Polycystic ovary syndrome (PCOS) is a complex condition that affects millions of women worldwide. It’s well known for causing irregular periods, acne, and unwanted hair growth, but what’s less talked about is its strong link to disordered eating.
If you’ve struggled with emotional eating, intense food cravings, or feeling like your hunger is out of control, you’re not alone! Research shows that people with PCOS are at a significantly higher risk of developing eating disorders, particularly binge eating disorder.
So, why is this the case? Let’s dive into the science behind PCOS and disordered eating, and what you can do to develop a healthier relationship with food.
What Is PCOS?
PCOS is a chronic hormonal and metabolic condition that affects about 1 in 10 women of reproductive age. The exact cause isn’t fully understood, but it’s thought to be related to a combination of genetic and environmental factors.
Common symptoms include:
- Irregular or missing periods
- Insulin resistance (which can lead to difficulty managing blood sugar levels)
- Increased androgens (male hormones), leading to acne, hair thinning, and excess hair growth
- Weight fluctuations or difficulty losing weight
One of the biggest challenges of PCOS is its impact on metabolism and appetite regulation. Hormonal imbalances can make you feel hungrier than usual, crave certain foods, and struggle with energy crashes, setting the stage for PCOS disordered eating patterns.
What Are Eating Disorders?
Eating disorders are complex conditions that go beyond food and weight. They involve psychological, biological, and social factors.
The most common eating disorders seen in PCOS include:
- PCOS and binge eating disorder: Recurrent episodes of eating large amounts of food in a short period, often feeling out of control and distressed. It often results in feelings of shame and disgust, which perpetuate a vicious diet-binge cycle.
- PCOS and bulimia nervosa: Episodes of binge eating followed by compensatory behaviours like vomiting, excessive exercise, or laxative use.
- PCOS and disordered eating patterns: Chronic dieting, yo-yo dieting, food restriction, and unhealthy relationships with food – even if they don’t meet the criteria for a full-blown eating disorder.
The Link Between PCOS and Eating Disorders
Eating disorders, particularly binge eating disorder and bulimia nervosa are commonly seen in PCOS. In fact, research has shown that up to 62% of people with PCOS have an eating disorder, with binge eating disorder being three times more common in those with PCOS!
So, why are eating disorders more common in people with PCOS? Studies offer several key reasons:
1. Insulin Resistance and Blood Sugars
PCOS is strongly linked to insulin resistance, meaning the body has trouble using insulin efficiently. When your body doesn’t respond properly to insulin, it can lead to something called reactive hypoglycemia, which happens when your blood sugar drops too low a few hours after eating.
This can lead to unstable blood sugar levels, causing intense hunger, cravings for carbs and sugar, and energy crashes. When your blood sugar dips, your body sends powerful signals to eat – and often, the quickest source of energy is high-carb, high-sugar foods.
Over time, this can create a cycle of intense hunger, cravings, and loss of control when eating. And to make matters more challenging, PCOS binge eating episodes themselves can make insulin resistance worse, creating a cycle where blood sugar spikes and crashes continue…
Over time, insulin resistance can also increase testosterone levels, which may further impact appetite and eating behaviours.
2. High Levels of Androgens
Testosterone and other androgens (male hormones that females also produce) may play a role in increasing appetite, affecting impulse control, and contributing to binge eating in PCOS.
Some research suggests that high androgen levels are linked to binge eating behaviours, regardless of whether someone has PCOS. This is because androgen receptors are present in areas of the brain that regulate hunger and food intake.
Interestingly, studies have found that people with bulimia nervosa tend to have higher levels of androgens, even if they don’t have PCOS.
Some trials have tested medications that block androgens and found that they helped reduce binge eating, cravings, and even self-induced vomiting. This suggests that high androgen levels may contribute to eating disorder symptoms in some people! Isn’t that wild?!
3. Appetite Dysregulation
PCOS disrupts key appetite-regulating hormones, including:
- Leptin (the “fullness” hormone) doesn’t work as effectively in PCOS, making it harder to feel satisfied after eating. In fact, one randomized controlled trial found that those with PCOS were less satiated and felt hungrier after meals compared to those without PCOS.
- Ghrelin (the “hunger” hormone) may be elevated, increasing appetite and cravings.
4. Emotional and Psychological Factors
Living with PCOS can be incredibly frustrating. Many women feel unheard by doctors, struggle with body image due to weight changes or hair growth, and experience anxiety or depression.
Emotional distress is a well-known trigger for disordered eating, leading some to turn to food for comfort or control. People with PCOS who struggle with depression may turn to food as a coping mechanism, leading to patterns of binge eating or emotional eating.
Similarly, anxiety in PCOS can drive rigid food rules, dieting, or avoidance of certain foods, increasing the risk of restrictive eating behaviours.
5. Weight Stigma and the Diet Culture Trap
One of the biggest issues in PCOS care is the overemphasis on weight loss as a treatment strategy.
Many people with PCOS are told to “just lose weight” without any real guidance on sustainable, evidence-based approaches. This pressure can lead to chronic dieting, restriction, and ultimately, binge eating when the body fights back against deprivation.
