistance had a BMR of 1,590 and those with PCOS and insulin resistance had a BMR of 1,116. That’s a significant reduction in metabolic rate!! Keep in mind that you MAY have to eat less than others. 
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Another potential hindrance could be deranged appetite regulation. A study by Hirschberg et al (2004) showed that PCOS women had significantly lower levels of a particular satiety marker.
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So that being said, what can we do?!!
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In terms of diet, weight loss is the key. Improvements have been shown with low carb (keep in mind that low carb in the research can be up to 40% of total calories) and low GI. That being said, weight loss has improved the presentation of PCOS regardless of dietary composition in the majority of studies.
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Other dietary protocols that could be beneficial include; increasing protein intake (due to potentially higher rates of muscle loss associated with PCOS), and also not discouraging the consumption of fruit. One study by Madero et al (2014) showed that 50-70g vs <20g fructose from fruit increased weight loss. 
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In summary for the dietary aspect, the research seems to suggest to not really stress too much on specific macronutrient balances (fat vs carb), and to focus on doing all you can to promote weight loss. In other words, do what works for you and what allows you to be consistent for a long time. You may also consider prioritising resistance training and HIIT where possible over other forms of exercise due to their positive effects on insulin resistance.
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There is also some positive research in the area of supplements for PCOS.
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Omega-3 supplementation with EPA + DHA has been shown to reduce insulin resistance (Yang et al, 2018 & Mohammadi et al 2012). Of course remember that supplementation isn’t particularly necessary if you eat adequate oily fish.
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Vitamin D supplementation has been shown to improve menstrual frequency (Jafari-Sfidvajani et al, 2018) and decreased insulin resistance (Selimoglu et al, 2010).
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Carnitine supplementation has shown promise in one particular study by Samimi et al (2016). Sixty overweight women with PCOS supplemented with 250mg carnitine for 12 weeks and saw significant reductions in weight, waist circumference and hip circumference as well as some markers of glucose and insulin control.
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And finally Inositol with:
Significant reductions in insulin levels/improvements in insulin sensitivity (Genazzani et al 2008). 
Improved aspects of menstrual function (Pundir et al,2018). 
Significant weight loss (Gerli et al, 2003 & 2007). 
Improved blood lipid profile (cholesterol and triglycerides); blood pressure (Constantino et al,2009; Gerli et al, 2007). 
Recommended dose of 2g per day, for a minimum of 6 months.
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So hopefully that helps. I’d be very interested to know if people have already implemented some of these strategies and seen positive results. Or if you now go and do so, please do come back to me and let me know.
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As always, consult your doctor before making a change to your exercise and nutrition habits.