Binge Eating and PCOS: Is there a Connection?

"I hate my body" Laura, a 25-year-old client with Polycystic Ovary Syndrome (PCOS) tearfully explained to me. "I try to be good, but after a few days I only find myself out of control with food and it's mostly high carb stuff." Like Laura, many women who struggle with binge eating also have PCOS. An under recognized and untreated endocrine and reproductive disorder, PCOS affects over 10 percent of females in the United States.

Signs and symptoms vary but include acne, excessive hair growth on face and other parts of the body, weight gain in the mid-section, hair loss, and irregular, heavy, or absent periods. Recently, researchers have found connection between women who binge eat and those that have PCOS.

Why it happens

Women with PCOS struggle with binge eating for several reasons involving emotional and physiological factors. First of all, almost all women with PCOS have high insulin levels because the body has become somewhat resistant to responding to insulin. Insulin is an important hormone that acts by putting glucose into cells where it is used as energy for the body. Having too much insulin causes weight gain despite no change to diet or exercise. It can also cause low blood sugar at times resulting in strong cravings for carbohydrates. The body actually craves carbohydrates as a physiological need to raise blood sugar to normal levels. Waiting too long to eat and not having enough protein at meals can also contribute to low blood sugar, making you feel like you want to eat everything in sight. 

It is also common for women with PCOS to struggle with binge eating due to emotional eating. A lot of women with PCOS have struggled with their weight for some or perhaps all of their lives and are unhappy with their bodies. In addition, most of the symptoms of PCOS have a direct affect on one's body image and self-esteem. For this reason, many women with PCOS have learned to turn to food to cope with emotional pain.

What can I do about it?

If you think the symptoms described here sound like you, consider getting tested for PCOS. Either your doctor or an endocrinologist or reproductive endocrinologist will order lab tests that will check your insulin level as well as other hormone levels. Medications such as insulin-sensitizers and changes to eating and activity are the primary treatment approaches. If you feel your eating is out of control or that you eat for emotional reasons, the following are some suggestions that maybe helpful:

Check in. Conscious or mindful eating involves being in tune with your body and recognizing signs of hunger and fullness. Often times I will have my clients keep food journals in which they not only write down what foods they ate and when, but also rate how hungry they were before they ate and how satisfied they were after. You can practice this yourself by using a rating scale from zero to 10 with zero being completely starving and 10 being the opposite extreme. Check in with yourself before a meal to see how hungry you are and throughout the meal to see how satisfied you feel.   

Eat often. This means eating every 3-5 hours, or eating 3 small meals and 2-3 snacks. The reason for this is to keep your insulin levels stable throughout the day. It is also important to add protein to all meals and snacks to fill you up and slow down the rate that carbohydrates are released in your bloodstream. Eating often can also help keep you from getting too hungry and bingeing.

Seek support. Sometimes it can be very difficult to overcome binge eating on your own, especially if it has been going on for many years. Meeting regularly with a nutritionist who specializes in PCOS and eating disorders can help you to become a more conscious eater and support you in making changes to your eating. Because food is sometimes a way of coping with intense feelings in an unhealthy way, it could also be helpful to work with a therapist who specializes in eating disorders.