Research shows that dieting is one of the strongest predictors of binge eating, yet it continues to be the go-to advice for PCOS management.
In fact, studies show that BED is 10 times more common in adults actively trying to lose weight compared to the general population.
Why Is Binge Eating So Common in PCOS?
Binge eating is three times more common in PCOS! This is due to a combination of:
- Blood sugar instability causing extreme hunger and cravings
- Hormonal imbalances making it harder to feel full and regulate appetite
- Chronic dieting and food restriction leading to binge-restrict cycles
- Psychological distress increasing emotional eating behaviours
How to Support a Healthy Relationship with Food in PCOS
If you resonate with these struggles, know that you’re not alone – and there are ways to manage PCOS without falling into harmful dieting patterns. Here is some inspo for you:
1. Practice Gentle Nutrition
Instead of focusing on cutting out foods, aim for adding back balanced, colourful, satisfying foods that stabilize blood sugar levels.
An ideal, well-balanced meal or snack contains a mix of carbs, fiber, healthy fats, and protein. Such a meal not only aids in regulating blood sugar levels but also provides lasting satiety. Fiber and fat help to slow the absorption of glucose into the bloodstream and protein keeps you full for longer.
For example, a balanced dinner might look like homemade easy enchiladas made with whole wheat tortillas (for fibre), chicken breast and black beans (for protein), cheddar cheese (for fats), and bell peppers, jalapeños, onion, garlic, and cilantro (for fresh veggies).
A balanced snack might look like apple with peanut butter (carb & healthy fat), pita and hummus (carb & healthy fat), or Greek yogurt with berries (carb & protein).
2. Ditch Dieting
When we physically restrict food, our bodies initiate a series of biochemical reactions that literally drive us to eat more. Ghrelin and the neuropeptide Y are released in response to food deprivation, which increases our appetite and our drive to seek out and crave carbs.
Not only this, but when we mentally restrict food, we become obsessed.
You may still eat the food you see as “bad” or “forbidden”, but you feel shame, guilt, and frustration for eating it. You might feel the need to work harder at the gym or eat less the next day to make up for it. This is “pseudo-restriction”.
If you constantly tell yourself that you need to avoid fun foods, it can become nearly impossible to resist indulging in them when the opportunity arises.
The key lies in trying to strike a balance. Experiment with regularly integrating a dessert with your balanced and nourishing snack or meal. Have a sweet treat occasionally! It’s okay. Give yourself permission. <3
3. Seek Support from a PCOS Professional
A registered dietitian (like me!) or therapist who understands PCOS and weight-inclusive care can help you navigate nutrition and body image without falling into the diet-binge cycle.
If you’re looking for guidance on where to start with curbing cravings, fostering trust within yourself and your body, and building confidence in your everyday eating with PCOS, I’d love to support you! Book in for an initial assessment to get started.
Conclusion
The connection between PCOS and eating disorders is complex but understanding the underlying biological and psychological factors can help you make sense of your experiences.
Instead of battling your body, focusing on balanced nutrition, self-compassion, and professional support can help you break free from restrictive dieting and find a way of eating that truly works for you.
If you’re struggling with food and PCOS, know that help is available. You deserve care that supports both your physical and mental well-being.
FAQ
Why do people with PCOS crave food?
If you have PCOS and constantly crave carbs or sugar, you’re not imagining it!
PCOS messes with hormones like insulin, ghrelin, and leptin, making it harder for your body to regulate hunger and fullness.
Insulin resistance can cause blood sugar crashes, triggering intense cravings for quick-energy foods. On top of that, stress and mood changes linked to PCOS can make emotional eating more common.
Why do I feel so hungry with PCOS?
If you feel like you’re always hungry, you’re not alone.
PCOS can throw off the hormones that control appetite, making it harder to feel full after eating. Insulin resistance plays a big role too. When your blood sugar spikes and crashes, your body craves more food to bring it back up. On top of that, stress and hormonal imbalances can make hunger cues feel all over the place.
It’s not just in your head girl. PCOS can make managing hunger super challenging. But understanding why can help you find ways to work with your body, not against it.
Does PCOS cause overeating?
PCOS itself doesn’t make you overeat per se, but it can set the stage for it.
Between intense cravings, delayed fullness cues, and emotional eating tied to anxiety or stress, many of my clients with PCOS struggle with overeating or even binge eating. Dieting and food restriction can also backfire, leading to rebound hunger.
Looking for more PCOS nutrition tips?
As a Halifax dietitian, I’ve got your back! Improve your eating habits with my PCOS Plate EBook and get back to what truly makes you feel good, inside and out.
As a nutritionist specializing in women’s health and PCOS, I’ve got the knowledge and experience to help you improve your health and glow from the inside out.
What are you waiting for? Get your guide to thriving with polycystic ovary syndrome or delicious recipes, simple hacks, and tips for eating well with PCOS from a registered dietitian in Halifax.
Madison is a Registered Dietitian and Certified Diabetes Educator passionate about helping women with PCOS navigate nutrition with confidence. Through science-backed nutrition and lifestyle strategies, she shares practical, sustainable approaches to support hormone health, blood sugar balance, and a healthier relationship with food — one meal at a time.