Intuitive Eating & PCOS: Why We Struggle and What to Do

Do you really understand what your body is saying when it comes to hunger and satiety? It's more complex than you might think, especially if you're managing PCOS. We're breaking down leptin resistance, a hormone intricately linked to our satiety signals. If you've ever wondered why you still feel hungry even after eating a satisfying meal, leptin resistance might be the culprit. With insights into the biological and emotional factors contributing to this disconnect, we're unraveling the mysteries of our relationship with food.

Intuitive eating sounds simple in theory, but for those with PCOS, it can be a minefield. Ever felt like your body is leading you astray, guiding you to consume copious amounts of sugar, starch, and fats? You're not alone. We're exploring the primal brain programming and potential genetic factors that make overeating feel inevitable for many with PCOS. Understanding these signals and influences can be the first step in regaining control over your food choices.

In the quest to eat more mindfully, understanding leptin resistance is key. But how do you improve your sensitivity to these crucial satiety signals? We've got practical advice for you, from slowing down during meals to avoid overeating, to managing cravings and choosing foods that support your individual needs. This isn't about strict rules - it's about flexibility and developing a healthier relationship with food. 

Chapters

• 0:39 Leptin Resistance and Intuitive Eating
• 9:18 Intuitive Eating and PCOS Challenges
• 20:37 Improving Intuition and Mindful Eating
• 32:20 Request for Additional Strategies

Transcript

Speaker 1: 0:40

Welcome back to An Amber a Day. I'm your host, amber Fisher, and I'm very excited that you're here today. We are going to talk about something else that's maybe a little controversial, and that is leptin resistance and intuitive eating and how those work when you have PCOS or don't work when you have PCOS, and where we can find sort of a balance there, probably how I would tell you to do things if I were your nutritionist. So let's get into it. First, I do want to mention a couple of things. There is a new way to support the podcast. You can sponsor the show by paying for, like Buy Me a Coffee or whatever. You can do it through my podcast host, buzzsprout now. So there should be a little option in the description box. If you want to pledge like five bucks a month, you can cancel it out anytime. Just to help get better equipment. Maybe hire an editor, gosh, you guys, I really want to hire an editor, somebody to cut out all my ums, because I feel like I say some pretty good stuff on here. But the editing of this podcast takes me ages and that is the main reason why I don't post more. So if we had an editor, you might get a true weekly podcast episode for me, or maybe more so anyway, you can support me through that link below and I appreciate any of you who do that. The thing is, you guys have been so sweet leaving me the five star reviews on Apple Podcasts and I can actually tell that it's really helping the podcast to reach more folks, which is always the exciting and also kind of scary. But I want it to continue. I'm excited to have us reaching a larger audience and just getting the message out about PCOS and nutrition and all the things that we can do.

Speaker 1: 2:28

All right, what is leptin resistance? Have you ever heard of that before? So I find it's about half and half. There was a little bit of time where people were talking a lot about leptin resistance because they were talking a lot about insulin resistance and it seems like it's kind of fallen out of fashion to talk about it. But leptin is a hormone that kind of helps to control your satiety signals. So if you've heard of ghrelin, ghrelin is a hormone that your stomach produces. It kind of like helps you to feel hungry, and leptin is kind of the hormone that your body secretes to help you feel full, and so in PCOS, we know that we have issues with both hormones, but particularly with leptin, and it's associated with how much extra body fat we carry, how insulin resistant we are and how high our androgen levels are. So, essentially, the more severe your PCOS symptoms are, the more likely you are to have leptin resistance, and so I'm of the opinion that almost all of us with PCOS are probably dealing with some level of leptin resistance, particularly if we struggle with our weight maintenance, with weight gain, with weight loss, if we struggle with issues around food like binge, restrict, cycling and things like that.

