Why Intuitive Eating for PCOS?
Perhaps you are wondering what this intuitive eating business is all about?
How can it help my PCOS?
I am here to answer your burning questions related to intuitive eating and why you might want to consider it for managing PCOS.
If you read the “What is PCOS?” blog post, you may remember that PCOS often presents with psychological symptoms, such as
Anxiety
Depression
Disordered eating
Body image distress
While lifestyle interventions are recommended as the first line of treatment for PCOS (30052961), most of the research interventions for PCOS ONLY focus on weight loss.
*cue: major eyeroll*
You likely have also been told by a healthcare provider to lose weight to manage your PCOS.
Spoiler alert: losing weight will not make a complex hormonal condition disappear.
Now, if you remember (again from the “What is PCOS?” blog - if you haven’t read it, check it out here), PCOS affects individuals ACROSS body sizes. Individuals with PCOS of all body sizes have higher risk of cardiovascular disease and type 2 diabetes. Also, as we just recapped, individuals with PCOS are at higher risk of disordered eating and eating disorders.
So that means by healthcare providers and researchers only focusing on losing weight, we:
incorrectly assume that living in a larger body is the cause or somehow related to having a complex hormonal condition
ignore the fact that PCOS affects individuals across different body sizes equally
do not address the deeper psychological needs of individuals with PCOS
may actually continue to promote feelings of negative body image and disordered eating
may promote weight cycling, repeated weight loss and regain, which is an independent risk factor for cardiovascular disease
As you can see there are several reasons why the focus on weight loss in both practice and the research literature on PCOS is highly problematic.
Taking a step back from PCOS and looking at the larger population, dieting and weight loss have been shown to be unsustainable. There is a growing body of literature that demonstrates that dieting and weight loss interventions are not sustainable in the long-term.
The biggest predictor for weight gain is dieting.
Up to ⅔ of people who diet regain more weight than they lost. Dieting is considered a risk factor for eating disorders (27136388; 21829159; 17469900).
Imagine the failure rate for a medication was as high as the failure rate for dieting? No one would EVER recommend it!
But why don’t diets work?
Diet culture would have you believe that not being able to stick to a diet is your fault or that you lack willpower and discipline. But that is not the case.
Dieting requires us to rely on external cues for eating, such as caloric goals. Focusing on external cues to eat challenges our ability to self-regulate and may lead to overeating, as our self-regulation is a limited resource. (11273412). Through repeating this process, weight cycling may occur. Weight cycling is similar to the concept of yo-yo dieting, if you have heard of that. Weight cycling, or repeated weight loss and regain over time, is its own independent risk factor for cardiovascular disease. Weight cycling is adversely associated with cardiovascular health (32366587; 31089525).
It is no wonder that individuals with PCOS are largely unsatisfied with the current lifestyle recommendations they receive and feel like the psychological aspect of PCOS is largely ignored (24925927; 27906550; 35197027; 28329428).
Our psychological health and cardiovascular health are closely connected. Recent American Heart Association recommendations highlight the very clear association between psychological well-being and cardiovascular disease, demonstrating that improvements in psychological well-being can lead to improvements in cardiovascular health. The opposite of that is true too, poor psychological well-being can negatively affect cardiovascular health (33486973).
Ultimately, what the research tells us is that there is a CRITICAL need for a less restrictive lifestyle approach to improve cardiometabolic health and psychological wellbeing in individuals with PCOS.
Intuitive Eating may just be that answer.
What is Intuitive Eating?
Intuitive eating is a weight-neutral, anti-diet approach to nutrition and lifestyle that may be a suitable approach to improve cardiometabolic health AND psychological well-being in individuals with PCOS.
The concept of intuitive eating was first developed by two registered dietitians, Evelyn Tribole and Elyse Resch in their book, Intuitive Eating. Intuitive eating is based on the premise of interoceptive awareness. Interoceptive awareness is one’s ability to recognize their internal physiological state. Intuitive eating improves interoceptive awareness and focuses on recognizing and honoring physiological cues of hunger and fullness. Intuitive eating increases reliance on internal cues for eating. This differs from dieting, which often relies on external cues to eat, such as caloric goals.
Now these cues and signals are things that we are born with. Yet, over time by living in a society that is so steeped in diet culture and fatphobia, we lose our innate connection with our bodies. But all hope is not lost, this connection can be restored.
Intuitive eating is guided by 10 principles. It honors both physical and mental health.
The 10 principles of intuitive eating are:
Reject the Diet Mentality
Honor your Hunger
Make Peace with Food
Challenge the Food Police
Discover the Satisfaction Factor
Feel your Fullness
Cope with Your Emotions with Kindness
Respect your Body
Movement - Feel the Difference
Honor your Health - Gentle Nutrition
There is growing research literature on the benefits of intuitive eating, there are over a hundred studies looking at intuitive eating. Some research has demonstrated that intuitive eating is associated with improved cardiovascular risk factors, irrespective of weight loss. Additionally, intuitive eating has been shown to improve body image and disordered eating.
Thus, intuitive eating would appear to be a suitable intervention for a population that has increased prevalence of disordered eating compounded with an increased prevalence of cardiometabolic risk factors. Now what population might that be….oh yeah, PCOS!
At Nourish, we work together to ditch the diet mindset and reclaim the intuitive eater within. We work towards reclaiming your body’s unique intuition that guides what and how much to eat. We work together to reconnect to your body’s signaling, reshaping your mind-body connection through an individualized and holistic approach to manage PCOS.
We incorporate gentle nutrition practices that work for you and your lifestyle. Ultimately learning to nourish your body through an intuitive, individualized, and body positive approach to PCOS.
If this sounds like something you are curious about or want to learn more about, schedule a FREE discovery call to learn if our 1:1 coaching program is right for you!