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Mélanie DesChâtelets

GLP-1s for PCOS (Ozempic, Mounjaro): Where They Fit, Done Ethically

By Dr. Mélanie DesChâtelets, ND. Licensed naturopathic doctor and founder of PMOS Health Collective.

If you’ve searched GLP-1 for PCOS, Ozempic or Mounjaro, you’ve probably found two camps: “lose 10 kilos fast” and “never talk about weight, it’s all diet culture.” I’ve sat with this question deeply, because two things are true at once. Women with PMOS (formerly PCOS) carry, on average, more mental-health struggles and harder relationships with food. And for someone where weight loss is genuinely indicated, a modest loss can improve ovulation, lower testosterone, and improve metabolic health. So where do GLP-1s actually fit? With what I call ethical PCOS weight loss.

One quick note. This is education, not medical advice, and I’m not your naturopathic doctor. Read it, take notes, then bring it to your own care team.

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The honest middle road

Let me be transparent: I have PCOS myself, and since 2010 I’ve worked with thousands of women, which is exactly why I don’t sell one roadmap. The medication question only makes sense inside a bigger frame. Most PMOS care belongs in a weight-neutral lane, and weight loss enters the conversation only when proper screening says it’s indicated, and only with your consent and your full view of the options. A GLP-1 is one of those options, not the starting line. So before we talk about the drug, let’s talk about whether the door should even be open.

Does losing weight actually help PCOS?

The research is genuinely two-sided. A modest 5 to 10% reduction in body weight can improve insulin resistance, ovulation, and cycle regularity in PCOS. That part is real. But the same literature shows the method matters as much as the result: chronic dieting, the up-and-down of weight cycling, and the stress of weight stigma can drive cortisol up, inflammation up, and disordered-eating risk up. So a metabolic gain that costs you your relationship with food isn’t a gain. That tension is the whole reason a medication this effective still needs guardrails around it.

So before any weight-loss plan, a GLP-1 included, I walk through four questions:

  • Is it medically indicated right now? We’re reading labs, metabolic markers, and quality of life, not the number on the scale or a deadline you set for an event.
  • Are you resourced for it? If there’s a hard history with food, that gets support first. Starting a medication on top of an unaddressed food relationship is building on sand.
  • Is your team consent-based? Someone fluent in the metabolic side and the mental-health side, not one without the other.
  • Can we measure success past the scale? Energy, cravings, cycles, labs. If the only metric is pounds, the plan is already off.

Where GLP-1s like Ozempic fit

Now the medication itself. GLP-1s like Ozempic and Mounjaro are everywhere in the PCOS conversation, and for a real reason: there’s research in people with PCOS showing they can help insulin resistance, liver fat, and body size. Here’s the nuance I want you carrying into the room. They work largely by quieting appetite, and a durable relationship with food depends on staying connected to your hunger and fullness cues, the very signals the drug turns down. So a GLP-1 can do genuine metabolic work while, if no one’s watching for it, eroding the foundation you’ll lean on when you come off. And coming off matters: regain after stopping is well documented, and the weight cycling that can follow carries its own harm. None of that makes these medications bad. It makes them a tool that works best with scaffolding around it, the mental-health piece, a settled nervous system, hunger-cue support, and the right timing for your life. Whether one is right for you is a decision for you and your prescriber, not a blog post. My job here is to make sure you walk into that decision already holding the questions.

Chase healing, not the scale

This is also why you won’t catch me promising a number of pounds by a certain date, or posting a before-and-after. You’re more than that, and those snapshots never tell the real story. I’m a fan of intuitive eating for rebuilding self-trust and easing food guilt, and I add one PCOS-specific layer: your metabolic health still counts. Intuitive eating says chase healing, not the scale, and I agree completely. In ethical weight loss we chase healing too, and if your body changes as a side effect of that repair, good. Tools, a medication or anything else, are welcome on the same terms: real informed consent, your autonomy honoured, it’s genuinely what you want, the foundation’s been looked at, and the timing is right.

