What came first, the chicken or the egg? That mystery can be applied to my health – what came first, my PCOS or my eating disorder(s)? The reality is I may never know but both co-exist, and for me will always co-exist, so instead of trying to get rid of one or ignore the other, I must accept and embrace them, together.
For me, PCOS and my eating disorder are so inter-connected. With PCOS there are hormonal issues with mensturation, same with eating disorders. With PCOS there are weight shifts, same with eating disorders. With PCOS there is depression and anxiety, same with eating disorders. As you may guess trying to figure out which symptom is caused by which illness is difficult.
I was officially diagnosed with PCOS just a couple months ago – however I have certainly had it since at least my early twenties (I’m 33 now), but arguably since adolescence. My process of diagnosing was difficult, painful, drawn-out (on my part), and I was confused, scared, and hopeless. I first had a doctor wonder if I had PCOS about 10 years ago due to androgen activity (I had adult acne and hiritsim) and rapid weight gain combined with a history of difficulty losing weight. I reacted poorly to this. This is because I have an eating disorder and I am incredibly sensitive to comments about weight; even health comments from a professional. Let me tell you a little history about my eating disorder before I go back into my PCOS history. Like I said, they are inter-connected so in order to make sense of it for you (and for me) I have to jump between them. So, I have struggled with weight and eating disorder(s) since I was 8 years old. That’s when I began to gain weight (before then I was a ‘normal’ weight child). As I went through puberty the weight stacked on and on. I was embarrassed and needed to do anything to fix it. I tried a healthy diet and increased activity – never seeing any results; little did I know I (probably) had multiple cysts on my ovaries that made weight loss very difficult. Plus I was an insecure teenager desperate to lose weight, bad combo. As a teenager with probable PCOS who was also developing an eating disorder the focus I had on weight loss and body image were out of balance and created a challenging dynamic for myself and my loved ones to handle appropriately, but that’s a different story. What I do want to emphasis is please be very careful about conversations regarding weight with anyone, especially those who are young. Anyways after health(ier) eating and increased activity failed to produce the results I was looking for I took matters into my own hands and just stopped eating. This is when my eating disorder became a monster. By my early twenties I had already become well versed in the caloric obsession and rigid ways of anorexia as well as the binge/purge cycles of bulimia. My eating disorder(s) have always oscillated between restriction (anorexia) and binging and purging (bulimia), and with it major weight shifts have occurred. I have always thought my weight gain was related to a failed eating disorder but the more I learn about PCOS the more compassion I can give myself due to the fact that weight gain and difficulty losing weight are common symptoms of PCOS.
Okay, I’ve focused a lot on the eating disorder part. Let’s go back to the PCOS part. In my early twenties, when I was first trying to recover from my eating disorder, which at the time was anorexia, I gained a lot of weight. Like a lot. More than I was supposed to. Some of this weight gain was necessary due to how much I had lost because of my eating disorder. But even after I was weight restored I just kept gaining and gaining and gaining. I wasn’t following a meal plan (yet – I’ll get to this, and trust me it’s worth waiting for!) but I wasn’t binging either. My weight got so high that I was considering suicide as the only solution to my shame (keep in mind, although I wasn’t active in my eating disorder, I still have an eating disorder so those thoughts still consumed me). I was clinically obese and I was devastated. And this weight gain was very very rapid. My doctor was concerned about it and wondered if I had PCOS. I had had irregular periods, but I thought it was due to malnutrition (which, it could have been). I also had increased androgen activity – adult acne and hirtism. My doctor sent me for an ultrasound. Well, let me tell you this was a bit traumatic for me. I had NO IDEA that an pelvic ultrasound meant an internal ultrasound as well. I have a complicated (to say the least) sexual history and well the idea of an internal ultrasound was too much for me. I couldn’t do it, I refused. I did manage the external ultrasound and the results did show multiple cysts on my ovaries. I went back to the doctor and was prescribed birth control, YAZ that time. I also got some kind of cream for my face as well as a prescription for spirlocatone. The YAZ definitely controlled acne, and definitely regulated my periods. The cream did nothing (I can’t even remember what it was supposed to do) and I don’t think I tried the sprilactone long enough to see results. I only stayed on YAZ (that time) for three months, the migraines I got while on it were too much for me. My doctor still wanted me to get the internal ultrasound done but I never did. I never fully accepted the PCOS diagnosis. And actually I never went back to that doctor. This was about ten years ago.
Back to the eating disorder.
