Diets, Weight Loss, and PCOS

Most people I talk to who have PCOS are interested in losing weight. That is why they are looking to talk to a dietitian. They may have been told by a doctor to lose weight. They probably have tried many different diets to lose weight.
I understand the desire to lose weight. We live in a culture where dieting and being a certain size or weight is seen as the answer to all of our mental and physical problems. People with PCOS are particularly vulnerable to these messages since weight is blamed as a root cause for PCOS and losing weight is seen as a solution. Many women in larger bodies who have trouble with fertility, even beyond PCOS, are told to lose weight.
What’s the problem with dieting to lose weight? It doesn’t work 80-95% of the time. The biggest predictor of weight gain over time is dieting. You may say that a certain diet “worked” for you, but if you ended up gaining the weight back and more, how did this diet work for you?
We also know that weight cycling or “yo-yo dieting” puts you at greater risk for heart disease and diabetes than if you had never lost the initial weight. Stress from body dissatisfaction, food restriction, overexercise, and weight stigma can also increase your risk for these metabolic conditions.
So if dieting is not the answer to improving PCOS symptoms, what is the answer?
The answer is learning how to be an intuitive eater. The 10 principles of Intuitive Eating, by Evelyn Tribole and Elyse Resch, have been around since 1995 and can help improve your health by learning how to listen to your body’s messages about what to eat and how much to eat. It is the answer to ending the diet cycle and making peace with food. Over 60 research studies have shown that Intuitive Eating helps people have lower rates of disordered eating including binge eating, increased well-being, improved blood sugar and cholesterol, reduced stress, and higher self esteem. Click here for a link to Evelyn Tribole and Elyse Resch’s website devoted to Intuitive eating.
With PCOS, you can learn how to eat intuitively, give yourself permission to eat all foods, and still work in some food strategies (gentle nutrition) to improve the metabolic and physical symptoms of PCOS.
Learning to become an intuitive eater can take some time, especially if you have been dieting for a long time. Getting support can be crucial as you take this journey since you will still be bombarded by diet culture in your everyday life. However, the rewards to making peace with food are immense. You will learn to truly enjoy food, notice how your body adjusts your intake based on what it needs, and feel like you don’t have to spend so much time being worried about what to eat. And this huge reduction in stress alone can help your symptoms of PCOS.
What are the Intuitive Eating Principles?
- Reject the Diet Mentality
- Honor Your Hunger
- Make Peace with Food
- Challenge the Food Police
- Feel Your Fullness
- Discover the Satisfaction Factor
- Cope with Your Feelings Without Using Food
- Respect Your Body
- Exercise: Feel the Difference
- Honor Your Health: Gentle Nutrition
Will I lose weight if I eat intuitively?
When you start to eat intuitively, you will either lose weight, have no weight change, or you may even gain weight. You have to fully nourish your body on a consistent basis before seeing if and how weight is impacted. Your body has a set point that it likes to be at and it is hard to know what your natural weight is before you let your body adjust with intuitive eating. The goal for learning to eat intuitively is not weight loss. The goal is to learn to trust your body to make food decisions without judgement. When you let your body be your guide, you will likely enjoy a large variety of foods and eat enough to satisfy your hunger without letting yourself get too uncomfortably hungry or full.
That sounds great, but what if I still want to lose weight?
It’s okay that you still want to lose weight. Most people can not undo a lifetime of negative thoughts about weight with the “flip of a switch”.
You can still start working on becoming an intuitive eater, even if you haven’t fully embraced it. This is a process, and for many people it’s a long process. Starting to work through the principles will likely benefit you. It’s not another diet where you have follow a set a rules. You can and probably should take baby steps.
As you know, PCOS can impact your whole body including mental health. It affects you throughout your entire life, not just when you are trying to get pregnant. It’s best to think about improving your physical and mental health for the long term. Quick fixes (diets for weight loss) will not serve you in the long run if they are leaving you hungry, tired, bored, and stressed.