What it looks like in practice

In practice it looks almost ordinary, which is the point. We anchor on metabolic health and how your days actually feel. We build nutrition that nourishes and fits you, lean on protein and fiber to steady hunger cues, and treat movement and sleep as self-respect rather than punishment. We bring stress down so choices get made from a grounded place. And if a tool like a GLP-1 or a supplement is part of the plan, it sits on that foundation instead of replacing it. That’s how you lose weight without losing yourself.

Watch the full video: PCOS Weight Loss (Ethical Weight Loss), and subscribe to my YouTube channel.

Want to go deeper?

For the full step-by-step education, there’s the PCOS Pivot Course, and the PMOS Energy Code is a short challenge for the energy and fatigue piece.

In BC? A free Clarity Call is a short, no-pressure fit chat, not a medical visit.

This article is educational, not medical advice or a diagnosis. Medication decisions, including GLP-1s, belong with your prescriber. If something here resonates, bring it to your healthcare team, who can look at it through the lens of your individual health.

Main references
  1. Teede HJ, et al. Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2023. PubMed

How to Exercise with PCOS (Do You Train by Your Cycle?)

By Dr. Mélanie DesChâtelets, ND. Licensed naturopathic doctor and founder of PMOS Health Collective.

If you’re figuring out how to exercise with PCOS, you’ve probably hit the cycle-syncing trend: train a certain way in each phase of your cycle. It sounds scientific and empowering, and women genuinely deserve research built for their bodies. But my honest worry is that it slows some people down. So here’s what the research actually says about training across your cycle, the HIIT myth answered, and where to actually start, without adding more rules to your life.

One quick note. This is education, not medical advice, and I’m not your naturopathic doctor. Read it, take notes, then bring it to your own care team.

▶ Liked this video? Subscribe on YouTube.

Want a plan that flexes with real life?

Shift Society is our community for women navigating PMOS (formerly PCOS) and metabolic health. Members also get my Good/Better/Best framework, so you have an easy version for a hard week and a stretch version for a strong one. Real science, real talk.

Join Shift Society

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It’s right that the research has real gaps. Most exercise physiology was done on men, and even many studies on women estimate cycle phase by the calendar rather than by hormone testing or the body’s own signs and clues, which weakens the conclusions. So yes, we need more and better research for women. As exercise physiologist Dr. Stacy Sims, PhD, puts it, “women are not small men.” We metabolize, recover, and respond to fuel and stress differently, and that deserves attention. No argument from me there.

Is training by your cycle really personalized?

Here’s the irony. In the name of personalization, cycle syncing breaks the cycle into tidy boxes and then tells everyone to do the same thing at the same time. That’s not personalization, that’s templating, and it assumes your cycle is the number one predictor of your performance and that you feel the same every month. Think of the variation in your own cycles. And what about life? The toddler who wakes you at 2 a.m., the deadline that ate your sleep, the iron that’s low again. Your cycle is one input. So is your sleep. So is your stress. So is your capacity. So is context.

What the research actually says

A large review of 51 studies in women with regular cycles (which may not extrapolate to PMOS (formerly PCOS), where cycles often aren’t regular) concluded performance might be trivially reduced in the early follicular phase, roughly day one to five, basically your period. “Trivial” is the operative word. In the clinic we separate statistically significant from meaningful: it may be true that some women perform slightly worse on their period, but if you got eight bicep curls instead of your usual ten, do we actually care? A 2023 critical review out of McMaster University found an absence of high-quality evidence for programming resistance training around cycle phase. The honest takeaway: a hint of slightly lower performance on your period in some women, and that’s it. None of these say “don’t care.” They say ask her, the individual.

