PCOS weight loss treatments: what are your options?
Exploring PCOS weight loss treatments? Learn about your options, including lifestyle changes and medications like Wegovy and Mounjaro.
Polycystic ovary syndrome (PCOS) is a common hormonal condition that affects many women and people assigned female at birth.
Alongside symptoms like irregular periods, acne and excess hair growth, PCOS can make healthy weight loss feel harder than it needs to be. Biology plays a big role: insulin resistance and higher androgen levels can influence appetite, fat storage and where weight sits on the body.
If you live with PCOS, you may have struggled to lose weight using conventional methods. But don't give up – there may be PCOS weight loss treatments you haven't tried or aren't aware of.
Most people start with lifestyle changes. Some benefit from tablets like metformin or orlistat. Others do best with newer injectable weight loss medications, such as Wegovy and Mounjaro.
In this guide, we explore the different ways you can lose weight with PCOS. But first: why is it so hard, anyway?
Why weight loss can be difficult with PCOS
PCOS is closely linked to insulin resistance. This is when the body stops using insulin effectively. Insulin is a hormone that helps control blood sugar.
With insulin resistance, insulin levels rise and can make the body more likely to store fat. It can also make hunger harder to manage.
Many people living with PCOS also have higher androgen levels. This can cause weight gain (especially around the abdomen), as well as symptoms like acne or excess hair growth.
All these complications can create a cycle where weight gain makes PCOS symptoms worse, and PCOS makes weight loss tougher. That's why PCOS weight loss treatment often requires more support than diet and exercise changes alone.
Lifestyle changes: a solid start
Maintaining a healthy lifestyle is often the first-line polycystic ovary syndrome weight loss treatment in the UK.
It's recommended that people living with PCOS eat a balanced, lower-energy diet that prioritises whole foods, protein and fibre. This can help with satiety and blood sugar control.
Exercise is important, too. Regular activity – including resistance training and aerobic exercise – can improve insulin sensitivity and make weight loss more achievable.
Lifestyle changes can have a positive effect on many PCOS symptoms. As well as promoting weight loss, a healthy diet and regular exercise can improve cycle regularity and fertility.
Counselling from your doctor or a weight loss coach can help the healthy habits stick. For some, though, weight loss remains a challenge – and medication may be a logical next step.
Weight loss medication for PCOS
If changing your lifestyle isn't helping you lose weight, your healthcare provider may discuss tablets or injections for weight loss.
Most of these medications are licensed for obesity or diabetes rather than PCOS itself. However, they can be used off-label to treat PCOS where appropriate. This is where a drug is used to treat a condition it's not licensed for. This should always be done with clinical oversight.
Orlistat
This oral medicine reduces fat absorption from the food you eat. It's available over the counter (as Xenical) or on prescription (as a double-strength tablet).
Orlistat can help you lose weight, but the effects are modest – you can expect about 3% more weight loss than with diet and exercise alone. Gastrointestinal side effects (stomach problems) are common.
Metformin
Metformin is widely used in people with PCOS to target insulin resistance. It's not licensed specifically for PCOS in the UK. However, it's commonly used off-label to support cycle regulation and weight loss – particularly in higher-risk groups.
If you're interested in using metformin, ask your prescriber whether it could work for you.
GLP-1 injections
These weekly injections help regulate blood sugar and reduce food and hunger cravings.
GLP-1 injections are not licensed for PCOS specifically. However, they are approved for obesity and can be considered for people with PCOS who are also living with obesity and meet the medicines' criteria.
Semaglutide (Wegovy)
NICE recommends semaglutide for managing overweight and obesity in adults who meet certain criteria. Within the NHS, it's usually prescribed by specialised weight-management services.
In a large clinical trial, the average weight loss with Wegovy was 14.9% when combined with lifestyle support. And at least one study showed improvements in weight and menstrual regularity among Wegovy users with obesity and PCOS.
However, it's early days. We know that weight loss helps with PCOS. But we need more evidence before we can determine whether Wegovy has direct benefits for people living with the condition.
