Fed up with being told to “just lose weight” to help with your PCOS? Looking for a non-restrictive way of managing your symptoms? Introducing intuitive eating, a different way to think about food. Learn more about PCOS and intuitive eating in this ultimate guide, with practical advice to get you started on your food freedom journey.
What is PCOS?
Polycystic ovary syndrome, commonly referred to as PCOS is the most common reproductive hormone disorder, affecting 5-10% of people of reproductive age. Whilst the exact cause is unknown, multiple factors appear to play a role, these include; genetics, hormones, environment and lifestyle, including how these factors interact together.
What is intuitive eating?
Developed by two dietitians called Evelyn Tribole and Elyse Resch, intuitive eating is a ten-principle framework designed to help you honour your health whilst paying attention to the messages of your body and meeting your physical and emotional needs.
The process works in two ways, some of which help you to gain body attunement, which is the ability to hear and therefore respond to the physical sensations within your body e.g. biological cues of hunger and fullness. Whilst other principles help you to remove the obstacles to body attunement.
There have been over 120 studies published supporting the use of intuitive eating to promote health, with no diets in sight! The original book on intuitive eating was published in 2012 and the latest edition was published in 2020.
What are the 10 principles of intuitive eating?
There are ten principles or pillars of intuitive eating. But, they don’t need to be followed exactly or in order. Think of them as a guide or set of suggestions to help you find food freedom, reject restriction and forget about diet culture.
Reject the diet mentality: Throw away the scales, unfollow calorie counting accounts on Instagram and ditch the diet books. Consider the amount of time, money and energy you’ve put into trying to change your body shape. Think about what you could have been doing if dieting wasn’t taking up so much of your brain space. This first principle is vital because as long as the diet mentality is lingering, you’re not free to discover intuitive eating.
Honour your hunger: Learning to trust that your body will tell you when it is hungry and honouring it by feeding yourself is a vital step in regaining a positive relationship with food. We all need food to survive and who is better to tell you when you need food than your body?
Make peace with food: Leave behind the labels like ‘clean’ foods or ‘naughty’ foods. Making peace with food is giving yourself unconditional permission to eat and reaching food neutrality – all food has its place. Restricting certain foods can quickly lead to a ‘restrict and binge’ cycle – eating past comfortable fullness and feeling guilty.
Challenge the food police: Your inner food police will try to berate you for enjoying previously restricted foods. It is important to challenge this inner monologue and take away the morality of eating choices.
Respect your fullness: Learning to respect your fullness can be linked to honouring your hunger. Being mindful during eating can help you rediscover when you’re truly full, the feeling of comfortable satisfaction after a meal.
Discover the satisfaction factor: Everyone has the right to enjoy the food they consume. Pleasure is a large part of eating and when we enjoy the food we are eating, we find it takes just the right amount of food to feel truly satisfied.
Cope with your emotions with kindness: Emotional eating is a normal part of life. Food can offer us comfort in certain situations but food will not fix the problem. Delving into the root cause of our feelings and developing other coping mechanisms can help us in the long term.
Respect your body: Accept your body and respect what it can do. Body diversity exists in our world and we need to become better at accepting that it exists. It is time to free yourself from unrealistic expectations and start treating your body with kindness.
Exercise – feel the difference: Once you begin to uncouple exercise from weight loss then you can begin to truly find the joy in movement. I genuinely believe that there is some form of movement for everyone where you can find fun in movement, rather than punishing yourself.
Honour your health with gentle nutrition: This principle is all about reintroducing some gentle nutrition to allow you to make food choices that honour your health and are pleasurable whilst making you feel good. There is a reason this is the last principle, nutrition advice can easily slip into obsessing over every meal and snack. It is important to remember that what we eat consistently over time is what will benefit our health. There is no perfect food, meal or way of eating.
Why diets don’t work for PCOS
Often, upon the diagnosis of PCOS, weight loss and dieting are recommended by many healthcare providers, despite the fact that dieting has many disadvantages, particularly in relation to PCOS.
Repeatedly losing and regaining weight happens to the majority of dieters and is known as weight cycling (or yo-yo dieting). Studies show that up to 95% of people will regain the weight lost and between one-third and two-thirds of people will regain more than they lost within 5 years of dieting.
