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Bursting the Myth: PCOS Only Affects Overweight Women

PCOS affects all ethinicities

After dissolving the myth that claims that you must have ovarian cysts to have PCOS, we are tacking a crucial myth next.

 

One of the most persistent – and harmful – myths about Polycystic Ovary Syndrome (PCOS) is that it only affects those who are overweight or obese. This misconception not only leads to stigma, but also delays diagnosis for people who don’t “fit the mold” – including those with a healthy body mass index (BMI) or who are lean. 

Let’s clear up this myth using the latest science and real-world stories.

The Myth

“PCOS only affects overweight women.”

This belief likely comes from the fact that being overweight is a common trait in PCOS. However, it is far from universal.

The Facts: PCOS Affects All Body Types

What Does the Research Say?

  • PCOS can impact people of all shapes and sizes: overweight, obese, average, and lean.​

  • Around 20% of women diagnosed with PCOS are lean or have a normal BMI, though estimates vary by population and definition.​

  • Being overweight or obese is a risk factor for more severe metabolic complications in PCOS, but it is not a requirement for diagnosis or symptom development.​

  • Lean women with PCOS often experience similar symptoms (irregular periods, excess androgens, infertility) and metabolic challenges—including insulin resistance—as those who are overweight.

Why the Confusion?

  • Weight gain is a symptom that can be made worse by, or contribute to, underlying hormonal imbalances and insulin resistance—two hallmarks of PCOS.​

  • The stereotype that PCOS is a “weight problem” alone may lead doctors to overlook lean individuals with textbook PCOS symptoms.​

  • Some diagnostic delays occur when “cystic ovaries” or weight gain aren’t present, but other symptoms are.

What Do the Guidelines Say?

  • International clinical guidelines (including the Rotterdam Criteria) recognize that PCOS can be diagnosed regardless of weight; the diagnosis requires two out of three core features and does not mention body size as a criterion.​

  • Both lean and overweight people with PCOS deserve full evaluation and support.

Visual Insight

When I first started talking about PCOS as a health advocate, I met people who were surprised to learn that their diagnosis came despite being slim or even underweight. Their stories echo a common theme: “I didn’t think PCOS could happen to someone like me.”  
Awareness is empowering – weight is just one piece of a much bigger picture.

Key Takeaway

PCOS is not bound by body size. Both lean and overweight women – and people assigned female at birth – can develop PCOS, experience its symptoms, and face challenges with management. Recognizing this diversity ensures that more people get the diagnosis, support, and care they deserve.

Next Up:

The next myth we are tackling is “PCOS Can Be Cured with Birth Control Pills” wherein we will explain the difference between symptom management and cure, with clinical evidence.

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