People living with PCOS are often targeted by the dieting industry and they receive many conflicting messages on what they should/shouldn’t be doing in order to manage their condition. There are many parts to the condition that signal the dire need for the person to diet in order to control their symptoms, however research has shown us that doing this only results in worsened symptoms.
In this blog post, we’ll dive into: what is PCOS, how is PCOS a diet culture magnet and alternative ways to manage it that are independent from weight loss!
First, let’s get a better understanding of what PCOS actually is and common misconceptions about this condition!
Polycystic ovarian syndrome (PCOS) is an endocrine disorder that starts in the brain, and results in a set of symptoms that promote a hormonal imbalance. It is inherited and not something that develops as a result of weight gain or what someone eats.
In order to be diagnosed with PCOS, you must have two out of three criteria for the Rotterdam criteria:
Most people with PCOS, have high circulating insulin levels. Not everyone, but there’s an estimated 75-95% of people with PCOS who have high insulin levels.
What ends up happening from that are these really intense carb cravings. These high circulating insulin levels, even without restriction, they promote these carb cravings like a primal urge to eat carbohydrate, because the body is not able to use the carbohydrates for energy, since the insulin is unable to be the little doorman to open the cell coasts. It’s like the system’s not working.
So, the body’s trying to save itself! It sends signals to our brain, telling it to hurry the f*** up and get some carbohydrates. It’s telling your brain “You see that loaf of bread right there? I need that NOW!”. This is a normal response but instead of trying to manage the issue in a more patient centered way, these people are told to cut out carbohydrates which, as you can see, only makes things worse because it will only intensify the craving!
When someone is diagnosed with PCOS, the doctor will typically tell them to start birth control (to manage the hormones) and focus on weight loss by cutting out one particular macronutrient because that is the only way they can manage this condition forever. Can you guess which nutrient it is?
CARBS! OF COURSE!
Typical diet culture, it reinforces the need for you to restrict and labels food/nutrients as good and bad. Indeed, this is a medical condition and some people need to restrict certain foods (i.e. gluten for people who are celiac), in order to properly manage their condition without the influence of diet culture. But in the case of PCOS, we can clearly see that it is demonizing carbs and associating it to weight gain and shame, while claiming that it’s for the good of their health.
Shame becomes to worst symptom of PCOS and not the fact that our body is not producing enough insulin to make sure it’s using the energy it needs.
This is why diet culture is so harmful for PCOS because it puts on these expectations that you must restrict, no matter what.
Some people with PCOS are in higher weight bodies, and some people aren’t. So, if someone is in a higher weight body, they are told they have to lose weight to manage their PCOS. This means you are asking someone to change their bodies that has nothing to do with the actual condition itself. Now, because of this high pressure to lose weight, people end up in the throes of eating disorders, such as anorexia, because weight loss/management has been taught to them as the answer to managing their condition. However, the worst part of this is that even though these individuals may have an eating disorder, their weight is not “that low”, they are off the radar for a proper diagnosis and support.
The 2018 evidence-based guidelines for PCOS management found that there were ZERO diets that have been shown to help most people with PCOS long term manage the condition. Chronic dieting, whether you stay on it the whole time, or you go on and off a diet, is something that causes higher insulin levels. If you have PCOS, you’re already going to have issues with insulin. So, we know from the general population that it’s going to make insulin worse.
All of this to say, I know it’s hard to unpack the idea that weight loss is NOT the way to go, but we need to start changing the messaging around.
Learning about what PCOS is and finding resources do not promote dieting while helping you explain your physiology is really, really important. Understanding the “what” behind your cravings, and then learning non-diet tools such as supplements, food, self-care, that make a huge impact to support you through this.
(*PLEASE CONSULT WITH A DIETITIAN BEFORE TAKING SUPPLEMENTS OR CHANGING YOUR EATING HABITS*).
One of the best things you can do when you notice cravings happening is first, to satisfy the craving. Getting yourself nourished, satisfy the craving, as much as you can is okay! Sometimes, they may not be satisfied. They may be insatiable, but as you notice a craving coming on, trying to take a step back in the throes of a craving, is really difficult and can make the craving stronger.
Yes, as we always mention, you have unconditional permission to eat the foods you want, you enjoy and that are right for you. As mentioned above, dieting and restriction is counterproductive to treating PCOS (and many other conditions).
PCOS is a genetic medical condition that has been used by diet culture to promote weight loss and harmful eating behaviours. If you are living with PCOS, it can be difficult to navigate, especially while being in a larger body. Remember that you are not in this alone and there are many anti-diet, registered dietitians who are here to support you!
Canadian Women’s Health Network. (2013). Polycystic Ovary Syndrome. Retrieved from: https://cwhn.ca/en/node/44804.
Check out my podcast episode “PCOS and Disordered Eating” with guest dietitian Julie Dillion. Julie is fantastic and so so knowledgeable when it comes to nutrition and PCOS! Make sure you give it a listen!
The Balanced Practice is a team of professionals specialized in eating disorder outpatient treatment, disordered eating. Our mission is to help as many folks heal their relationship with food and their bodies so they can live happily outside of diet culture!
We strive to provide evidence based nutrition counselling to support you, or your loved one, in achieving full recovery. Schedule a connection call now.
Marie-Pier Pitre-D’Iorio, RD, B.Sc.Psychology
Lead Registered Dietitian and Founder of The Balanced Practice