Tirzepatide (Mounjaro)
Mounjaro is currently going through a phased rollout by NHS England. Like Wegovy, it's offered through specialised services – though some areas are planning controlled primary-care access for those at the highest clinical risk.
In a large clinical trial, Mounjaro users saw an average weight loss of 20.9% when taking the drug alongside lifestyle support.
Other treatments for PCOS symptoms
Not every PCOS treatment is about addressing weight. Many target other symptoms, such as fertility, and can work alongside PCOS and weight loss medication when appropriate.
These treatments include:
- The contraceptive pill, to regulate periods and reduce the long-term risk of endometrial cancer
- Fertility medicines, including letrozole and clomifene, which support ovulation when trying to conceive
- Anti-androgens, such as spironolactone, for excess hair growth
- Hair reduction treatments, such as prescription creams and laser treatments, for excess hair growth
Your healthcare provider will personalise these treatments to your goals and health history.
Choosing the right PCOS weight loss treatment
There's no single best plan for everyone.
Some people do well with lifestyle changes alone. Others benefit from metformin. And many who meet obesity criteria find that GLP-1s provide the boost needed to lose weight, especially when combined with nutrition, exercise and behavioural support.
The ultimate goal is finding a plan that fits your life and is safe and sustainable.
Avoid unregulated products and crash diets that promise quick results. Evidence shows that clinically guided approaches are safer and more effective in the long run. With the right support, healthy weight loss with PCOS is possible.
Would I qualify for GLP-1 injections?
Remember that GLP-1 injections are not licensed as a PCOS treatment. However, by promoting weight loss, they can indirectly help to improve PCOS symptoms.
That means you could qualify for treatment at a lower BMI threshold. Most private clinics offer these injections to people with a BMI of 30 or more. However, this threshold can sometimes be lowered to 27 when a person has a weight-related condition such as PCOS.
It's important to note that NHS criteria are different. With Wegovy, the usual BMI cutoff is 35. With Mounjaro, it's 40. NHS patients must also have weight-related health conditions to qualify.
SemaPen: expert-led weight loss support
Are you living with PCOS and want to lose weight? SemaPen provides regulated, expert-led GLP-1 programmes to help you start PCOS weight loss treatment safely.
Your journey begins with a simple online consultation. If a GLP-1 treatment is appropriate, we can issue a private prescription and build a weight loss programme around you. That includes clinical reviews, nutrition guidance and smart scale tracking so you and your care team can monitor your progress clearly.
Safety always comes first. We screen for contraindications, review other medicines and give clear guidance on side effects and what to do if you experience them. All medicines are UK-licensed and dispensed via regulated pharmacies – and you'll receive clinical support from obesity experts throughout your programme.
If you're ready to begin your weight loss journey, why not
start your SemaPen assessment today? Our friendly team will help you choose the right next step.
Sources
1. Drew, S.B. et al. (2007) "Obesity management: Update on orlistat" Vascular Health and Risk Management, 3(6) https://pmc.ncbi.nlm.nih.gov/articles/PMC2350121/
2. NHS (2022) Treatment: Polycystic ovary syndrome. Retrieved from https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/treatment/
3. Wilding, J.P.H. et al. (2021) "Once-weekly semaglutide in adults with overweight or obesity" The New England Journal of Medicine, 384(11) https://doi.org/10.1056/NEJMoa2032183
4. Carmina, E. & Longo, R.A. (2023) "Semaglutide Treatment of Excessive Body Weight in Obese PCOS Patients Unresponsive to Lifestyle Programs" Journal of Clinical Medicine, 12(18) https://doi.org/10.3390/jcm12185921
5. NHS (2025) Weight management injections. Retrieved from https://www.england.nhs.uk/ourwork/prevention/obesity/medicines-for-obesity/weight-management-injections/
6. Jastreboff, A.M. et al. (2022) "Tirzepatide Once Weekly for the Treatment of Obesity" The New England Journal of Medicine, 387(3) https://doi.org/10.1056/NEJMoa2206038
This article was reviewed and approved by Alice Fletcher, Lead Bariatric Dietitian, on 3 September 2025.
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