Lena, a 20-year-old college student is the quintessential example of how physical illnesses, especially those that negatively affect body image and self-esteem, can lead to disordered eating. Lena has Polycystic Ovarian Syndrome better known as PCOS. Although the prevalence of PCOS and eating disorders has not been well studied, there evidence that the disorders are linked.
PCOS is an endocrine disorder that affects 5% to 10% of reproductive-age women. PCOS is characterized by the accumulation fluid-filled sacs (cysts) on the ovaries. Symptoms include excess facial and body hair, acne, irregular menstrual cycles, and infertility. PCOS is caused by hormonal and metabolic disturbance, which helps to explain the link between PCOS and eating disorders.?
50% to 70% of women with PCOS are insulin resistant and experience weight gain in the abdominal area, have difficulty losing weight, and have intense cravings for carbohydrates. Many women with PCOS are overweight, and doctors working with these women may recommend diets that restrict carbohydrate intake. PCOS symptoms can affect body image and self-esteem and may lead to the development of distorted eating habits.
In Lena’s case it was both dieting and body image issues that began her now 3 year struggle with bulimia. “I tried hard to limit my carbs, but kept craving them,” she says “I would be so good during the day but then binge on cookies, bread, all the things I couldn’t have. I needed to purge to get rid of the calories. I felt so awful about the way I looked,” Restrictive eating is often a precursor to binging behavior and in Lena’s case the accompanying weight gain has been the most challenging factor in trying to stop the bulimic symptoms.
With people with PCOS and eating disorders it is important to concurrently address the symptoms of both disorders. Treatment for PCOS may include hormonal therapy such as the use of birth control to regulate hormone levels. There are also newer treatments such as ovarian drilling, in which tiny holes are made in the cystic ovary resulting in a lowering of androgen levels. Women with PCOS may also be prescribed metformin to help regulate insulin levels.
In addition to stabilizing PCOS symptoms, women with PCOS should also work to normalize eating patterns by developing more mindful eating practices such as rating hunger and satiety levels. They should eat a variety of foods including healthy carbohydrates. If they are using food to manage emotions, healthy coping and self-care strategies are also beneficial.
