The Truth About Weight Loss Options with PCOS (GLP-1s, Metformin, and the Surgery Conversation)

If you have PCOS, you’ve probably heard the same advice over and over again:

“Just lose weight.”

It sounds so simple when doctors say it. But anyone living with PCOS knows it’s not simple at all.

For years I’ve been trying to navigate the weight gain that comes with PCOS. Diet changes. Exercise. Drinking more water. Cutting out soda. Doing all the things that are supposed to help.

And yet… the scale barely moves.

So, like many women with PCOS, I’ve had to start looking at medical options for weight loss. Not because I want an easy way out, but because sometimes our bodies need help that willpower alone can’t provide.

This is not a post telling you what you should do.

It’s just me sharing what it looks like to navigate these options in real life.

The GLP-1 Conversation

You’ve probably heard a lot about GLP-1 medications lately.

Drugs like Wegovy, Ozempic, and others have become incredibly popular for weight loss, especially for people with insulin resistance — something many of us with PCOS struggle with.

GLP-1 medications work by helping regulate blood sugar, slowing digestion, and helping you feel fuller longer.

I have taken GLP-1 medications before. And just started taking Wegovy Pill this morning. I have used the injection before, but who likes stabbing their self. So, this time I am taking the daily pill. We will see how it works.

And I’ll be honest… they can help.

For some people with PCOS, they are the first thing that finally makes the scale move after years of trying everything else. (It was for me!)

But there are some real challenges too.

The biggest one for many people, including me, is cost. Without insurance coverage, these medications can be extremely expensive. For something that often needs to be taken long-term, that becomes a very real barrier, and sometimes a big burden.

There are also side effects for some people like nausea, fatigue, or digestive issues, and let's not forget the sulfur burps (which is something I cannot handle!).

For some women, GLP-1 medications are life-changing. For others, they aren’t sustainable.

And that’s part of the complicated reality of PCOS.

My Current Reality: Metformin

Right now, I am currently taking Metformin.

Metformin is actually one of the most commonly prescribed medications for PCOS because it helps with insulin resistance, which is one of the root issues behind many PCOS symptoms.

For some women it helps with:

• Weight management

• Blood sugar regulation

• Hormone balance

• Even ovulation in some cases

It’s not a miracle drug.

But for many of us, it’s a starting point.

Some people lose weight on Metformin. Some people don’t. Some feel better overall because their insulin levels are more stable.

I’m still in the process of seeing how my body responds, because I have only been taking it for about a month.

When you have PCOS, everything feels like a long experiment with your own body, or at least it does for me.

The Conversation That Scares People: Bariatric Surgery

This is the one people don’t like to talk about.

But it’s a real conversation happening in doctors’ offices everywhere.

I have considered bariatric surgery.

And to be honest… I still am.

Not because I’m giving up. Not because I’m lazy. Not because I haven’t tried.

But because PCOS can make weight loss incredibly difficult, even when you’re doing everything right. As I said before, I have taken the GLP-1 and it did help me lose weight. I ended up losing about 50lbs, but as soon as I stopped taking it (cost of course) the weight came right back like it always does.

Bariatric surgery has helped many women with PCOS:

• Lose significant weight

• Improve insulin resistance

• Restore ovulation

• Improve fertility

• Reduce other PCOS symptoms

But it’s also a major life decision.

It’s surgery. It’s lifestyle changes forever. It’s something that deserves serious thought and prayer.

And if I’m being completely honest, it’s something I’m still navigating.

The Truth No One Talks About

There isn’t one perfect answer for PCOS weight loss.

Some women find success with:

• Diet and lifestyle changes

• GLP-1 medications

• Metformin

• Bariatric surgery

• Or a combination of things

And some of us are still trying to figure out what works for our bodies.

The truth is…

PCOS weight loss is not a straight line.

It’s messy. It’s emotional. It’s frustrating.

And sometimes it feels like you’re trying everything while your body fights you the whole way.

Where I Am Right Now

Right now I’m focusing on:

• Taking Metformin

• Drinking more water

• Moving my body more

• Trying to give myself grace through the process

And being honest about the fact that I don’t have all the answers yet.

But I’m learning.

And if you’re reading this while trying to navigate PCOS and weight loss too, just know this:

You’re not alone in this.

We’re figuring it out together.

✨ If you’re comfortable sharing, I’d love to hear your experience.

Have you tried GLP-1 medications, Metformin, or bariatric surgery with PCOS?

What worked for you? What didn’t?

Let’s talk about it in the comments. Because sometimes the best support comes from other women walking the same road.

With love,

Libby 💛