Speaker 1: 3:48

Now, that said, of course, if you have a diagnosed disordered eating tendency of some sort, there are other things involved there too, and trauma can be a factor in your relationship to food and all that kind of stuff. So I'm not suggesting that leptin resistance is the only thing. However, we often don't talk about leptin resistance as being part of this factor of issues with PCOS surrounding food. Why is it that so many of us with PCOS have disordered relationships to food? We know childhood trauma and things like that is more common in PCOS, but certainly not everybody who has PCOS has trauma and insulin resistance, we know, can contribute to issues with satiety signals, but not everyone with PCOS has raging insulin resistance, and some of us with PCOS don't struggle with weight at all. Some of us are underweight. There's a lot of different factors going on in the relationship that we might have to food, but so often what I'm seeing people do is turn the other way on biological, hormonal or chemical sort of signaling issues that might be getting in the way of this. The focus is so much on the psychological aspect. I don't know about you guys, but I find the concept that the only thing that I can do to manage any kind of disordered relationship around food is kind of let the whole thing go and work on, like my psychological state around food. There is absolutely a biological, physical component to our relationship with food that we don't talk about enough. We also don't talk about the fact that eating food stimulates the vagus nerve, and so one reason why people can overeat is because, if they have anxiety, sometimes stimulating that vagus nerve by having food literally travel down the throat makes you feel better, reduces your stress. So is that emotional or is it physical? It's kind of a combo of two things, right, so it's a self soothing technique for sure.

Speaker 1: 6:05

Now, leptin resistance is something that's going to make it harder for you to understand when you are full and when you're satiated. So what this often means in PCOS is we eat too much because we don't feel quite full enough. So we kind of keep eating and our satiety signals sort of catch up to us later. So oftentimes we overeat, later we will feel extra full or our stomach will hurt or we'll feel bloated or whatever, but we won't feel that until it's kind of too late, because we've been waiting for that satiety signal and we have resistance to it. So it's similar to the concept of insulin resistance, where your body keeps pumping out the insulin to deal with your blood sugar and it's making more than it should. The same thing with leptin. It's like your cells are not opening up to that signal from leptin saying, hey, we're full, like, slow down, stop, we don't need any more food. So what that means is that you may struggle with figuring out how much is enough, when is enough enough, when is it not enough.

Speaker 1: 7:16

And if you go purely based off of those signals those satiety signals, whether you feel full or whether you feel hungry and cravings surrounding that, if you base your nutrition plan solely on that, what I have seen is that a large percentage of people do not do well with that. It becomes more defeating in the end, because their body's signals are not signaling properly, and so they're trying to listen to their body's signals, but they end up following these sort of warped signals, which then get them going down the same path that they were trying to avoid. This definitely has been the case for me I think I talked about this in a previous podcast where, for example, if I've eaten more sugar let's say I went on vacation or something and I'm eating a lot more sugar starches than I usually do I find that it can very quickly sort of snowball into this thing where suddenly I'm craving sugar all the time and now it's not just a little sweet treat after dinner, now it's like I've got to have one in the afternoon and I've got to have one in the morning, and then, before you know it, the cravings can become a little bit out of control. Is there a psychological element to that? Sure, I'm sure there is. But there's also a physical component to it. There's a physical hunger. There's a signal to my brain telling me hey, you want sweets, you're hungry for a sweet and you need it. And that is very hard to overcome, particularly when you're trying to just do it intuitively. Now, before I get myself in trouble by talking about intuitive eating in a way that it's not really intended, I do want to state that I know that true intuitive eating is not solely based on craving cues. There are other factors that go into being intuitive with your body and that's the kind of intuitive eating that I believe those with PCOS should be practicing and should be working towards, and I'll kind of explain what that looks like later.

Speaker 1: 9:18

But the way that a lot of people interpret the concept of intuitive eating is, I think, where it can get a little bit problematic for PCOS. Now, some of us interpret intuitive eating as basically just listen to any time I have a craving, listen to how hungry my body's telling my am and eat accordingly. So if I'm craving sweets, carbs, whatever it may be, I'm going to eat those and I'm going to eat until I feel satisfied, and in theory that sounds wonderful, right, it takes all the pressure off. We're just listening, we just need to be mindful, we need to slow down weight, let our body, sort of like, tell us what it needs, and it does work really, really well for a lot of people, especially people who have been harmed in the past by diet culture or who don't have issues with insulin resistance and things like that. However, for a lot of us with PCOS it doesn't work well, and the reason that I feel comfortable saying that is because I've been told that by numerous, numerous people and I've had that experience myself, where that sort of following my body signals and cues doesn't really translate into me eating what's appropriate or good for my body. It instead leads me towards slight increases over time in the amount of sugar, starch and usually saturated fat that I'm craving, with very little ability to tell when I've had too much of those specific types of foods. So protein, sure, my body will tell me you've had enough proteins for your filling.

