Dear Dietitian, 

I have lowered my total cholesterol by 100 points to a healthy level, but I haven't lost weight. I've been trying to lose weight, but it has consistently stayed the same. Is this normal? 

I was recently diagnosed with polycystic ovarian syndrome, which may have something to do with it. Still, it's frustrating to do so well for my cholesterol and not see any changes. 

Georgia

Dear Georgia,

Congratulations on improving your health! You have lowered your cholesterol by an impressive 100 points! As a result, your chances of having a stroke or heart attack have been significantly reduced. A 10 percent decrease in total blood cholesterol can reduce the incidence of heart disease by as much as 30 percent (1).

Your frustration with the scale is understandable. When one chooses healthier foods, such as lean proteins, and increases fruits and vegetables in their diet, weight loss is often achieved. As you know, caloric reduction is required for weight loss. You simply must burn more calories than you take in. It seems ironic, but you may not have reached a caloric reduction sufficient for weight loss.

However, you mention that you have polycystic ovarian syndrome (PCOS), which is the likely culprit.

For readers unfamiliar with PCOS, it is a hormonal disorder that affects as many as 5 million US women of childbearing age (2). Its name derives from the fluid-filled sacs (cysts) that form on the ovaries. In PCOS, the ovaries produce abnormal amounts of androgens, which are male sex hormones normally present in females in small quantities. Symptoms of PCOS include excess body hair, irregular periods, acne, and weight gain.

Many women with PCOS have trouble losing weight, but the reasons for this are unclear. I recommend seeing an endocrinologist, a doctor specializing in hormonal disorders. He can test for other conditions, such as insulin resistance, that may challenge weight loss. Insulin resistance is when your body doesn't use insulin efficiently.

Don't give up hope. Although it may take longer to lose weight with PCOS, it can be done. Your endocrinologist can refer you to a Registered Dietitian Nutritionist (RDN) who can work closely with you to help you reach your weight loss goal. Most insurances will cover the cost of an RDN consultation. 

Until next time, be healthy!

Dear Dietitian

References

1. Centers for Disease Control and Prevention: Division for Heart Disease and Stroke Prevention. July 2014. https://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_state_cholesterol.htm
2. Centers for Disease Control and Prevention. PCOS (Polycystic Ovarian Syndrome) and Diabetes. March 2020. https://www.cdc.gov/diabetes/basics/pcos.html