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  • Aryane Oar, MS, RDN, CD

PCOS at a glance series {final part}



This is the final part of the PCOS at a glance series and to wrap up, we will briefly discuss the psychological impact that PCOS may have on women, which can ultimately affect their eating habits. Before you move on, make sure to check out parts 1, 2, and 3 if you haven’t done so yet! 


The hormonal imbalances caused by PCOS may result in undesired weight gain (especially around the abdominal area), infertility, decreased sex drive, and dermatological issues, such as acne, unwanted hair growth, and balding. As expected, women may feel ashamed about these symptoms and, consequently, develop a sense of negativity, distrust, and discouragement about their body. 


It is worth noting that body image and self-esteem are closely associated with each other in the majority of cultures. Body image is defined as one’s thoughts, perceptions, and attitudes about their physical appearance [1]. Self-esteem, on the other hand, is described by the expert Morris Rosenberg (1965) as a positive or negative attitude toward oneself [2].  Simply put, it refers to “a person’s overall sense of his or her value or worth” [3].


As women with PCOS experience more body dissatisfaction and depression than those without the disorder [4-7], it is easy to see that their eating habits can be negatively affected as well as their overall quality of life. In an effort to lose weight, disordered eating behaviors may develop, such as meal skipping, food restriction, and feelings of guilt or shame associated with eating. After unsuccessful weight loss attempts – usually only to see their weight going up - the new eating pattern may turn into a restricting/bingeing cycle, which can intensify those feelings of guilt and shame. This can easily lead to a depressive mood, also affecting other areas of life, such as social interactions. In addition, many individuals find comfort in food when feeling depressed, which can also contribute to weight gain.


Low self-esteem, poor body image, dermatological issues, weight issues, and concerns regarding infertility may also result in an increased risk of anxiety symptoms in women with PCOS [8]. In this case, getting a qualified mental health professional on board should be considered as it might be very beneficial. Concerns can trigger a need to eat to relieve anxious feelings and can also contribute to emotional eating and bingeing.


The complexities of PCOS should not be underestimated, especially among health care professionals. As we saw, these women are more prone to suffer from emotional distress than those without the syndrome and are at a higher risk of experiencing body dissatisfaction, depression, and getting involved in dieting. These are important risks that need to be taken into account, especially when making weight loss recommendations. Working toward a more peaceful relationship with food and body may be more important to the overall health of women with PCOS than the pursuit of weight loss. 


If you are suffering from PCOS and feel distressed and confused about food, you are not alone. You don’t lack willpower, you aren’t a bad person and you are capable of cultivating a positive, peaceful relationship with food. 


This was a brief overview of the psychological aspects of PCOS and I hope that the PCOS at a glance series could clarify some of the common misconceptions around this complex endocrine disorder. If you have PCOS and are facing some (or many) of the challenges mentioned throughout this series, don’t hesitate to seek the support of family, friends, and qualified health professionals to assist you in achieving good overall health and well-being. We are here to assist and support you in any way possible!



References: 


1. Body image and eating disorders. National Eating Disorders Association (NEDA). https://www.nationaleatingdisorders.org/body-image-eating-disorders. Accessed September 18, 2020.


2. Rosenberg M. Rosenberg self-esteem scale (RSE): acceptance and commitment therapy. Measures Package. 1965;61(52). 


3. Ackerman CE. What is self-esteem? A psychologist explains. Positive Psychology. https://positivepsychology.com/self-esteem/. Accessed September 18, 2020.


4. Brady C, Mousa SS, Mousa SA. Polycystic ovary syndrome and its impact on women’s quality of life: more than just an endocrine disorder. Drug, Healthcare and Patient Safety. 2009;1:9-15.


5. Himelein MJ, Thatcher SS. Depression and body image among women with polycystic ovary syndrome. Journal of Health Psychology. 2006;11(4):613-625.


6. Himelein MJ, Thatcher SS. Polycystic ovary syndrome and mental health: a review. Obstetrical and Gynecological Survey. 2006;61(11):723-732.


7. Cipkala-Gaffin J, Talbott EO, Song MK, Bromberger J, Wilson J. Associations between psychologic symptoms and life satisfaction in women with polycystic ovary syndrome. Journal of Women’s Health. 2012;21(2):179-187. 


8. Hu X, Wang J, Dong W, Fang Q, Hu L, Liu C. A meta-analysis of polycystic ovary syndrome in women taking valproate for epilepsy. Epilepsy Research. 2011;97(1-2):73-82.



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