Speaker 1: 10:58

Veggies definitely have an off switch with veggies, but when it comes to dessert sometimes the brain doesn't have a real good off switch. For that we often call desserts and other fast food items in nutrition that's called the hyperpalatable trifecta, because their foods convenience foods, usually made from sugar, salt and fat, and the combo of sugar, salt and fat together is one of the most addictive combos for the brain. It just tastes delicious, it's high calorie and that means it's hyperpalatable. So what that means is it's very tasty. Your brain wants more and more of that because our brain's a primal and they're programmed to want more of high calorie, dense foods in order to help us store a little extra for the famine. But we're not living in a time of famine anymore. We're not living in well I shouldn't say that we're in the developed world. We're not living in a type of famine for the majority of us who don't live in food deserts and things like that. Most of us have more than enough access at least to those kinds of cheap, hyperpalatable foods, and so we don't have that same problem of needing to kind of store up enough for winter.

Speaker 1: 12:18

And that's, I think, where those of us with PCOS tend to get into some trouble here, because my belief is that the PCOS brain is a bit more primal than maybe the average person, and I remember reading something about this and for the life of me I cannot find it whenever I look for it. So if you guys have read this, send it to me. But I remember reading an article about how researchers were thinking that those with PCOS were carriers or inheritors of some more primal genetics related to fat storage. Because if your ancestors had lived in a time of famine, you would likely have been more fertile because of your ability to hold on to more body fat, and so it was like a genetic mutation, essentially to kind of help. You tend towards more fat storage in order to keep you and yours, keep your line continuing. And, like I said, I haven't been able to find that article again, so maybe I dreamed it, but it rang really true for me because I do feel like some people.

Speaker 1: 13:27

Let me take my husband, for example. My husband is a naturally thin person. Certainly has had his share of health issues. It's not that he hasn't ever been in an unhealthy state, but he's never had issues with weight or with insulin. He can drink regular sodas, he can have cookies and cake and things like that, and it doesn't spike his blood sugar like crazy and it's not necessarily hard on his body from those perspectives. He also has an off switch when it comes to dessert. So there will be times when we're both eating the same dessert and my brain is telling me to continue eating. It's telling me I'm still hungry, my stomach's telling me I'm still hungry and his is like, oh my gosh, I gotta stop like this enough. And so if I let myself keep going, I can throw back double of the dessert than him, and he's six foot three, so there's something that's not quite up to par with those signals. And, in fairness, my own hunger signal issues do have somewhat of a trauma basis. There's some stuff in my past that sort of makes the psychological aspect part of what I'm dealing with. So when I use my own personal experiences I just wanna be clear that that's part of the picture too. But I just know a lot of people like this where they've tried intuitive eating. They've tried to listen to their body signals and it just doesn't seem to work. They just seem to keep gaining weight and it doesn't have the intended effect.

Speaker 1: 15:06

You hear about people who switch to intuitive eating and suddenly they feel like they have a freedom around food and they feel so much better. They feel like they eat what they want and their body tells them what they need and so they listen to all their signals and they just feel so much better. But with PCOS, what I find is that a lot of us who try to do that we feel less freedom around food. We feel more controlled by food because we feel more confused about food. We're like wait a second. I thought I wasn't supposed to have sugar all day long, but that's the only thing I'm wanting. You're not wanting anything else. My body's not telling me you need to eat, like it's hungry for vegetables. It's not telling me it's hungry for protein. It's only telling me at once this or that and so.

