Emily Van Eck
Can Intuitive Eating Help Your Hormones?
The short answer - yes, absolutely. Wow, what a relief.
Hormone Health, Femmes, and Diet Culture.
Many women struggle with hormone imbalance at some point in their lives. Unfortunately, women's "issues" are often brushed aside by mainstream medicine as "normal". Many women are told to "just lose weight" to treat diabetes or PCOS, or pop a birth control pill to until they are ready to have babies. Women are often blamed, shamed, and accused of not trying hard enough and complaining too much. What bullshit.
The uneven power dynamic in the doctor's office is hard to argue with, so women internalize this treatment and may try diet after diet to "fix" their hormones, their weight, their body. This often leads to very disordered eating, weight cycling, binging, restricting, moralizing food and food choices, and certainly a difficult relationship with ones body. But I promise, it doesn't have to be this way.
There are many conditions, such as PCOS, diabetes, and thyroid dysfunction that can be greatly affected by out-of-balance eating. I mean eating too little, or too much - but more importantly, I mean eating inconsistently. Skipping meals, cutting out food groups, waiting till 2pm to eat your first meal, restricting and binging - all of these patterns can disrupt hormones and can make healing your hormones more difficult. But asking your doctor and the internet will tell you to restrict, restrict, restrict. So part of this post is to explain why that is not good advice. And what to do instead. But first, a little bit about hormones.
Hormones make up the endocrine system. They are brilliant chemicals that are released from glands and other tissues (pituitary, thyroid, adrenal and hypothalamus glands, and the ovaries) in response to something in the environment. They travel in your blood and then carry out one of a million functions in another part of the body. There are a myriad of ways that we can feel off when they are out of balance. Our lives affect our hormones just like our hormones affect our lives. Some hormones relevant here include:
Insulin controls the amount of blood sugar floating around in your blood. Insulin allows your cells to use glucose from your blood (from carbs in your diet) for energy. Insulin also helps your body store unused glucose for later. Insulin resistance is a main metabolic change with both PCOS and diabetes and is when the cells aren't as great at using the insulin as they used to be, so glucose doesn't get into the cells. Then your body makes more insulin, which it eventually gets sick of doing and then the blood sugar stays high.
Cortisol is your stress hormone. It is released in response to the fear response in the body. This happens when something super scary happens, like a car jutting out in front of you in traffic, but also happens in response to regular life stuff, like a busy work life, family drama, and to systemic issues like racism, fatphobia, and gender-based discrimination.
Thyroid hormones are a group of hormones that regular metabolism, energy, and also play a role in sleep, mood, and more.
Estrogen, progesterone, and testosterone are what we call the "sex hormones". These hormones control your monthly cycle, but are also key plays in mood regulation, appetite, metabolism, sex drive, and reproduction - of course.
If you have a condition that affects your hormones, you may have been tempted to google "hormone diet", "diabetes diet", "PCOS diet" or something along those lines. You probably have read something - 100 different things - about what to cut out of your diet, how you should be not eating dairy, or beans, or carbs, or meat, or any number of other solutions. I see you. It can be so frustrating and scary to get a diagnosis for a condition that is vague and less-than well-understood.
Restrictive diets affect the body in several ways that I see often in my practice. Here's how restriction harms your hormones:
1. Your body is smart and it's trying to keep you from starving.
If you are counting calories, "clean eating", or cutting carbs, it's possible you are eating less than your body optimally needs to perform all it's many functions. This under-eating can have many negative effects including putting your body into starvation mode. This can cause you to hold onto weight that you may not if you gave your body enough food. So if you have been eating 1200 calories a day and are noticing that you're not losing any weight - this is probably why. Your body is smarter than your diet.
2. Low calorie diets mess up your hormones!
Cortisol, the stress hormone, increases in response to a low calorie diet.(5) Yep - dieting is stressful. Stress is an emotion we feel due to a perceived threat. That fear creates a physical response. When we feel stress, our body releases blood sugar in order to give us enough energy to run from that stress. So for some folks, their stress response is running a lot, and their blood sugar follows. Not getting enough sleep regularly also causes an increase in cortisol release, which is why sleep is so important for healthy metabolism.
3. Restriction backlash
This phenomenon shows up in many ways, but somehow it always does. Here are some common experiences that my clients tell me about (and that I experienced back in my yo-yo dieting days - so glad that's over!) At the beginning, when the "diet is working", and you're able to stick to the "plan" for weeks or months - it feels great and you feel in control. But at some point you will stop. This usually doesn't happen in a super chill way, but feels like A LOT. You may experience binge eating at this point, or feeling like you're unable to stop. You eat pizza one day, then more and more pizza. Donuts and more donuts. These foods are wonderful, by the way, and I don't mean to demonize them. But these foods aren't allowed on ANY diet I've ever seen, so they are often the ones we reach for once the diet stops working. Another thing that ends up happening so often on a restrictive diet is you eat so little all day, just salad for lunch, very little dressing and definitely no croutons or cheese, you drink water and caffeine to make hunger go away, then you get home from work and are famished. You start there and eat all night. This is disordered eating. This does not mean you have no willpower, just that you're extremely hungry and your body has figured out how to get what it needs, despite your best efforts. Not only does this make you feel guilt and shame, but this inconsistent eating - restricting and binging - is also pretty bad for your hormones.