The outcomes that actually matter

Let me flip the tone. At a population level, we’re trying to get adults to 150 to 300 minutes of exercise a week, and the outcomes tied to hitting those targets aren’t “two extra reps.” They’re body composition, all-cause and cause-specific mortality, and disease progression in conditions like hypertension and type 2 diabetes. People who hit those targets literally live longer. So I genuinely don’t care if once in a while I lift eight times instead of ten because I listened to my body. Even Dr. Stacy Sims, PhD, once a “train by your cycle” voice, has shifted to “train by your readiness,” because so many things feed readiness. Not rules, not restrictions, just informed flexibility.

Should you avoid HIIT with PCOS?

One claim I see a lot: skip high-intensity interval training because it raises cortisol, and high cortisol can worsen insulin and therefore PMOS. Here’s what the research actually shows. Yes, intense exercise raises cortisol, but it rises and then comes back down, our bodies are built to be adaptable. And when HIIT is studied specifically in PCOS, it improves insulin resistance, inflammation, and menstrual frequency, the outcomes we actually care about. So I don’t worry about a temporary cortisol bump and leap to assumptions when the measured outcomes are clearly positive. And to be clear, HIIT isn’t mandatory. Non-HIIT, moderate exercise is beneficial too, so don’t let any of this pull you away from the real goal: 150 to 300 minutes a week, in whatever form you’ll actually keep doing.

Where to actually start

Don’t let the conversation get more complicated until you’ve mastered level one: consistency. Get to 150 to 300 minutes of moderate movement a week, plus about two weight sessions. Don’t make it harder than that. Your number one job is finding what makes you want to show up, because in the long run attendance matters more than anything else. I like a Good/Better/Best approach: an easy version for a hard week, an average goal for an average week, a stretch goal for a strong one. Keep it personal, and remember it’ll rarely be a single input that decides everything.

Watch the full video: Cycle Syncing vs. Science: Should You Train by Your Period?, and subscribe to my YouTube channel.

Want to go deeper?

For the full step-by-step education, there’s the PCOS Pivot Course, and the PMOS Energy Code is a short challenge for the energy and fatigue piece.

In BC? A free Clarity Call is a short, no-pressure fit chat, not a medical visit.

This article is educational, not medical advice or a diagnosis. If something here resonates, bring it to your healthcare team, who can look at it through the lens of your individual health.

Main references
  1. McNulty KL, et al. The Effects of Menstrual Cycle Phase on Exercise Performance in Eumenorrheic Women: A Systematic Review and Meta-Analysis. Sports Med. 2020. PubMed
  2. Colenso-Semple LM, et al. Current evidence shows no influence of women’s menstrual cycle phase on acute strength performance or adaptations to resistance exercise training. Front Sports Act Living. 2023. PubMed
  3. Teede HJ, et al. Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2023. PubMed

PCOS Food Rules: When “Being Mindful” Becomes Control

By Dr. Mélanie DesChâtelets, ND. Licensed naturopathic doctor and founder of PMOS Health Collective.

With PMOS (formerly PCOS), PCOS food rules tend to run deep, and “being mindful” can quietly turn into one more way to police yourself. Mindful eating has been hijacked by diet culture, and a lot of what passes for it is really perfectionism in disguise. True mindfulness isn’t a voice in your head judging your plate. It’s an experience in your body that feels like safety, not performance. Here’s how to tell the difference, and loosen the food guilt without losing the structure that helps.

One quick note. This is education, not medical advice, and I’m not your naturopathic doctor. Read it, take notes, then bring it to your own care team.

▶ Liked this video? Subscribe on YouTube.

Want a gentler way to think about food?

Shift Society is our community for women navigating PMOS (formerly PCOS) and metabolic health. Members also get my 30 mindful-eating affirmations to rebuild self-trust and ease food guilt, gently and gradually. Real science, real talk.

Join Shift Society

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Can you be “too mindful”?

This question comes up in my practice all the time, and when we unpack it, “too mindful” almost always turns out to be something else: a brain that won’t stop auditing the plate. Constant calculating, self-surveillance, judgment dressed up as awareness. It sounds like “Should I be eating this? Is this too much sugar? I want more, but should I?” That’s not presence. That’s pressure with better PR. Real mindfulness doesn’t mean careful, and it isn’t a rulebook. It means slowing down enough to actually hear what your body is telling you.

