The Link Between PCOS and Binge Eating
Trigger Warning: This post discusses disordered eating habits
Did you know that people with PCOS are more likely to have disordered eating patterns than people without PCOS?
Scientists conducted a meta-analysis of seven studies that assessed binge eating symptoms and eating disorders in patients with PCOS. On average, those with PCOS were over three times more likely to have abnormal eating disorder scores than those without PCOS. One study even cited it as four times the likelihood. Specifically, scientists suspect that binge eating disorders are particularly problematic for those of us with PCOS for a variety of reasons. Hyperandrogenism, or elevated testosterone levels, may be to blame for increasing appetite. Metabolic imbalances, or insulin resistance, can also induce intense cravings for sugary, high salt/fat, or high calorie foods.
Additionally, those of us with PCOS often suffer from psychological distress due to issues with body image, difficulty losing/maintaining weight, or hearing from our doctors that PCOS is “our fault” and that if we just “lower our calorie intake and exercise more,” our symptoms will magically disappear. And with encouragement to increase restriction, we are more likely to deprive our bodies of the nutrients we need, thereby sending ourselves into a dangerous cycle of restrict, and then binge to make up for the restriction.
So what can we do?
Sure, we can take Spironolactone to normalize our free testosterone levels, drink a couple cups of spearmint tea per day, and/or limit our processed food intake. We can take birth control pills to receive synthetic hormones to help with leveling sex hormones. Or we can use Metformin and/or inositols to help with blood sugar regulation, pair our carbohydrates with healthy sources of fat and protein, and try to increase our insulin sensitivity to reduce those pesky cravings. But what about that last piece? What about the psychological distress around food that so many of us with PCOS suffer from? There’s no pill for that. And I’ll tell you, the biggest unlock in my journey to healing my relationship with food and binge eating has been uncovering my underlying psychological patterns behind binge eating episodes and subsequent food restrictions.
Origins of My Personal Psychological Distress With Food
I’ve struggled with body image and disordered eating for as long as I can remember. Before we discovered my PCOS and Hashimoto’s Thyroiditis, the name of the game was control. With wholesome intentions of wanting me to be healthy and happy, my mom restricted my diet. She only allowed pretzels for snacks, or sliced fresh peppers. If I had ice cream, it was reduced fat Edy’s, just the ¼ cup, with a drizzle of Hershey’s syrup. The chips, cookies, fruit snacks and full fat ice cream that were so prevalent at my friends’ houses were off limits in the white split level I grew up in. And I knew the root of it. I knew what they all thought of me - my parents, sisters, grandparents, my friends. I felt so deeply in my core that anyone who looked at my body only had disdain and disapproval, which I associated with disdain and disapproval for my character, value, and person. My grandmother would grab my belly from the time I was in grade school. My mother would restrict, restrict, restrict, in the hopes of bringing down the number on the scale. I grew up with a complex relationship with and view of food.
The Need for Approval…And the Simultaneous Craving for Rebellion
I am, what I call, a recovering perfectionist. I had to be “good”, or at least, perceived as “good”. I was class president, in multiple clubs and extracurriculars, a straight A student, and went to church with my family every Sunday. It was in my nature to strive to be seen as “good”. So on the surface, I was following the food restrictions my mother laid out for me. But the feeling of not being in control of my own body was overbearing, even as a child. It led to a scarcity mindset where I viewed those “bad” foods as available in limited quantities. I never knew when I’d get my hands on them again, so I binged whenever I possibly could - when hanging out with friends, shoving chocolate in my mouth while walking home from school, on holidays, etc. Subconsciously I developed this mindset that filling my body with high calorie, low nutrient foods was some act of rebellion. A big middle finger to all the people who thought they could control me. An act of independence. And when I’d successfully hide those binges, especially from my mother, I felt satisfaction. I outsmarted the process. I outsmarted the control. But what I didn’t outsmart were the deep-seeded sensations of shame that drove me to intense self-loathing, and self-disgust. The food I was binging on was “bad” and therefore, I was “bad”.
Her Inner Child Follows Her to Adulthood
I carried this habit, this act of rebellion around food, with me into adulthood. When I became more autonomous, and when I was able to drive, I frequented fast food chains, ice cream shops, and convenience stores for candy and chocolate. My car became my little rebellion safe haven, somewhere I’d be alone to commit these crimes against my body. In college, I eagerly awaited weekends or nights when one of my roommates would be out of town, so I could transgress once again. So I could eat myself to the point of sickness and immobility once again. And then I’d sob. I’d cry a visceral cry that sent chills throughout my veins, look at myself with utter disgust, and would not eat for days afterwards.
Brene Brown defines shame as the
“intensely painful feeling or experience of believing that we are flawed and therefore unworthy of love and belonging—something we’ve experienced, done, or failed to do makes us unworthy of connection”.
It took me more than two decades to realize that I was associating each binge with proof that I was worthless and disgusting. So for every binge, there was a more intense act of restriction. Eat, but then restrict. For every act of rebellion, you must punish yourself to become worthy. And this mentality followed me every. single. day. My value and self worth were intimately intertwined with my most recent patterns of eating. If I restricted, if I ate 500 calories per day, I was “good” - worthy of love, connection, belonging. My flat, hungry belly made me eager to make plans with friends, go out and enjoy life. If I binged, I was “bad”, and I not only punished myself through intense restriction of food, I also punished myself through restriction of love. I shut out my friends, I canceled plans, I postponed dates. I was “disgusting”, and therefore was not capable of receiving human connection.
The Role of Core Beliefs in My Binges
Uncovering these underlying thought patterns was frightening and a bit painful, but it was also wildly empowering. Binge eating and restriction was just one avenue through which I was reinforcing a core belief about myself that I was inherently unworthy of connecting, belonging, and loving. And once those subconscious thoughts came to the forefront, I was able to pause and ask myself why when I felt tempted to binge. I will say, my relationship with food, disordered eating habits, and food anxiety in general are much more complex even than what I’ve laid out here. And if it’s helpful, I’ll dive further into those complexities in upcoming blog posts.
Questions to Ask Yourself
If you’re struggling with psychological distress around binge eating, here are some questions I started to ask myself that were incredibly helpful:
Look at the origin of the binge behavior - what were the circumstances that led to one of my very first binges?
Do I see reasoning behind binges showing up in other areas of my life?
What does binging make me believe about myself or the people around me?
How am I trying to use this binge to meet needs that I haven’t been able to voice?
How am I trying to use this binge to avoid something I’m afraid of?
Questions like these may help you to unlock your core beliefs about food, yourself, or who you believe you are in relation to your food choices. In my experience, awareness is one of the most effective steps in changing your underlying beliefs, and subsequently, changing your behavior.