PCOS and Eating Disorders: Understanding the Connection
By Katelyn Van Hofwegen, ANAD Marketing & Communications Intern
Polycystic Ovary Syndrome (PCOS) and eating disorders are two complex conditions that can profoundly affect physical and emotional health. What many don’t realize is how often these two overlap — and how the challenges of managing PCOS can contribute to or worsen disordered eating behaviors.
In this post, I want to share both my personal experience living with PCOS and my recovery journey from an eating disorder. I hope to shed light on how these conditions can intertwine and remind anyone struggling that healing, though complicated, is possible.
My Story
I was diagnosed with PCOS when I was 16 years old. At the time, I was already engaging in eating disorder behaviors, though I hadn’t told anyone. When I received my diagnosis, I was told I might not be able to have children.
The physical symptoms were intense — bed-reddening cramps that often made me sick, which only increased my food restriction. I would get my period maybe once or twice a year, and I constantly felt like something was wrong with me. My weight fluctuated up and down, and I convinced myself that my eating disorder was the one thing I could control.
As I got older, that control slipped away. My body didn’t respond the way I wanted it to, which led me to engage in more disordered behaviors. I struggled with hair growth and other visible symptoms of PCOS that intensified my body image issues.
When I entered eating disorder treatment, I remember feeling devastated. I feared I might one day learn to accept my body — but the world never would. Doctors would still tell me to eat less, exercise more, and lose weight. I’d still hear warnings about carbs, sugar, and needing to “watch what I eat.”
The messages were endless and often contradictory: Eat less, but not too little. Move more, but not too much. Lose weight, but don’t raise your cortisol levels. It felt impossible to balance medical advice with recovery.
Now, even in recovery, I face challenges. Because of my PCOS and a family history of diabetes, I have to be mindful of what and how often I eat. While I try to let go of food rules, I also have to keep some structure for my health. Recovery for me isn’t about perfection — it’s about navigating this balance with compassion and patience.
What is PCOS?
Polycystic Ovary Syndrome (PCOS) is a hormonal and metabolic condition that affects people of reproductive age. It often involves irregular or absent periods, insulin resistance, ovarian cysts, and symptoms like weight fluctuations, acne, and hair growth.
These physical symptoms can cause emotional distress, body image struggles, and feelings of shame or isolation — all of which increase vulnerability to disordered eating behaviors.
The Link Between PCOS and Eating Disorders
Research has shown a significant connection between Polycystic Ovary Syndrome (PCOS) and eating disorders, with many individuals navigating both conditions simultaneously. PCOS affects roughly 1 in 8 women of reproductive age, yet the emotional and psychological impact of this chronic condition is often under recognized.
Women with PCOS are at a notably higher risk of developing disordered eating behaviors. A large meta-analysis reviewing over 28,000 women with PCOS and 258,000 controls found that women with PCOS were 1.5 to nearly 3 times more likely to have an eating disorder than those without the condition. Another study reported that 11% of women with PCOS had a diagnosed eating disorder compared to 7.6% of women without PCOS. Some studies even estimate that disordered eating behaviors occur in 8% to 58% of individuals with PCOS. This wide range highlights the complexity and variation in how PCOS affects eating patterns and mental health.
The reasons behind this connection are multifaceted. PCOS often involves weight fluctuations, hormonal imbalances, insulin resistance, and increased androgen levels, all of which can contribute to negative body image and emotional distress. Many individuals are told repeatedly to “lose weight,” “cut carbs,” or “exercise more,” which can reinforce restrictive or compensatory behaviors. The result can be a painful cycle of guilt, shame, and frustration — feelings that often fuel eating disorders.
Additionally, the psychological burden of managing a chronic condition can intensify anxiety and depression, which are both risk factors for eating disorders. The pressure to maintain strict food rules for symptom management can blur the line between medically necessary nutrition care and disordered restriction.
Navigating Recovery with PCOS
Recovery while managing PCOS is not a straight path — but it’s absolutely possible. One of the most significant turning points in my journey was working with a dietitian who also has PCOS. She not only had her own lived experience but was also one of the most knowledgeable and compassionate professionals I’ve ever met. Having someone who truly understood my struggles and validated my pain meant the world to me. I would not be where I am today without my treatment team by my side.
Here are a few lessons I’ve learned along the way:
- Work with a team that understands both PCOS and eating disorders. Having providers who recognize the overlap between the two can make all the difference.
- Focus on nourishment, not numbers. Your body deserves consistent care, not punishment or restriction.
- Challenge medical stigma. You have the right to weight-inclusive, recovery-informed treatment — even when healthcare systems don’t always make that easy.
- Honor your body’s reality. Healing with PCOS may look different for you, and that’s okay.
For me, recovery has been about learning that my worth is not measured by weight, hormones, or lab results — but by the kindness and patience I extend to myself every day.
Final Thoughts
Living with PCOS, or other insulin resistance disorders, while recovering from an eating disorder can feel like constantly being pulled in two directions — between what your body needs and what the world tells you to do. But healing means learning to trust your body again, even when others don’t understand it.
Our bodies are complex, adaptive, and deserving of care. You are not broken — you’re resilient.
If you’re struggling, ANAD offers free peer support groups, a helpline, and recovery mentors who understand. You don’t have to walk this path alone.
References
Cooney, L. G., Gyorfi, K., Sanneh, A., Long, K., & Dokras, A. (2019). Increased odds of disordered eating in polycystic ovary syndrome: A systematic review and meta-analysis. Eating and Weight Disorders, 24(5), 787–797. https://doi.org/10.1007/s40519-018-0610-2
Cooney, L. G., Gyorfi, K., Sanneh, A., et al. (2024). Prevalence and etiology of eating disorders in polycystic ovary syndrome: A systematic review and meta-analysis. Journal of Clinical Endocrinology & Metabolism, 109(12), 3293–3304. https://pubmed.ncbi.nlm.nih.gov/39115340/
Endocrine Society. (2024, February). Eating disorder risks elevated among women with PCOS. https://www.endocrine.org/news-and-advocacy/news-room/2024/eating-disorder-risks-elevated-among-women-with-pcos
Gastroenterology Advisor. (2023, July). Eating disorder risk factors include polycystic ovary syndrome. https://www.gastroenterologyadvisor.com/news/eating-disorder-risk-factors-include-polycystic-ovary-syndrome/
Drugs.com News. (2023, July). PCOS linked to increased odds of eating disorders. https://www.drugs.com/news/pcos-linked-increased-odds-eating-disorders-120778.html