Overthinking food isn’t mindfulness

We tend to confuse vigilance with awareness. But mindfulness doesn’t live in your head, it lives in your body, in the felt sense of hunger, of fullness, of what sits well and what doesn’t, noticed without a verdict. So here’s a simple test: if there’s a voice grading or narrating every bite, that’s not mindfulness. Real mindfulness is quiet. It’s your body whispering, not your brain commenting.

What true mindful eating feels like

It feels like safety, not performance. So many women treat mindful eating as one more skill to perfect, which just keeps the performance running. The real thing gives you room, and lets you trust your body even when the answer isn’t tidy, and yes, that can include structure and science. Balance is part of mindfulness, and balance has room for nutrition. The aim is simply to notice how your body answers, and decide from there.

Reframing the food-rule voices

With PMOS and metabolic health, the food rules get wired in deep: “you don’t need more,” “that’s too much,” “be good.” They sound responsible, but they usually grow out of fear, not truth. A useful gut-check: a tense, punishing, tight voice is rarely mindfulness, which feels more like permission to choose than pressure to perform. And the freeing part is that the food doesn’t decide. A plate of vegetables can be eaten mindfully or not. So can a slice of pie. What makes it mindful is the presence you bring, not the item.

Why there’s no one right PCOS diet

Bodies and lives differ, which is why there’s no single right PCOS diet. My ND bestie, Dr. Anne Hussain, ND, also lives and breathes PCOS care, and she eats fully plant-based. I land closer to plant-forward Mediterranean. Both of us meet our needs, enough protein, fiber, vegetables, fruit, in a way that fits our actual lives. So treat nutrition as the structure and mindfulness as the experiment: try a way of eating, feel how your body responds, then keep what genuinely works for you rather than what you were told to do.

How to actually do it

So build on mindfulness first, and let nutrition be structure, never a cage. Real feedback from your body doesn’t sound like “do this perfectly, forever.” It sounds like “that helped, do more of it.” At a celebration meal or a dinner out, I’ll happily eat for the joy and the connection, savouring things I don’t have often, while still checking in so I feel good afterward. That’s the nuance. Mindful eating is the live dance between what you know and what you feel: awareness, not obsession. Choice, not fear. Progress, never perfection.

Watch the full video: The One Thing Most People Get Wrong About Mindful Eating, and subscribe to my YouTube channel.

Want to go deeper?

For the full step-by-step education, there’s the PCOS Pivot Course, and the PMOS Energy Code is a short challenge for the energy and fatigue piece.

In BC? A free Clarity Call is a short, no-pressure fit chat, not a medical visit.

This article is educational, not medical advice or a diagnosis. If something here resonates, bring it to your healthcare team, who can look at it through the lens of your individual health.

Main references
  1. Teede HJ, et al. Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2023. PubMed

PCOS Nutrition: The Foundation Almost Everyone Skips

By Dr. Mélanie DesChâtelets, ND. Licensed naturopathic doctor and founder of PMOS Health Collective.

If your PCOS nutrition never seems to stick, you might be building the house from the roof down. You can have the best nutrition knowledge in the world, but if you’re disconnected from your body, it doesn’t hold long term. The foundation almost everyone skips is mindful eating: reconnecting with your body so the rules, macros, and plans finally have something to sit on. Here’s why it comes first, and how to start.

One quick note. This is education, not medical advice, and I’m not your naturopathic doctor. Read it, take notes, then bring it to your own care team.

▶ Liked this video? Subscribe on YouTube.

Want help rebuilding the foundation?

Shift Society is our community for women navigating PMOS (formerly PCOS) and metabolic health. Members also get my 30 mindful-eating affirmations to reinforce this kind of thinking, gently and gradually. Real science, real talk.