Speaker 1: 15:53

And the argument that I've heard on the other side is a little just keep going, keep going with it and eventually switch. I've seen some people who've kept going and it hasn't switched for them. So I just think it's like it's kind of dismissive. A lot of times when people run into issues with that type of intuitive eating, the response is just like, well, you're not doing it right, or like you haven't let go enough, or you're just like it's just a little dismissive. The reality is that there are a lot of people who have tried and failed at listening to their body's cues, and what I think is going on here is that, with PCOS, we have to have our emotional state, our body's cues. We need to listen to those, paired with our logic and our nurturing mind. So there's two things going on. There's, out of love for ourselves, we are going to, without judgment, eat what our body is telling us it wants to eat. At the same time, we're going to be using what everyone call it your higher self or whoever, to inform the fact that we also need to mother ourselves and nurture ourselves by making sure that we eat the things that are going to make us feel better in the long term. So there's kind of like a mesh of the two things going on, and the real point is that all of it's done without judgment, all of it's done from a place of love.

Speaker 1: 17:25

But I always get this example with my son. He's three and a half and he would love nothing more, probably, than to just eat chocolate chips all day. He loves chocolate chips and I would love to see the joy on his face just feeding him nothing but chocolate chips. And I do give him a lot of chocolate chips because chocolate is a great antioxidant and it, you know, bad for you thing. And he's a little kid, you know. At the same time, I know that his body also needs protein so that his muscles can grow and so that he has the different amino acids that he needs. I know that he needs to eat some veggies so that he gets some antioxidants too and he gets fiber and all that kind of stuff. I know that if I don't feed him enough fibrous foods, that he will have trouble going to the bathroom and that will be painful for him later. So I'm thinking ahead and I think that's what we have to do with. Intuitive eating is we don't necessarily have to throw it all out the window and say I'm going to strictly follow this calorie amount for breakfast, lunch or dinner, this macro and this, and that we can be a little bit more like, intuitive with it and say, okay, like for breakfast, I generally am going to have this makeup of foods, but we're gonna think about what we want right now and we're gonna think about what our body is gonna want from us later as well.

Speaker 1: 18:55

So I always think about it for myself, like if I were a child. If there's a little girl inside of me who's craving whatever, what would a good mom tell me to do or not to do? What would be something that my mommy would let me do or not do? And typically, if it's you know day, I haven't had a snack yet or anything like that, and maybe I want like a chocolate chip cookie or something I think, okay, if I were my own mom, I would probably let myself have a chocolate chip cookie, but my natural kind of inclination might be like, instead of just one, maybe I'd have three, or maybe I'd have four, you know. And so what would a mom do? A mom would let you have the cookie, but ideally the mom would probably not let you have four cookies because you'd spoil at your dinner. So I just kind of like think about it that way and I don't know that's a helpful device for me, but there are many different ways that people kind of felt with themselves. But I find that you know, especially if we have like inner child issues or what have you? Pretending to be our own mom and re-parenting ourselves, basically, can be really helpful in figuring out how to understand our satiety signals. Now the other thing that we need to do is understand how leptin and insulin are going to impact our body signals and prepare our meals to offset them as much as possible, because we're always going to have these sort of issues, but they don't have to be as bad. The more under control your PCOS symptoms are, the less severe both of these things are. So the cool thing is that as you improve your PCOS symptoms, as you keep working on your PCOS nutrition.

Speaker 1: 20:38

With time you might be able to be a lot more intuitive than you were before. This has definitely been the case for me. There have been times in my life where I've had to be more structured, more strict, I guess and and have you know, more thought go into my meals. There's definitely kind of a switch in mindset and relationship around food. That often happens, but with time I've been able to let go of that somewhat. I'm not counting macros, calories or grams of protein at my meals anymore, you know. But I do know, like generally, what my plate should look like and I'm kind of following that in my head the majority of the time. Nothing is all the time. Nothing is never Moderation and all things, but I think if we can understand that, like leptin resistance, for example, is going to make it harder for us to know when we're full, then one of the things that we might want to start by doing is taking more time with our meals, and this is something that any person who works with intuitive eating will tell you. You need to be more mindful with your food.