Weight cycling may contribute to increased chronic inflammation. Low-grade chronic inflammation is present in people with PCOS and, although the nature of the link between inflammation and PCOS is unclear, inflammation appears to contribute to PCOS symptoms.
Insulin resistance is when the body’s tissues are resistant to the effects of insulin – they don’t allow glucose to enter the cells as we would expect. The majority of people with PCOS have insulin resistance. In the short-term dieting appears to improve insulin resistance, although in the long-term dieting and weight cycling can actually increase insulin resistance and blood glucose levels.
People with PCOS have a high prevalence of eating disorders. Although more research is needed, it has been suggested that this is because of the emphasis on weight loss by mainstream doctors, dietitians and healthcare providers. It is vital to find a way to live with PCOS and manage symptoms without triggering an eating disorder.
PCOS and intuitive eating: can it be done?
In short, yes. Intuitive eating isn’t a diet or a strict set of rules. It is a framework that guides you to embrace food freedom by rebuilding trust in yourself.
Is intuitive eating different for people with PCOS?
Although intuitive eating can be done by people with PCOS, there are a couple of things to consider to ensure PCOS symptom management.
Managing carbohydrate cravings
People with PCOS often have intense, overwhelming carbohydrate cravings. This is because of the insulin resistance seen in the majority of people with PCOS, leading to elevated insulin levels in the bloodstream.
The final principle of intuitive eating is gentle nutrition. This pillar encourages experimenting with curiosity, not judgement, to see what sort of foods and which way of eating helps you feel your best.
Gentle nutrition tools to help with PCOS carbohydrate cravings may include pairing fats and protein with carbohydrates for the majority of meals and snacks to help slow down the release of glucose into the bloodstream. Spreading your meals throughout the day and swapping white carbohydrates for brown may also improve your carbohydrate cravings.
Remember, gentle nutrition is all about curiosity, not judgement – find what works for you and be kind to yourself throughout the process!
Managing insulin resistance
As many people with PCOS experience insulin resistance, it’s unsurprising that people think they have to diet or cut carbohydrates out completely to improve their symptoms.
But, there is another way! Insulin resistance can be improved through gentle nutrition strategies as we mentioned above, as well as through movement, medication and supplements like inositol. Read more about managing insulin resistance in our dedicated article.
How can I start eating intuitively?
Intuitive eating is a lifelong journey and process. Diet culture has probably been a focus for the majority of your life so breaking free from restriction will take time. But there are various things you can do to start eating intuitively.
Give yourself permission to eat all foods
Giving yourself permission to eat all foods may feel scary. Breaking away from the black-or-white approach to labelling foods as “good” or “bad” and removing the morality to food can help you break away from dieting and restriction.
Break up with diet tools
Throw away those scales and delete MyFitnessPal, let’s move away from diet tools that keep us relying on external tools to validate our worth.
Remove the influences that encourage restriction, calorie counting, body checking and dieting. Fill your social media feed with people of all body shapes and sizes who are living their life authentically and to the fullest.
Invest in education
Intuitive eating is a skill we can develop and a tool that will last us a lifetime. Investing in educational tools like our book Eating Intuitively for PCOS can help guide you on your journey to food freedom.
Work with a non-diet professional
You may prefer to have bespoke, tailored support to support you on your intuitive eating journey as well as help you manage your unique PCOS symptoms. Check out our directory of PCOS providers and gain access to a database of PCOS pros.
Key takeaways: PCOS and intuitive eating
Intuitive eating if you have PCOS is possible. You may need to be more aware of the gentle nutrition principle and be conscious of finding ways to eat that help with carbohydrate cravings and insulin resistance. Reading relevant books on PCOS and intuitive eating or working with a non-diet PCOS professional may help you on your intuitive eating journey.
Founder and Editor | Registered Associate Nutritionist
Founder of Be The Collective LTD [The PCOS Collective & The Endo Collective] Alex Okell ANutr is a London-based reproductive health nutritionist with experience in research, private practice and digital media. She holds a Master’s degree in Nutrition from King’s College London and has co-authored papers with the University of Cambridge, King’s College London, The Food Foundation and the Food Standards Agency. Alex offers 1:1 PCOS support in our virtual PCOS clinic.