Hormonal imbalances can leave many dancers overwhelmed and confused. Polycystic ovarian syndrome (PCOS) is a common endocrine disorder that impacts approximately 5% to 10% of women of reproductive age. This article will deconstruct the complexities of PCOS and how those with a diagnosis can navigate management without the pressures of diet culture.
What might one experience with PCOS?
Common characteristics of PCOS include:
- Weight changes (most often weight gain)
- Hyperandrogenism (often characterized by acne and facial hair)
- Ovarian dysfunction
- Irregular or missing periods
- Difficulty getting pregnant
Because weight gain is commonly experienced with PCOS, suggestions to lose weight are often the focus of medical management. This is further compounded by systemic fatphobia and weight stigma, both of which can make a PCOS diagnosis extremely hard to navigate from both a physical and mental standpoint. The recommendation to lose weight might explain why those with PCOS are at an increased risk for disordered eating.
How is PCOS diagnosed?
A PCOS diagnosis requires the presence of at least two of these three symptoms:
- Irregular or missing periods.
- An ultrasound showing the precense of ovarian cysts.
- A blood test revealing a multitude of hormonal imbalances, along with glucose (blood sugar) intolerance, insulin resistance, and/or elevated triglyceride levels.
Tips To Manage PCOS Without Dieting
#1 Steer Clear of Diet Culture
Despite the weight-centric approach that is often prescribed for PCOS management, the research doesn’t actually support the use of restrictive dieting for treatment. First of all, diet cycling (AKA the binge-and-restrict cycle commonly experienced when dieting) may worsen symptoms as food obsessions propagate into a poor relationship with food and increase one’s risk for binge eating.
#2 Take The Focus Off of Body Weight
PCOS-focused Registered Dietitian Sam Abbott encourages those with a PCOS diagnosis to focus on “…behaviors (sleeping habits, stress management, etc.), not body weight.” According to Abbot, eating should “honor your physical health, along with your mental and emotional wellbeing.” Bottom line: It’s about healing your relationship with food. A weight-neutral approach can guide you to better understand what behaviors feel good, and ultimately, feel best for your mind and body.
#3 Focus on Food Neutrality
Since insulin resistance is a common side effect of PCOS, many feel the pressure to cut carbohydrates from their daily meal plans. Insulin resistance, if you’re unfamiliar, is a condition that makes it difficult for the body to metabolize glucose (sugar). Since associations exist between insulin resistance and diet/lifestyle factors, treatment for the condition is often translated to involve behaviors like cutting out carbs, swapping out dairy, and avoiding sugar.
But cutting out carbs and avoiding sugar will likely lead to rebellion eating as a compensatory response to deprivation. Also, complete avoidance of grains and dairy can lead to detrimental deficiencies of iodine, a nutrient important for thyroid (and thus, hormone) health. Unless you also have celiac disease and require the avoidance of gluten, and/or, you’re lactose intolerant and cannot tolerate dairy, cutting out carbs, fearing grains, eliminating dairy, or restricting sugar is neither necessary nor suggested. We know that those with Type 2 Diabetes (another condition that involves insulin resistance) respond better to intuitive eating. So, focus on food neutrality (you can learn more about this here) and an intuitive approach.
#4 Consider Gentle nutrition & ANTI-DIET, WEIGHT INCLUSIVE RESOURCES
Instead of avoiding carbohydrates, integrate sources of complex carbs into your meals and snacks. This will slow digestion and ultimately lead to more controlled glucose (and insulin) levels throughout your day. To do this, when feasible, try adding whole grains, fruits, and vegetables to your week. You can learn more about the different types of carbohydrates here. And for a deep dive into the benefits of fiber, check out this article.
Joyful movement and intuitive eating will help you ultimately build a sustainable lifestyle that simultaneously manages the unpleasant symptoms of PCOS. For more help, check out Christy Harrison’s podcast Food Psych Episode #199 with Julie Duffy Dillon. You can also follow Sam Abbott’s page (@PCOSNutritionist) and free workbook for PCOS nutrition. Last, additional help from Angela Grassi & Stephanie Mattei’s course PCOS Secrets Masterclass.
#5 Don’t fear medical management
Remember that trying to manipulate your body’s energy balance by restricting your intake or excessively exercising will not allow your body to focus its energy on achieving homeostasis. Adding medication to help manage symptoms is oftentimes helpful and shouldn’t be discouraged. Speak to a trusted medical professional about the various protocols available to help in the management of your PCOS diagnosis.
Article and research assistance with the help of RD-2-Be Ali Simkins. Expert edited and reviewed by Rachel Fine.