Expert: Matthew Cook - 3/12/2010

Question
QUESTION: Hi,
I get down sometimes and look at myself and see so many imperfections. It is impossible to speak out about them as others just see me as slim. I don't mean I want to openly discuss my floors but I want others to not just blurt out "your thin you don't have to worry about these things" when yes...i do! Why is it people think they know me better then I know myself? I wish I was thinner but who doesn't. I really want to get on top of things, I even hate the clothes I have to wear to cover up. I cannot go to my doctors for diet plans as she "wants to discuss it further" meaning label me with another disorder. I really need advice on how to not gain weight with the condition polycystic ovaries syndrome. I've heard once you gain weight its near impossible to get it off. Is there anything you can suggest?

ANSWER: Hello Abbey!

You’re right of course, no one can ever really know what it is like to be someone else. However, do bear in mind that when other people make comments about you being thin, they might be genuinely concerned, but maybe not know how best to express their concern for you.

Regarding your question about polycystic ovaries and weight control. Have you actually been diagnosed with PCOS? If you have, then I hope you are having regular medical check-ups.
You are right, that PCOS makes weight control harder. This is because it causes a resistance to insulin in the body. This leads to the blood sugars from the food that we eat not being used for energy as efficiently as normal, and it therefore ends up being converted and stored as fat more readily.

This is the reason that very often, a diet low in refined carbohydrates is recommended (as these are so readily digested and converted into blood sugars).
But this does not mean we should under-eat or starve ourselves! Far from it!
Instead, a diet rich in unrefined, wholegrain carbohydrates, with plenty of vegetables and good quality protein and ‘healthy’ monounsaturated fats is often recommended. This would equate to a low GI kind of eating plan, and the same as would be recommended for diabetes control.

Spacing our food out during the day by having regular meals – breakfast, midday and evening, with a healthy snack in between, is also one of the best ways to help control our blood sugars.

It sounds like you are not overweight at present, so a stable healthy weight is a good goal. Along with any medical interventions, eating well and regularly to help keep your blood sugars balanced should help bring this stability.

Other positive lifestyle adjustments would include stress reduction and regular exercise.

If you do have PCOS then I hope you are getting support from your doctor, and you should be able to ask for a referral to a dietician who can give you personalised advice if necessary.

I am concerned however, because from some statements in your question, it sounds like you might actually be of low weight. You are worried that your doctor will “label me with another disorder”. Does this mean you have a history of eating disorders?
Please bear in mind that the thinking styles (and what people refer to as the ‘voice’ of the eating disorder) can still arise even when ‘recovered’ from an ED , so you need to be aware, and be willing to speak to someone about things if you notice old behaviours or thoughts returning.

And you express thoughts of poor body image and low self esteem. It would be great to get some help to look at these issues. Take a look at this thread for some positive body image/self esteem ideas:  http://forums.psychcentral.com/showthread.php?t=86781

I hope that all helps.

The fact that your doctor wants to discuss things further simply indicates that she/he recognises that these issues can be complex and that they want to help you by giving things proper consideration. Please give them, and yourself that opportunity!

Good Luck and Best Wishes,

Matt C


---------- FOLLOW-UP ----------

QUESTION: Hi, thank you for your advice. You really listened and didn't just presume. I have been diagnosed with pcos, saw a gynacologyst for a while but stopped going as she weighed me regualy and spoke to my doctor when I lost some weight. I don't understand pcos, like why I need regular check ups. This was the second time my docotr had spoken to me about ed. I don't like talking about weight and stuff, the feelings I have I like sometimes. They make me feel good and bad. It's so easy to slip into old habbits.

Answer
Hello again Abbey.   

Thank you for your positive feedback.

It does sound like it would be good for you to learn more about your condition. If you have PCOS it is important have regular check ups because of the way it can affect your fertility and other areas of your health. It just re-emphasises the importance of looking after yourself as far as possible through healthy eating, getting good nutrition, maintaining a healthy weight, and regular exercise.
I do not know what resources are available in Germany, but you can find out about PCOS online at websites like:
http://www.nhs.uk/conditions/Polycystic-ovarian-syndrome/Pages/Introduction.aspx
and:
http://www.patient.co.uk/health/Polycystic-Ovary-Syndrome.htm

Regarding eating disorders. Even if you have not been diagnosed with one, you do seem to be concerned about your feelings about weight, food and body image, so it could be useful to talk to someone directly who knows about such things, and to start learning more about the subject. There are helplines in the UK and US but you could search online to find out what services are available in your own country.
Again, there are excellent on-line resources such as:
http://www.bbc.co.uk/headroom/wellbeing/guides/rr_anorexia.shtml

Learning about any conditions that we have can help in so many ways. It allows us to feel more in control of our situation, therefore helping to reduce anxiety or un-necessary worry, and enables us to take responsibility for our own health and future.

Once again, thank you for your feedback and Best Wishes for your future,

Matt C