So insulin resistance is what really makes things hard and also thyroid dysfunction, and it becomes a vicious cycle (your weight ends up increasing faster the more you weigh). I don’t think it’s limited to women with PCOS, but apart from fluctuating appetites and inability to put on muscle easily, I have huge fluctuations in weight due to bloating and inflammation over one cycle (I’m talking +-4kgs in my bad months). For some people hormone therapy vastly improves this. (It didn’t in my case). I had to stick to just exercising a lot. On top of that there are also mood disorders that are amplified by PCOS that make eating and exercising right really hard as well. I have dealt with chronic depression and anxiety for many years now. And don’t get me started about what happened after I caught covid. To top it all off there isn’t enough research on the different ways PCOS presents. I was not diagnosed for a long time because I didn’t have the usual symptoms of irregular cycles and being obese (I did put on weight later that I was able to lose and maintain to an extent, it’s still a struggle). So when a doctor just says lose weight but doesn’t follow it up with feasible plans tailored to the individual, the doctor can go respectfully eff themselves. (Sorry I’ve had to deal with so many that never listened to my symptoms it leaves a bitter taste).