Speaker 1: 21:53

Often with PCOS, we kind of we're eating on the go, we're shoveling our food down and we're getting on with our day, and so, you know, not great for your digestive juices and your enzymes and all those things to break down your food and your food might not sit well with you if you do that In theory. If you're measuring out your meals and you have them all perfectly appropriate for PCOS and you've shoveled on your food, is it going to make that big of a difference with your goals? In the end? Probably not, because you're eating the correct quantity that you previously determined. However, if you're trying to eat intuitively and you're eating really fast, it can be really difficult to know when you've had enough. I find this is especially true when eating something like fast food and eating while driving. If you're not paying attention to eating, it's very easy to just like keep eating, keep eating, keep eating. And if you eat too fast, you really won't give your leptin time to catch up.

Speaker 1: 22:51

And so what often happens is folks with PCOS will overeat. They'll finally start to feel full after eating, you know, higher than what their body actually needed, and then that sends their blood sugar spiking, which then causes that increase in insulin. So then you start getting on the blood sugar roller coaster, right? You're feeling really tired after your meal, but then, like, two hours later, you need to eat again, and so the cycle continues. So the first strategy to improve our leptin resistance and allow us to be more intuitive with food is to take your time with your meals.

Speaker 1: 23:26

Sit down, chew appropriately there's no set number, but like, chew 25 times, I don't know. Chew until your food is really chewed and very well coated with saliva, because did you know that as enzymes go, the enzymes that digest carbs are secreted by your tongue, so they're made in your saliva, and so if you don't coat your food with saliva, you'll have a hard time breaking down carbs. Anyway, that's neither here nor there. Chew your food really well, take each bite, then set your fork down. That's another little technique that can be helpful, as just setting things down in between bites. It's also helpful often if you eat with other people, if possible. So people often eat less overall when they're eating as part of a group, not because of peer pressure, but because they're talking, and if you talk in between bites, then you eventually get full faster than you would before. Another technique that sometimes people do is just take a sip of water between bites.

Speaker 1: 24:31

I would caution with this one, that that can dilute your stomach acid, which you need to break down your food. So, especially if it's a big meal like a steak or something like that, I wouldn't probably do that because I think you'll have digestive issues afterwards, like you might struggle to break down that meal. So typically I try to avoid drinking too much during my meals. But it is a nice device to kind of like slow you down. So if there's something you can do, some little ritual you can do to kind of slow down your eating process and then, as often as possible, to eat when your attention can be focused on your eating, that's mindful eating and that is really. It's really important for all of us. It will start to train your brain a bit more on. You know what it needs, what it doesn't need.

Speaker 1: 25:15

The other thing I would suggest is, if you are gonna have to be on the go, to do more prep in your mind on what's gonna be good for your body and your long-term health. So let's say you do need to go and get fast food or something like that. You might be really hungry. You might know that you can eat a large french fry, for example, but it's gonna be very difficult for you to intuitively stop eating those french fries when you're ready because you're gonna be driving and you're not gonna be able to pay attention. So order a small meal or a meal that kind of meets your goals a little bit more. That way it's almost like a stopper on yourself.

Speaker 1: 26:00

I don't know some people do this already, but one of my old MOs was like I would order more food than I was intending to eat. I would just like up-size whatever I was getting, because I'm like I'm not gonna eat all these fries, but I also don't wanna get to the end of my fries and want more fries. You know what I mean. So don't do that. That's probably not the best way to do things, especially if you're not gonna be able to be focused on what you're eating, because it's that focus that helps you figure out those satiety signals. And when I say focus, that includes not watching TV or scrolling through TikToks or scrolling on your phone while you eat. I know that's hard, but again, if you're gonna do more of that stuff, set yourself up for success by not giving yourself the substrate to overdo. That goes for lunches, all kinds of stuff like that I find people often do at lunches.