Join Shift Society

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Why your healthy eating isn’t working

Often the foundation got skipped. I’ve had patients laser-focused on a protein goal who realize late in the day they’re behind, so they chug four shakes before bed. On paper, goal met. But when I ask the mindful questions (how did your digestion feel? how was your energy?), the answer is “off” and “I’m struggling.” That’s the tell. Mindful eating is the foundation because it catches the red flags even when you think you’re checking every box.

Why digestion needs a relaxed state

We were designed to eat in one. Your autonomic nervous system shifts you toward parasympathetic (rest and digest) or sympathetic (stress) on its own. If a bear were chasing you, you’d want blood flowing to your legs, not your gut. The catch is that today’s stress is mostly mental, and many of us live in that go-go state far longer than it was meant to last. In that sympathetic state (think “S is for stress,” to help you remember), the body deprioritizes digestion. Picture food as a pearl necklace and your body’s job as making scissors to break it down: in the stress state you make only a few scissors; in the parasympathetic state you make more saliva, stomach acid, and enzymes, breaking down that same necklace with far more scissors. This is just physiology.

Checking in with your nervous system

Start by noticing your own stress cues: short shallow breaths, a tight jaw or shoulders, a climbing heart rate. And here’s an important nuance, stress can be good. Some of my highest achievers say “I love my work, I’m not stressed,” and they’re right. Stress helps you perform and show up. I’m not here to vilify it. It’s just not the right mode for digestion. “Stressed” here doesn’t mean freaking out, it can simply mean you’re in the get-it-done state and need a moment to downshift before you eat.

Shifting into rest-and-digest before a meal

Here’s the cool part: the nervous system runs automatically, but you have a say. Because it’s so tied to your breathing, you can actively raise the tone of your rest-and-digest response. So bring back the pre-meal ritual. A few minutes of slow, deep breathing before you eat can genuinely shift your state. Breathing isn’t the only way to do this, but it’s one of the most accessible places to start.

What eating mindfully actually means

It means being right here, with your food. Eating in front of the TV or scrolling your phone is a bit like ghosting your own body. I’m not here to vilify those things, they have a real place in joy and downtime, but studies show again and again that when we’re distracted, we eat significantly more, because we can’t hear our cues. So try eating without the big distractions sometimes. Music, a candle, slowing down, whatever turns eating into presence instead of just function.

Slowing down and reading fullness

Fullness takes time to register, so if you eat fast you blow past it. If rushed eating sounds like you, time a meal, then stretch it by five minutes: chew slowly, pause between bites, put the fork down. Then get curious instead of controlling, what does 80% full actually feel like? If you’re not sure yet, that’s fine. The curiosity itself is the first step.

Where nutrition knowledge fits

It doesn’t get replaced, it gets grounded. Evidence-based nutrition still matters, it’s just layered in on top of connection, not forced on top of disconnection. And with insulin resistance the signals can get noisy, more cravings, a bit disconnected from what you actually need. That’s exactly when we add gentle structure on the foundation: how are the fruits and vegetables, the fiber, the minimum protein? Those sharpen cravings, satiety, and metabolic health, so the signals get clearer again. Nutrition knowledge supports the connection. It doesn’t replace it.

Watch the full video: Mindful Eating First, and subscribe to my YouTube channel.

Want to go deeper?

For the full step-by-step education, there’s the PCOS Pivot Course, and the PMOS Energy Code is a short challenge for the energy and fatigue piece.

In BC? A free Clarity Call is a short, no-pressure fit chat, not a medical visit.

This article is educational, not medical advice or a diagnosis. If something here resonates, bring it to your healthcare team, who can look at it through the lens of your individual health.

Main references
  1. Teede HJ, et al. Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2023. PubMed

PCOS Supplements: How to Tell If One Is Actually Worth It

By Dr. Mélanie DesChâtelets, ND. Licensed naturopathic doctor and founder of PMOS Health Collective.