I kind of dismissed the idea of having PCOS. I think I felt hopeless because of it. An incurable condition. No solution (that I knew of then) for the weight problems (which were my primary concerns with it as I was not trying to get pregnant and I have an eating disorder). No solution, for me, must mean no problem. I was in denial. My weight was quite high and so I did the only thing that has worked for me before, starvation. So I stopped eating again. And I lost weight again. I was around 26 at the time and for the next five years my eating disorder would jump back and forth between restricting and binging and purging, and my weight would shift from low to normal to high to normal to low and on and on and on and by the time I was 30 I found myself in an inpatient treatment center for my eating disorder. I have been in eating disorder recovery now for three years and it is the best thing I have ever ever done. First of all because I got my life back. But also because I learned about nutrition and a meal plan and and inadvertently found a way to manage some of the PCOS symptoms.
Okay, back to PCOS.
When I was in hospital for my eating disorder my periods came back, except they came back twice as often as they should be! I went from no period (amenorrhea) to double periods (a period every two weeks! – metrorrhagia). Again, I thought this was about hormone changes from weight gain caused by eating disorder recovery and not from PCOS. But even after my weight stabilized I was still getting too many periods. Although infrequent periods is more common in PCOS, periods that are too frequent are still considered irregular and still considered a symptom of PCOS. Also, when I was in treatment I got a, drumroll please, a MEAL PLAN! Oh my goodness, this meal plan has not only restored me to health, but it is a meal plan that is good for any human being, including those with PCOS. I will post my meal plan below, but before I do that I want to give a disclaimer. This meal plan is specific to my needs and you might not need the exact same plan, I’d recommend running this by a dietitian before jumping on board with it. That said, it is a basic meal plan, suitable for basic humans. It is healthy, and balanced. And it is timed so that one is eating every 2-4 hours, which is ideal for blood sugar control for people with (or without, but especially with) PCOS. If you don’t have access to a dietitian the following meal plan is definitely sufficient for someone with PCOS.
This is my meal plan:
Breakfast: (within one hour of waking up)
1-2 Fruit/Veg Servings
1-2 Grain Servings
1 Dairy Serving
0-1 Added Fat Serving
1-2 Added Fat
1-2 Added Fat
I also have an activity protocol. It is important for me to stick to the recommended activity because of weight issues with PCOS but also because without an activity plan my eating disorder can be activated.
Birth Control History:
I have never been on a birth control pill longer than three months, so I don’t have any recommendations or stories really. I have tried three different brands, two of them twice. I am currently back on YAZ for the second time and I’m hoping to give it a solid 6 month trial. YAZ was recommended because of it’s anti-androgen properties.
Before YAZ I was on Linessa for a grand total of 4 days! This is because immediately I broke out and my unwanted hair growth increased dramatically. Everyone’s response to birth control is different so don’t take my word as reason, just as experience. I have also tried Alesse twice, and aside from regulating my periods I found it generally unhelpful.
February 2018, yes just a few months ago, I was officially diagnosed with, and I officially accepted my diagnosis of PCOS. I have a new doctor. I had some unwanted weight gain this fall and I didn’t know why. My eating disorder recovery was decent and although I had derailed off my meal plan a bit it honestly wasn’t long enough to create such dramatic shifts. My periods also became irregular, again (due to weight gain, which was due to my PCOS). I was in school and my activity did decrease a little due to a new schedule, but not to a point where I should have been gaining as much weight as I was. Weight gain for many people is difficult in and of itself, but combine it with an eating disorder and it’s a recipe for disaster! Because of my eating disorder I have regular check ups with my doctor unrelated to PCOS. In fact my current doctor didn’t even know of my history of PCOS investigations. When she wondered this past autumn if I had PCOS I began to accept the probability of the diagnosis. I got blood work done but just like in the past it came back normal. I agreed to getting a full pelvic ultrasound, including the internal, and surprise surprise multiple cysts confirmed.
Accepting the PCOS diagnosis is still a work in progress. I don’t want to have a condition that isn’t curable and effects the way I look. And at the same time having PCOS explains so much of my history, especially in regards to weight, and even in regards to my eating disorder, and every day I am learning to accept it, and having some understanding and self compassion towards myself. Though I can’t help but wonder if I didn’t have PCOS would I have struggled so severely with eating disorder(s)?
I’m a work in progress and the progress is good.
My current treatment plan includes:
Birth Control (YAZ) to regulate periods and to reduce androgen activity.
A mechanical meal plan and activity protocol – which means I eat three full meals and three snacks every single day, regardless of what the scale says, regardless of what my eating disorder says, regardless of anything. My meal plan is my priority. Not only does it keep me safe from my eating disorder, but it honestly controls so much of my PCOS symptoms. My meal plan is flexible, so I have the same food groups at the same time of the day but I can choose the variety of items, and generally stick to lower glycemic index foods for the sake of my PCOS. It also means I exercise moderately. I don’t over do it, but I must do it. I have two mandatory rest days a week, and five days were I can do an activity of choice, usually walking or jogging for myself.
I have PCOS.
I have an eating disorder.
I am in recovery.
I am a cyster.
Thank You for reading.
Thank You for this blog. It has helped me so much.