Adopt a Healthier Food Relationship with PCOS
Trigger Warning: This post discusses disordered eating habits
When I was 27, my friend popped over to my apartment unannounced one day. I didn’t have time to do my usual walk-through to tidy up, and now I’m grateful I didn’t. His eyes immediately darted to my collection of pink post-its on the kitchen counter. Each outlined in detail the number of calories I had eaten every day that week - typically showing right around 900 calories. I felt the heat rising to my face, and moisture gathering in my palms and back. My breathing shallowed, my eyebrows furrowed. He looked up at me, simultaneously stunned and concerned, “Rach, are you okay?” The embarrassment felt like the ice cold plunge I needed to wake me up to the fact that once again, I was depriving my body of the nutrients she needed.
Why are our relationships with food so difficult, especially for those of us with PCOS?
Research has found that biological females with PCOS display disordered eating habits at 4 times the rate of those without PCOS. As PCOS patients, we are indoctrinated with the belief that our laziness and our lack of willpower caused our condition. We are led to believe that weight gain is the cause, when in reality, weight is a symptom. We are educated that weight loss will cure our symptoms, without the understanding that it is a healthy lifestyle and a nourishing nutrient-dense diet that helps us keep symptoms at bay. The American Family Physician Journal clinical recommendations state, “a calorie-restricted diet is recommended for all PCOS patients who are overweight”. Nowhere does it state quality of those calories, nutrient density or nourishment. The verbiage “calorie restriction” encourages a predisposed population to not only measure their food obsessively, but also restrict it. While physicians have proper intentions of wanting patient symptoms to improve, we often feel like no one is listening.
At 27, my cystic acne was completely out of control. It was so painful that it would wake me up in the middle of the night. My once thick and bountiful hair was falling out in clumps. My period took a one-way flight to the other side of the world. Anxiety and stress dreams woke me up every night with heart palpitations. Three doctors told me my symptoms were out of control because I had to lower my BMI - it was too high. Yet, I was secretly only eating 800-1,000 calories per day, and burning 600+ calories per workout. The amount of stress I was putting my body under with limited calories, intense workouts, cycled in with binge eating episodes, was only worsening my hormonal balance, feeding the vicious cycle.
Research has found that biological females with PCOS display disordered eating habits at 4 times the rate of those without PCOS
My Diet Cycle
For as long as I can remember, every time I would start to feel like I needed to pay additional mind to my weight, it was from a place of hate. I would punish my body into submission from day one of little to no carbs, or egg whites with broccoli, or dry chicken breast alongside vegetables prepared with hardly any oil. I was so angry with my body for so long, and that was how every diet began, with an internal voice scolding my physical self for not operating the way my friends’ bodies did, for taking up more space than their bodies did, or for not tightly adhering to the outline of my jeans, and instead slightly spilling over them. My cerebral self was entirely disconnected from my physical self. But what if I could change my view? What if I viewed my physical self as a servant to the cerebral, and vice versa? What if I could finally see that I could not heal a body I hated?
Cognitive Dissonance in My Relationship with Food
I started to uncover my underlying beliefs about food, and the cognitive dissonance that plagued my plate and mind. Here were a few of my findings:
I had very strong associations of the words “good” and “bad” with foods
I believed “bad” food was a reward for accomplishing something difficult, and “bad” foods could only be enjoyed guilt-free during those times. This led to binge episodes during the allotted times I deemed “guilt-free” to eat the “bad” foods.
“Good” foods were the things you punished yourself with for all of the poor food decisions you made prior. Depending on the size of the binge mentioned earlier, this punishment could go on for quite some time.
When I chose “good” foods, it was from a deeply rooted space of hate for my body. It further perpetuated the ‘food as reward’ cycle, and a state of unhappiness, when I was eating in a restrictive way.
Putting Festinger to the Test
Festinger’s Theory of cognitive dissonance offers a few strategies to assist our psyche with processing the difference between what actions we want to take, and what we actually do. I underwent an exercise in which I turned every harmful belief I had around food into something different. I challenged myself to see my cognitive distortions from a different perspective, but this process is still underway and does not happen overnight.
Rather than labeling foods “good” or “bad” in a black and white manner, I challenged myself to think about how foods made me feel after I consumed them. Was a food “bad” because diet culture and society deemed it as such? Or was it “bad” for my individual needs because of how it made me feel afterwards? Was a food “good” because diet culture said so, or because it made me feel whole, nourished and energized?
Are “bad” foods really rewards? If I challenge my current definition of “bad” foods, and assign a food “bad” specifically because of how it makes me feel, how can I view that as a reward for achieving something?
Is “good” food really a punishment? By defining a food as “good” for myself, based on how it makes me feel, how it assimilates to my digestion, helps my cognitive performance, and energy levels, how is that punishment?
If I achieve subscribing to new definitions of “good” and “bad” foods, based on my needs, then choosing “good” foods can be the ultimate act of self care and self love.
Challenging these underlying beliefs about a lifelong cycle of binge and restrict was a true unlock. It was a way for me to build new neural pathways to automatically think about the connection between mind and body. I was always thinking about how I felt after a meal, and suddenly that translated to a completely new outlook on my relationship with food. Instead of trying to starve my body into obedience, what if I thought about how I wanted to feel? I completely transformed the way I thought about my goals around health, nutrition and fitness.
My Updated Goals and Beliefs
Suddenly, my goals were far more gentle and filled with self love. They focused on how I wanted to feel and started to sound something like this:
I want to choose the foods that are “good” for my body because I want to feel energized. I want to become the person who does not struggle to get out of bed every morning, and I want to be the person who wakes up with a sharp and clear mind.
I want to choose these foods because digestive issues have robbed me of too much of my life. I want to feel at home in my body, and like I’m giving her what she needs to work and function properly, so that I can focus on my work, creativity and healing.
I want to choose these foods so I can feel strong. For me, there is no better feeling than being physically capable of pushing myself. High intensity interval training, and long walks, cleanse my mental health and put me in a positive mood. Physical strength and ability make these things possible for me, and I do not want to lose that.
Relationships with food are highly complex. They are rooted deeply in family history, culture, current environment, and virtually every area of our lives. Challenging my underlying beliefs around food was a key way for me to see that nutrition is a path to self love, and helped me heal. If you are struggling with your relationship with food, starting to question underlying beliefs, understanding their root, and analyzing whether they still serve you, can be a wonderful place to begin.