PCOS Is a Metabolic Condition First, and Insulin and Weight Are the Real Levers

Summary

Polycystic ovary syndrome is best understood as a **metabolic condition first** — insulin resistance sits near its core — and the genuinely evidence-backed levers are insulin sensitivity and modest weight loss (a 5-10% reduction can improve menstrual regularity, lower testosterone, and is associated with higher pregnancy rates) achieved through low-GI/Mediterranean eating, exercise, and metformin where indicated; meanwhile the consumer "PCOS diet" and supplement market overshoots badly: inositol is real but oversold, gluten-free and dairy-free are unsupported outside genuine intolerance, there