PCOS and Eating Disorders

People with PCOS have 4 times the rate of disordered eating compared to those without PCOS

Written in partnership with Julie Duffy Dillon RD. (IG: @foodvoicerd)

Many people with PCOS experience intense carb cravings, extreme fatigue, and weight gain. These symptoms are a result of high circulating insulin levels and other imbalanced hormones as well as chronic inflammation. Unfortunately, diets are pushed as the cure all for these symptoms yet long term research shows it only makes them worse and further complicates their relationship with food and one’s body.

Anyone with PCOS has heard the advice: eat less, exercise more, and lose weight. This is the first line of treatment for PCOS yet has severe consequences. Two of the most common eating disorder behaviors: Bingeing and restricting often result from the imbalanced hormones and push to diet. Research has shown that dieting predicts binge eating for those with PCOS. In one PCOS study, 39% met full criteria for binge eating disorder and 70% met at least one criteria.

Eating disorders take on average 7 to 14 years to recover and significantly impact physical and mental health. Treatment is often expensive or inaccessible. If dieting sets up people with PCOS to experience an eating disorder, why is it recommended? 

You can manage your PCOS to promote health without risking an eating disorder Here’s how:

Stop deciding health based on weight.

People with PCOS are pushed to lose weight to “help reduce their PCOS symptoms” however causing more detriment to their mental and physical health. Higher weight people with PCOS are expected to practice calorie restriction just to access reproductive medicine, gender affirming surgery, and knee replacements. Even more, dieting causes long term harm to insulin, blood sugar, blood pressure and inflammation.

It is important to know that there are ways to manage PCOS in a healthy way without dieting. Speak with a registered dietitian you trust and be sure you are eating enough, getting rest, and have access to medical care. Pushing weight loss only gets in the way of these, and ignores a whole subset of lower weight people with PCOS.

Listen to your body and try to not be ashamed of it.

Cravings, fatigue, and other symptoms are messages from the body about unmet needs. Ignoring them or pushing past them disconnects you from natural tools to prevent and treat disease.

Avoid diets because they predict eating disorders

If you are recommended a diet when diagnosed with PCOS or while receiving medical care, know that there are other options and this advice should not be the end all be all.

You need to be reminded to connect with hunger, fullness, and the need for rest and boundaries. Imagine the difference if health care providers encouraged you to listen to your body rather than punish it?!?

Connect with non-dieting tools to help lower your insulin levels.

Some include:

  1. Be sure you are eating enough–and because you’ve been told to diet for so long it is probably more than you think!
  2. Be sure you are getting enough rest and sleep.
  3. Speak with your healthcare provider about medications and supplements.
  4. What can you add to your meals and snacks rather than take away? Many people with PCOS feel more energized by adding protein, fiber, or fat. Don’t restrict carbs, rather think about what you can add to them.

Connect with non-dieting tools to help lower your inflammation.

Some include:

  1. Consider your stress level. Some of it may be coming from things you cannot control (racism, anti-fat bias, ableism, homophobia, etc). Be kind to yourself when it comes to the amount of stress you live with day to day. Consider compassionately the stressors you can modify. A therapist who understands PCOS and eating disorders may be able to help.
  2. Be sure you are eating enough. Dieting causes inflammation when done long term.
  3. Eating more sources of a type of fat, omega-3, can help. Speak with your healthcare provider about an omega-3 supplement.
  4. Don’t force yourself to exercise when you feel drained. This only worsens inflammation by increasing stress hormones.

Advocate for weight inclusive care for everyone with PCOS.

This is important because:

  1. Constant weight loss advice keeps higher weight people from going to the doctor. 
  2. Constant weight loss advice is traumatizing.
  3. Anti-fat bias in PCOS care oppresses higher weight people and causes their insulin, blood sugar, and inflammation to worsen.
  4. Skipping weight checks helps center the health care visit on holistic matters including self-care, medications, supplements, etc.
  5. Everyone deserves compassionate and comprehensive treatment of their PCOS.

Allara provides personalized treatment that takes the guesswork out of managing PCOS, and offers a customized, holistic plan of attack that merges nutrition, medication. supplementation, and ongoing, expert support to begin healing your body.