Women with PCOS: Don’t touch diets with a 10 foot pole

Have PCOS? You can make peace with food too. Let's navigate this.
Have PCOS? You can make peace with food too. Let’s navigate this.

PCOS sucks. PCOS = polycystic ovarian syndrome. Never heard of it? Most people haven’t although the TLC reality series My Big Fat Fabulous Life is changing that. PCOS is poorly understood and takes over the whole body (more on that here). It causes facial hair, male pattern baldness, mood disorders, infertility, insulin resistance with ensuing intense carb cravings, and can lead to diabetes. The icing on the cake? PCOS makes some women fat especially around the stomach 1.

Women with PCOS often tell me the pressure they feel to lose weight. It’s no secret our world judges fat people as lazy, stupid, and without self-control. Do you know how hard clients with PCOS try to lose weight? Harder than you can imagine. Most of the time, women with PCOS see the scale go down only after extreme diets (read: eating disorder behaviors) that are impossible to continue. This is not lack of will power or self-control. This is human physiology. Even more, this sets up a human body with more disease.

I will break it down over the next few days why diets don’t help PCOS rather make it worse. First up:

Diets don’t work.

A fat person walks into the health provider office. She is given a diet.
No matter why they are there.

This is not a joke.

I am known to be a non-diet dietitian and many people try to convince me when diets are necessary: diabetes, high cholesterol and very fat bodies are common examples. And, I agree at times a person can eat in a way that is harming his or her body and possibly causing the body weight to be higher than his or her body would like it to be. Without fail, upon meeting a person with a very fat body, I find diets have been a central part of their eating experiences. Fat people seeking to lose weight are in a constant rotation of one of these:

  1. Preparing to go on a diet.
  2. On a diet.
  3. Bingeing after a diet.

The length of time may vary and yet for most of the population this cycle continues as long as diets are pursued as an answer. My question: if diets work, why do we need to keep going on them?

There is no research to date that shows any diet keeps weight off for more than one year. Not one. Almost every scholarly journal publishing articles on a diet stops at one year or earlier. Those looking further out have incredibly high drop out rates (the eating or exercise plans are too tough to stick with) or correlational. And my college stats class taught me correlation does not equal causation. You too? We should expect more out of modern medicine and research.

We know diets don’t help health 2. Rather, they are the greatest predictor of weight gain 3 and 95% of dieters regain all of weight lost 4. Wait. What???

Say no to diets. Choosing diet free living is not neglectful rather healthful. It’s not letting yourself go, it’s letting yourself be.

Click here to see Part 2 of this series: PCOS + Diets Can Promote Eating Disorders