The market for PCOS supplements is enormous, and most of it is sold with five-star reviews, a “science-backed” badge, and a sleek list of ingredients. So before you spend money on the next one, here’s the exact six-step filter I use to tell a real bet from good marketing. It works on any supplement, not just the one in your cart.

One quick note. This is education, not medical advice, and I’m not your naturopathic doctor. Read it, take notes, then bring it to your own care team.

▶ Liked this video? Subscribe on YouTube.

Want the filter as a cheat sheet?

Shift Society is our community for women navigating PMOS (formerly PCOS) and metabolic health. Members also get my How I Decide What’s Worth Trying cheat sheet, the exact decision matrix I run on new supplements. Real science, real talk.

Join Shift Society

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The wrong question vs the right one

The smart question isn’t “could this help?” It’s “is this where I place my first bet?” Your time, money, and energy are finite, so think of it like a horse race: when you can see all the options and how deep the research is behind each, that’s when you can bet on the fastest horse. These six filters are how I read the field, and how you can read any product before you buy.

Filter 1: a long reference list isn’t proof

A wall of PubMed links on a website doesn’t tell you how confident we can be in the outcome. The questions that matter: Was it studied in humans, or in a petri dish? In people with PMOS (formerly PCOS) or a metabolic history like yours? Different research types carry different confidence. Sometimes we extrapolate from thin evidence, which isn’t always wrong, but it’s a weaker bet when other options were tested in real humans with measured, hard outcomes.

Filter 2: they don’t all work the same way

Some strategies block the absorption of glucose. Others improve how your body actually uses it. On a glucose monitor they can look similar, but long term they point to very different physiology. I’ll take improved physiology over a quick patch that helps just one meal, every time.

Filter 3: what it should actually change

Mechanisms give us a theory. What I care about are hard outcomes in real humans. “This lowers post-meal glucose” is fine. But if another option shows it improves hemoglobin A1C or an insulin-resistance measure over 90 days, that’s the one I’d bet on first. A change on your bloodwork over months beats a blip on a monitor after a single meal.

Filter 4: the croissant context

Here’s a research trick: if you want the biggest possible improvement, you test it in the situation most likely to produce one. One sleek site claimed a “40% blood sugar reduction,” but what did the person eat? A croissant, a highly processed carb we already know spikes blood sugar a lot. What that number doesn’t tell you is how much it would do for a balanced meal, and whether that would even be meaningful. That gap is exactly what to weigh before you prioritize something.

Filter 5: the permission slip

This one is behavioral, and it’s the one most people miss. Some products quietly become psychological permission slips. If a supplement makes the croissant feel less harmful, that food might show up more often, or you decide you don’t need to change it at all. That’s not a moral failure, it’s human nature. But what you do most often matters, and even with the spike blunted, you may have skipped the chance to choose something with more fiber, more whole, less processed. That’s a real opportunity cost.

Filter 6: foundations are leverage

The supplement that prompted this had some human data, so I’m not saying it does nothing. I’m saying that out of everything you could choose, it wouldn’t make my top five to ten. Around 80% of Canadians aren’t meeting their fiber goals, and that one shift alone touches blood sugar, insulin, inflammation, and cardiovascular risk. Most people with PMOS don’t need more novel information or more complex protocols, they need support being consistent with the foundation. When you do layer supplements or medication on top, start with the ones that influence several systems at once and have the most human studies behind them. So this was never about good versus bad. It’s about sequence: is this really where you place your first bet?

Watch the full video: PCOS Blood Sugar Supplements: Not All Created Equal, and subscribe to my YouTube channel.

Want to go deeper?

For the full step-by-step education, there’s the PCOS Pivot Course, and the PMOS Energy Code is a short challenge for the energy and fatigue piece.

In BC? A free Clarity Call is a short, no-pressure fit chat, not a medical visit.

This article is educational, not medical advice or a diagnosis. If something here resonates, bring it to your healthcare team, who can look at it through the lens of your individual health.

Main references
  1. Teede HJ, et al. Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2023. PubMed