4. Elimination diets are temporary and symptoms often return.
Elimination diets are not the answer to hormonal health either. This is because the restriction makes you feel better for a short while, and then when you go back to eating "normally" (likely after a period of backlash or rebellion from the restriction) the issues return. This happens when you follow rules like Whole 30 or whatever other new anti-lectin bs comes along. Yes, I'm calling out The Plant Paradox - what a racket. Let me be clear, I'm all about making small sustainable changes to your diet if it feels like self-care, rather than self-control. If adding some greens to the weekly rotation or trying to get extra protein in at breakfast makes you feel better - amazing. It would make sense if it did. But all too often, folks with PCOS or diabetes are shamed into trying restrictive weight loss diets and end up in a cycle that only causes more harm. SOAPBOX alert.
I'm not saying that what you eat does not matter for your hormone health. It can affect it. But so many things do to a much larger degree. The minutiae of your diet matters much, much less than your stress levels, your sleep routine, your emotional life, and other environmental factors. The answer is healing your relationship to food and movement and learning to eat consistently, with balance, flexibility, pleasure, and knowledge. Enter intuitive eating.
Intuitive eating is a way of eating that taps into your inner body cues to tell you what, when, and how much to eat. It is a self-care framework that takes the emphasis off of body weight as the central indicator of health and places in on your inner knowing. It is now supported by over 200 studies! And the founders, Evelyn Tribole and Elyse Resch just had this wonderful article written in the NY Times about their life's work. Intuitive eating is very effective as a eating framework to deal with type 2 diabetes, pre-diabetes, and PCOS.
How To Eat Intuitively For Hormone Health
1. Eat Enough
You need to be eating three meals a day and probably a couple of snacks. These meals need to include carbs, protein, fat, and ideally, fiber. The key here is paying attention to your hunger signals and eat enough on a regular basis. You don't want to let yourself get to that famished place, where you're cranky and irritable, and so hungry you can't think straight enough to find a meal you're actually happy with and eat. Getting that hungry isn't great for your blood sugar levels and also triggers an intense drive to eat quickly, and often too much. Intense carb cravings are a common manifestation in PCOS. This is hard enough to manage as is, but if you're trying to eat low carb, or restricting in general, you're going to crave what you're not getting. So having an Intense carb cravings in the afternoon can be improved by eating enough carbs, along with fat and protein, at all of your meals.
2. Use gentle nutrition to add the good stuff.
Increase the good fats in your diet like nuts, fish, avocados, and flax seed oil. Get plenty of fiber in your diet. Eat fruit, vegetables, and my favorite - beans. Eat a savory breakfast half of the week or so, with eggs and/or avocado. If you are at the beginning of your intuitive eating journey, these suggestions may be triggering. That's ok - you can get there eventually. It's possible it's too soon to do this step. Just be patient and work through giving yourself unconditional permission and banishing the food police. Reach out for help or with questions if you aren't sure if you're ready.
3. Use as much self-compassion as you can muster.
Just as stress can cause your hormones to be out of whack, self-compassion can settle your nervous system and return you to a state of calm. According to Dr. Kristen Neff, the leading self-compassion researcher, talking kindly to yourself can directly lower your cortisol response. How cool. There is a major misconception that shaming or criticizing yourself will cause you to make change. This is untrue. Real change happens when we are kind to ourselves. Here are a couple ideas for bringing more self-compassion into your daily life:
notice when negative self-talk arrises in your thoughts
use soothing self-touch, like putting your hand on your heart or a relaxing scalp massage
using a loving mantra to remind yourself you are doing the best you can - something like "my body is doing the best it can for me every day", or "I trust myself".
4. Get enough sleep.
Most people need between 7-9 hours of sleep each night. Our busy lives can make this hard, but it really is so important to prioritize your sleep routine. Incorporating some solid sleep hygeine into your life can make a huge difference. Limit alcohol, especially in the hours right before bed, turn off electronic devices, try meditation, or calming music. My personal favorite - using Insight Timer nighttime sleep meditations. And if you've tried everything and still have trouble getting to sleep or staying asleep, talk to your doctor - and ask for the same solution they would give a thin person coming in for the same problem.
And a word about inflammation - restricting and dieting are PRO-INFLAMMATORY, especially for people with PCOS and hormonal difficulties. Weight cycling causes your body's natural anti-inflammatory processes to work less effectively. This is such a common question I get these days, so I wanted to just add this little tidbit in here.
I hope this has been helpful to remind you that you should not try a restrictive diet to heal your hormones, especially if you have a history of disordered eating, chronic dieting and weight cycling. There are non-restrictive ways to improve your hormones, your health, and your relationship to food.
If you have questions, please feel free to reach out for help or comment below. I offer one-on-one nutrition counseling for all of these issues. I also have a super exciting program that will be released this spring on healing your hormones with intuitive eating. We'll be learning about how to liberate yourself from diet culture while keeping your self-care and health front and center. If you'd like to get on the waitlist for that, click here. You'll be the first to find out when things are getting rolling, and will get a big discount for being on the waitlist! I cannot wait to get things started.
1 - https://bmcendocrdisord.biomedcentral.com/articles/10.1186/s12902-021-00890-8
2 - https://pubmed.ncbi.nlm.nih.gov/6380904/
3 - https://www.fertstert.org/article/S0015-0282(08)01008-X/fulltext
5 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2895000/
6 - https://self-compassion.org/the-chemicals-of-care-how-self-compassion-manifests-in-our-bodies/