Speaker 1: 26:52

Another device that's helpful is to not just plan your meals around how you're feeling as far as what you're craving, but to have the craving along with other things that your body does well with. So what I mean by this is, let's say, you are craving cookies. Instead of just having the cookies, you understand that you might be craving the cookies and so, intuitively, you're gonna follow that cue and eat a cookie. But at the same time, you also know that your body does well, or does better, with more protein. So have the cookies with Greek yogurt, for example, or something that's gonna help balance out the ratio of the different ingredients in there. So if you're having dinner and you're only craving mashed potatoes, you can have the mashed potatoes, but then also think about having a piece of salmon, even if it's just a small piece, and having like some broccoli or something like that. You're pairing meals together. You're pairing foods together with the cravings. So on the one hand, you're indulging the cravings, who you are being intuitive. On the other hand, you're mothering yourself, you're caveatting yourself, you're kind of balancing yourself out. It's all about that. Balance really is what leads to long-term success.

Speaker 1: 28:13

Another tip would be to try not to skip meals if you're early on in your intuitive eating journey. So skipping meals, fasting, things like that they can be supportive for some people longer term, but at the beginning of repairing sort of a relationship around food and repairing leptin resistance, it's often better to have regular meals, scheduled meals and snacks, because the scheduled meals will help prevent you from ever getting too hungry. It'll help you prevent you from overdoing it at the meal that you're allowing yourself to eat. So like if you're not eating all day but you're eating dinner and you eat fast and you're craving different things, it can be really easy to kind of like get into a situation there. So eating regular meals, having planned snacks, that can be really effective.

Speaker 1: 29:03

I think, more than anything else, planning is really key when it comes to PCOS nutrition and I know planning doesn't always go with the concept of intuitive eating, but I've seen people run into more issues when they're unprepared than anything else, and so if you're already hungry but you have no leftovers in the fridge, you have no quick, easy things to put together. It's a lot easier to just grab a handful of Oreos or to have some of your I don't know to go doordash something, having prepared a meal structure for yourself in advance, maybe prepped some things on the weekend or have something that's thawed and ready to cook in the fridge, or having even just something like deli meat, cheese, sticks, nuts, things that are easy to snack on but that are a little bit more nutritionally balanced. That's going to set you up a lot more for success than just kind of waiting around for cravings to strike. So being as prepared as possible is also really helpful when recovering from leptin resistance and insulin resistance and just in general for nutrition.

Speaker 1: 30:17

A lot of us don't put a big focus on our food. We put everything else first, right Like other people's needs, what they need to do. We often put other people above ourselves, but even with our own self we often put our other needs above our nutritional needs. We might put our exercise needs or our water needs or something not even related to that. We might put our need for rest or put our need for friendship and community and all those things right. Everything's important. That's why it's hard to pick, but as a nutrition professional I'm a little biased and I think that if you put your nutrition in a high spot, then you will feel better in general, have more energy and be able to do a lot more of the things that you wanna do, whereas if you're not eating well I know you're gonna feel tired, you're just gonna wanna lay on the couch. So putting your nutrition in a high place of importance in your life is really helpful for your overall life and the balance of your life.

Speaker 1: 31:22

So that's a little bit about leptin resistance and how you can implement some strategies to help you be a bit more intuitive with your PCOS eating and just more balanced overall. So those are some of my favorite strategies for PCOS focused, intuitive eating. It's a lot more about, again, the combination of listening to your body's cravings and signals, while also listening to your higher self or inner mother's guidance on what you need. So intuitive eating can't just be about what we want. It has to be about what we need too, and, again, all from a place of love and not from a place of judgment. That's the hard part. The hard part is not judging ourselves when we inevitably have bad days, but you don't need to. This is a process, right? We're learning and we're learning together, so good luck.

Speaker 1: 32:21

I would love to hear from you guys if you have any strategies that I didn't share, because I'm getting to the end of this and I'm like I feel like there's a couple of things that I could have said, but I didn't remember or not on my notes, so please feel free to send an email to the podcast if you want to. You can email an Amber a day podcast at gmailcom and let me know if there's anything that I forgot. And thanks for being here once again. Appreciate you all and I'll talk to you soon. Bye.