Does PCOS put you at risk for an eating disorder?
PCOS comes with its main challenges. Common symptoms of the syndrome include acne, hirsutism, weight gain, irregular cycles, and hair loss. These symptoms as well as the increased challenges around fertility and lowered quality of life among many women can trigger negative emotional states such as anxiety and depression.
And for many of us we use food as a coping mechanism to modulate these negative emotions.
The majority of PCOS women suffer from excess weight, and studies report that up to 80% of PCOS women are overweight in the US (1). The pressure of losing weight weighs heavy on these women as it is commonly the main focus. But with PCOS this can be more challenging then simply exercising and changing up the diet due to metabolic disturbances like insulin resistance.
A study showed women with PCOS demonstrated significantly more binge eating behaviors than those without the syndrome as well as experience higher energy intake in fewer episodes of eating (3).
In an attempt to lose weight, women begin restrictive diets while exercising more, unaware that they are worsening their condition. Obviously this brings up a lot of frustration by not getting the results they want.
Dieting can worsen eating disorders such as bulimia and increase the likelihood of developing problematic eating patterns.
I can’t tell you how many times I hear women tell me that they are doing “everything right” but just can’t seem to budge on the scale.
This is a vicious cycle that repeats itself if the focus stays fixed on weight loss as a numbers game and not addressing the core foundations to PCOS.
High levels of insulin have been shown to cause low blood sugar, which stimulates cravings for carbohydrates and sugars as well as an increased appetite. With PCOS the majority of women experience insulin resistance (up to 80%) and it is a major roadblock as to why women have such a hard time losing weight.
Studies have shown that even a single meal of high-fat overfeeding can alter glycemic control and increase the risk of insulin resistance (4). Which means binge eating behaviours could have instant effects on metabolic health.
With increased insulin levels and blood sugar disturbances not only do we see increased weight gain but also increased levels of inflammation which can alter our mood. Emotional disturbances and distress that come with the frustration of not being able to maintain a healthy weight also play a big role. There is a lot of shame and guilt surrounding PCOS weight loss which promotes the likelihood of turning to food for comfort or developing an unhealthy relationship with food.
High androgens are characteristic of PCOS and can contribute to unwanted symptoms like anovulation, irregular cycles, hirsutism, acne, and hair loss.
These symptoms affect a woman on an emotional level and may cause stress around conceiving and achieving pregnancy with PCOS. Not only that but many women report feeling de-feminized because of not being able to conceive a child in addition to the common male characteristics of PCOS such as thinning hair and facial hair growth.
Many women show frustration around losing their period for months to even years and for good reason. A regular menstrual cycle is an important part of the female cycle for optimal health as regular ovulation benefits more than just conception. Check out my past blog post on periods to understand it a bit better!
In addition to the psychological stress, the high androgens may also increase hunger, anxiety, and depressive states, which can increase the risk of bingeing episodes (5).
This acts as a vicious cycle because the resulting bingeing episodes can increase insulin resistance, high androgens, body dissatisfaction, and weight gain. Which is why a holistic approach that targets the underlying issues, supports physiological imbalances and provides psychological support is recommended for true healing.
Due to the many debilitating symptoms that can accompany PCOS such as acne, hirsutism, weight gain, and hair loss, the rates of body dissatisfaction among PCOS women are significantly high. Not only do PCOS women have high rates of anxiety and depression in the first place, but the shame and guilt can also feed into these negative emotions.
The negative body image that results from the change in physical appearance may prompt women to seek comfort in food in order to cope with the negative effects of PCOS.
These behaviors are initiated by emotional distress in order to flee from the pain, at least temporarily. But as many can attest, actions like bingeing make you feel worse after the fact which can lead to even more bingeing, and the cycle continues.
Bingeing and emotional eating may seem like a symptom from a food problem but in reality it has nothing to do with the food. The psychological motives behind bingeing cannot be addressed by cutting calories or restricting but instead by looking at why these motivates are there in the first place.
What can you do?
Seek out support
You are not meant to do this alone. Humans need one another and it’s normal to ask for help. We all need it at some point. Instead of trying to cope with it all yourself, do yourself a favor and seek guidance from a professional who can assist you. This will save you so much time and frustration instead of doing it all by yourself through trial and error. I promise you it will be the best thing you ever do.
Avoid over restriction
Many PCOS diets focus on restriction which can prompt food fear among women. Over restriction of foods can result in disordered eating patterns and an unhealthy relationship around food which can feed into a vicious cycle of restriction and bingeing. Believe me I tried it. And it seems as if the more we tell ourselves we can’t have something, the more we want it. So instead of forcing yourself into a diet that you hate, focus on eating real whole foods that are nourishing and delicious. By focusing on what you CAN eat and not on what you can’t eat, you shift your thinking from lack to abundance. And when we are in an abundant state we cannot be in a negative state. Once we see food as nourishment we can start to shift from that place of fear and control.
Sit with your emotions
Eating disorders such as bingeing result from a need to escape our current reality and more specifically to drown certain emotions. We become so afraid of feeling a feeling that we suppress it with food. But have you ever tried to sit with the emotion and talk with it? You will find that it is really not that scary. Your emotions cannot harm you, they can only help you to receive the messages that your body is trying to communicate to you. Use these as guidance. Ask yourself what these emotions are trying to tell you. You may want to take this time to journal out your feelings and emotions, which can be a great tool to assess which ares of your life are being neglected or need attention.
Check in with yourself
When was the last time you took time for yourself? As women we tend to put ourselves last, but you can’t pour from an empty glass. When we use food as a coping mechanism we are really trying to patch up an underlying issue that needs to be expressed and addressed. Most cravings are actually emotionally based which means your body is craving something deeper than food. Do you need rest? Fun? Love? Play? Creativity? The next time you feel the urge to grab food to cope with a difficult situation or in a moment of solitude check in with yourself and ask yourself if it’s really the food you want, or is it something else?
Create a joy menu
Stress is a leading trigger for emotional eating. We all do it. It’s a physiological reaction from the body to ensure energy is ready for an emergency situation. But these days we are rarely in a life threatening situation but rather are sitting at our desk trying to meet a deadline or worrying over finances. Instead of reaching for food, create alternative habits that allow for you to release tension and mental stress. I love suggesting to my clients to create a Joy Menu which lists all the activities that they enjoy that they can refer to when they feel anxious or triggered. This could be as simple as reading a book, playing with your dog, or going out for a walk.
Be gentle with yourself
Healing takes time and work. It’s normal to relapse as you go through your healing journey so be gentle and forgiving with yourself. Self love is a journey and a ongoing process that doesn’t happen overnight. But with consistency you will see things shift before you. Remember that your body loves you more than anything on this planet and it is not the enemy. You are worth it.