Sunday, January 24, 2021

PCOS and eating disorders

This guest post provided by Heidi_PsyD from

Lena, a 20-year-old college student is the quintessential example of how physical illnesses, especially those that negatively affect body image and self-esteem, can lead to disordered eating. Lena has Polycystic Ovarian Syndrome better known as PCOS. Although the prevalence of PCOS and eating disorders has not been well studied, there evidence that the disorders are linked.

PCOS is an endocrine disorder that affects 5% to 10% of reproductive-age women. PCOS is characterized by the accumulation fluid-filled sacs (cysts) on the ovaries. Symptoms include excess facial and body hair, acne, irregular menstrual cycles, and infertility. PCOS is caused by hormonal and metabolic disturbance, which helps to explain the link between PCOS and eating disorders.?

50% to 70% of women with PCOS are insulin resistant and experience weight gain in the abdominal area, have difficulty losing weight, and have intense cravings for carbohydrates. Many women with PCOS are overweight, and doctors working with these women may recommend diets that restrict carbohydrate intake. PCOS symptoms can affect body image and self-esteem and may lead to the development of distorted eating habits.

In Lena’s case it was both dieting and body image issues that began her now 3 year struggle with bulimia. “I tried hard to limit my carbs, but kept craving them,” she says “I would be so good during the day but then binge on cookies, bread, all the things I couldn’t have. I needed to purge to get rid of the calories. I felt so awful about the way I looked,” Restrictive eating is often a precursor to binging behavior and in Lena’s case the accompanying weight gain has been the most challenging factor in trying to stop the bulimic symptoms.

With people with PCOS and eating disorders it is important to concurrently address the symptoms of both disorders. Treatment for PCOS may include hormonal therapy such as the use of birth control to regulate hormone levels. There are also newer treatments such as ovarian drilling, in which tiny holes are made in the cystic ovary resulting in a lowering of androgen levels. Women with PCOS may also be prescribed metformin to help regulate insulin levels.

In addition to stabilizing PCOS symptoms, women with PCOS should also work to normalize eating patterns by developing more mindful eating practices such as rating hunger and satiety levels. They should eat a variety of foods including healthy carbohydrates. If they are using food to manage emotions, healthy coping and self-care strategies are also beneficial.

Learn more about PCOS at Mayo Clinic.


7 Responses to “PCOS and eating disorders”
  1. drummergrrrl says:

    I have PCOS and struggled with bulimia for more than 12 years because I went undiagnosed. It’s like, no matter what you do, you can’t be “normal” size. Also, no doctor believes you when you say you have an ED, and you’re also overweight.

    It’s been a nightmare trying to convince my own doctors that I was sick. They told me my symptoms “weren’t severe enough” to require medication, which made me become even more entrenched in the ED behavior because I figured it was something I was doing wrong.

    Thank you SO much for posting this article … a lot of women are suffering out there needlessly, and many of them are comorbid with these two conditions. It’s great that awareness about PCOS is finally on the rise.

    • Heidi_PsyD says:

      Thank you so much for sharing your story. Your experiences really show how difficult it can be, especially getting an accurate diagnosis. Thanks you also for sharing that people with eating disorders can be any size or shape. I have seen so many people with EDs have their problems minimized if they are overweight. If there are other topics that you would like to see covered in the columns here, please let us know!

  2. I am a Cyster, went undiagnosed from the age of 12 to 32, and am in recovery from eating disorders. Like drummergrrrl, no doctor ever believed that I was either starving myself, purging or indulging in restrictive dieting because I was fat. For 20 years I went to doctor after doctor with severe PCOS symptoms and was only ever told to “lose weight” or “worry about it when you want to have babies”.

    I co-write a blog about PCOS from an alternative view (fat acceptance and not fertility focused) The link is under my username above.

    • Heidi_PsyD says:

      Hi Cryster,
      Thanks for sharing your story too. I encourage readers to check out your blog. It’s wonderful when people can accept their bodies at any size!

  3. Natali says:


    I have just been diagnosed pcos and endometriosis. I also suffer chronic anorexia. I wonder if they could b linked? I dont feel like i starve due to emotions or loss of control. I want to eat but it doesnt let me. What do you think. Im so alone because i am one of a few who has regular menses at low weight and now this to cope with aswell. I guess i should also test for insulin resistance but it could be inaccurate because of anorexia. Im confused!
    Thanks for any thoughts

  4. Ashley says:

    I have been struggling with an eating disorder for a year now… No one really suspects anything because I am not thin. However, even when I have gone back to normal eating habits and exercise instead of extreme restricting (1,4oo well-rounded calories) I can’t even lose a lb. It is psychologically putting me in the position to refuse food. I am so hungry but so confused. I don’t want to suffer anymore. I am being tested for PCOS via ultra-sound (crossing my fingers) this week but my doctor is skeptical seeing that I have ‘regular’ periods. Does this sound familiar to any one?


  5. Tonii says:

    I have this and i hate it.. i got a hair on my chin i hate it but i look at it as if i am beautiful, i mean i know what it is likee.

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