PCOS & Eating Disorders
PCOS stands for Polycystic Ovary Syndrome. It is a common endocrine disorder caused by an imbalance in reproductive hormones. PCOS affects 1 in 10 women of reproductive age. There appears to be a strong link between PCOS and eating disorders or disordered eating, yet there are no established treatment protocols for the combined diagnosis of PCOS and eating disorders. An anti-diet, HAES approach can be a critical tool in the treatment and management of both disorders.
By: Nicole Guzman
PCOS is a multisystem disorder with reproductive, metabolic, and psychological complications. Women with PCOS have higher levels of male sex hormones called androgens, and low levels of the female sex hormone progesterone. Classic signs and symptoms of PCOS include irregular menstrual cycles, increased appetite and weight gain, excess hair growth on the face and body, acne, and insulin resistance. Psychological symptoms may include anxiety, depression, low self-esteem, and negative body image.
Due to the association between PCOS and higher weights or weight gain, women with PCOS are often advised to diet. In addition to an emphasis on weight loss, women with PCOS are also advised to restrict or lower carbohydrate intake to control their glucose levels. Combined with symptoms of low self-esteem and negative body image, these recommendations contribute to the pressure women with PCOS feel to diet. Dieting is a well-known risk factor for the development of eating disorders or disordered eating.
It is estimated that the prevalence of eating disorders among women with PCOS is four times the rate of eating disorders among women without PCOS. Specifically, the prevalence of disordered eating in women with PCOS is 12.16%, while the prevalence in women without PCOS is 2.83%. It has also been established that women with PCOS experience more concern about their shape and weight. This is likely a result of the prescription for weight loss and carbohydrate restriction by medical practitioners. This type of food restriction is unsustainable and can lead to preoccupations with food. Dieting also leads to weight regain in the long-term, especially for women with PCOS. This cycle may lead to the development of eating disorders.
Rather than advising women with PCOS to lose weight and restrict carbohydrates, medical teams should focus on treating the whole person and on incorporating healthy behaviors. These may include eating regular, balanced meals containing carbohydrates, fats, and protein. A balanced meal will allow women with PCOS to feel satisfied, while also decreasing the likelihood of binging. Women with PCOS should also be encouraged to engage in joyful movement or physical activity. Instead of restricting food groups or exercising for the sole purpose of weight loss, women with PCOS should listen to their bodies and find what is sustainable for them in the long-term.
In following this “anti-diet” or Health at Every Size approach, the pressure to look and eat a certain way will be alleviated. The Health at Every Size approach recognizes body diversity and promotes flexible, individualized eating behaviors. It is important for women with PCOS to work with a team of professionals well versed in this type of treatment program, as it will reduce the risk of developing an eating disorder or disordered eating behaviors.
At BALANCE eating disorder treatment center, we are dedicated to treating the spectrum of eating disorders, including anorexia, bulimia, binge eating disorder, compulsive overeating, and other disordered eating behaviors and body image issues. We understand that each client is unique and requires a customized treatment program.
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This post was written by BALANCE intern, Nicole Guzman.
Nicole is a second-year graduate student at Hunter College pursuing her Masters in Nutrition and Dietetics. Nicole graduated from Fordham University where she received a Bachelor of Science in Psychology. After struggling with disordered eating behaviors, Nicole became passionate about sustainable wellness and debunking common nutrition myths. In the future, Nicole hopes to help individuals cultivate positive relationships with food, confidence, and wellbeing.