PCOS and Eating Disorders

10 Aug

Aside from the fact that PCOS seems to predispose our bodies to hang onto calories, there is a connection between PCOS and disordered eating (binge eating disorder, bulimia, or compulsive overeating, for example). It’s not clear whether PCOS might cause the eating disorder or whether the eating disorder can change hormones enough to encourage PCOS to develop, as this article by Angela Grassi points out. The only thing that is clear is that the PCOS population has a higher rate of disordered eating than the rest of the female population.

But if you have PCOS and struggle with disordered eating, it doesn’t really matter which problem came first, does it? You just need to find the solution.

So what to do? Your first stop needs to be a counselor or health care professional. This treatment finder from the National Eating Disorder Association has some good resources. You could also go to your primary care doctor and ask for suggestions or a referral, or ask your counselor, psychiatrist, or other mental health care professional, if you have one.

Diagnosis

Your doctor or therapist can help you determine whether you have an eating disorder. In some cases, it’s very clear, and you already know that you have one, but some sufferers don’t realize that their eating is unusual or problematic. Each specific disorder has a separate set of diagnostic criteria, but in general, any of the following behaviors or experiences suggests that you should consult a professional. (I have focused on binge eating disorder and bulimia, as these seem to be the most closely linked to PCOS–anorexia may be the most publicized ED, but it is not the most common among PCOS ladies.)

Symptoms:

* You routinely eat when you are not hungry;

* You overeat large amounts of food, even to the point of making yourself feel ill or uncomfortable (and not just on Thanksgiving!);

* You feel as though your eating is out of control;

* You eat secretly and hide your eating habits from others;

* You feel ashamed or guilty over the things you eat;

* You purge after eating–for example, vomiting, abusing laxatives or diet pills, fasting, or exercising obsessively;

* You eat in response to non-physiological factors: stress, emotion, boredom, etc.

Keep in mind that some of these are behaviors that can be normal and fairly functional if they’re minor. After all, most of us would consider it reasonable for a woman who just broke up with her boyfriend to hunker down on the couch with a pint of Ben & Jerry’s, and most of us eat more than we need to in certain social situations. It’s a matter of degree. It’s a disorder if your eating habits interfere with your life (that is, if they’re harming your health, causing you anguish, interfering with your job or school, or compromising your family life). Ultimately, a trained professional is the person who will be able to help you figure out whether you have an eating disorder or just a few bad habits.

While you’re setting up treatment, check out this page from the PCOS Network–it has good suggestions for curbing binge eating, most of which apply to compulsive overeating or bulimia as well. Don’t assume that you can handle this problem on your own, however. Any eating disorder can wreak havoc on your health over time, and they are very difficult to manage.

Treatments

There are no shortcuts on this one: you have to do the hard work of figuring out why you eat the way you do and how to achieve healthier habits. Some of the things you might try, in the treatment process, include:

  • Cognitive-behavioral therapy (or other psychotherapy). In many cases, therapy can help. CBT is most often suggested, because it concentrates on revising your own self-talk–the things that you say to yourself inside your own head–and that can be very effective at changing behavior. But really, any kind of therapy that can help you be more conscious and mindful in your eating choices will help.
  • Group therapy. You can consider a group run by a mental health professional and/or something like Overeaters Anonymous.
  • Medication. Sometimes certain antidepressants can help. Your doctor can help you make decisions about this.
  • Nutritional counseling. While this is not really a problem that can be solved by a nutritionist–it’s a mental health issue, not a lack of education about nutrition–sometimes a good nutritionist can help you figure out what is reasonable, what kinds of things you will find satisfying that would also be good for you, and what you might do to avoid foods that trigger your binge behavior.
  • Treating your PCOS symptoms. This is only my opinion, and I haven’t seen it said anywhere, but if there is a link between the two problems, it would seem likely that treating the PCOS may also help.  Some researchers feel that the prevalence of binge eating disorder among PCOS patients may be due to the body’s response to insulin, and if so, treatments for insulin resistance–such as Metformin–could also help.
Summing Up
If you have an eating disorder, it will be very hard for you to treat your other health issues until it is under control. And it is very difficult indeed to manage it alone. While I think that self-care is often a good option for some problems (mild depression, for example), an eating disorder always requires treatment. If you need it, get it; if you can’t figure out where to find help or how to pay for it, ask your primary care doctor for suggestions.
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