There’s a reality TV show on TLC called My Big Fat Fabulous Life, which follows Whitney Way Thore, as she fights PCOS and body shame. On the show, Whitney shares her struggles with her weight, an eating disorder, and pre-diabetes. Watching the show, we were hoping Whitney would seek the support of a registered dietitian nutritionist (RDN) to help her. And we couldn’t be more thrilled that she connected with Julie Duffy Dillion, an RDN who has experience in treating women with eating disorders and PCOS.

In this article, Julie talks about working with Whitney, why diets don’t work for women with PCOS, and why we all need to put an end to dieting once and for all.

Move Away From Diets

Without a doubt, diets don’t work. Diets don’t help health and they’re actually the greatest predictor of weight gain. We also know that 95% of dieters regain all of the weight they lost.

Because diets don’t work in the long-term, most people experience the yo-yo dieting cycle. This cycle includes staying on a diet for a period of time, stopping, and then starting up again. Many women experience this for years, and can even do this their whole life. Chronic yo-yo dieting is exhausting, and it contributes to feelings of failure. Here’s the reality: dieters aren’t failing; the diet is to blame.

Besides negatively affecting health and self-esteem, dieting promotes bingeing and other disordered eating behaviors. A restrictive diet, combined with high insulin levels often seen in PCOS, changes brain chemistry, leading to more intense carbohydrate cravings. Reviewing “weight-cycling” research -the technical term for yo-yo dieting, helps us understand why this happens.

Weight-cycling studies suggest that dieting increases both inflammation and insulin levels in the body. Remember, women with PCOS already have high insulin levels. The higher insulin levels rise, the more intense the carbohydrate cravings. If carbohydrate or calorie intake is low, brain chemicals release messages to cells, further enhancing cravings. Carbohydrate abstinence only enhances binges.

Choosing diet-free living is not neglectful; rather, it’s healthful.

Move Away From the Scale

When I met with Whitney Thore on My Big Fat Fabulous Life (MBFFL) on the TLC network, she was close to 400 pounds. I encouraged her to stop pursuing weight loss. Stepping away from the scale as a marker of progress clears a more direct path toward health.

We live in a world where fat bodies are discriminated against. Unfortunately, a fat person who doesn’t pursue weight loss is not yet acceptable to a dieting public. In episode 8 (Season 2) of MBFFL, Whitney steps on the scale, and viewers can feel her shame and disappointment. Instead of her weight going down, it had gone up. Whitney ended up starving herself to lose weight, only to be followed by bingeing.

The pursuit of weight loss leads many women with PCOS to engage in dangerous unhealthy weight loss behaviors. Rather than focusing on healthy nutrition choices that could potentially decrease PCOS symptoms, I see women cutting out as much as possible, with the hope of seeing their weight go down.

Repeat after me: Stop pursuing weight-loss if you want to promote health.

As with Whitney’s experience, focusing on weight-loss causes women with PCOS to overly restrict their food intake, disconnect from their bodies, and exercise until it hurts. Although these are done in the name of health, focusing too much on the scale keeps people from seeing the forest through the trees. Most end up choosing unhealthy behaviors, such as skipping meals and denying hunger, which negatively impact insulin levels, blood pressure, and self-esteem.

The PCOS diagnosis includes a high circulating testosterone level, which contributes to greater muscle mass. Increased strength helps metabolism stay active, yet it will also make the scale not budge. Not only do diets predict weight gain, but higher circulating insulin levels will contribute to less weight loss.

This being said, society thinks not dieting means throwing in the towel. As if people who stop counting calories or points are letting themselves go. This is black-and-white thinking, an example of a “cognitive distortion”. Moving away from dieting allows women with PCOS to experience more variety of foods and less bingeing. Insulin levels and blood pressure go down and self-esteem and energy go up.

Move Toward Permission

A woman’s body has the answers to direct her toward healthy eating. Women with PCOS often talk about certain foods that cause them to feel sluggish, achy, or moody. This is important information! I encourage women to learn from this.

Everyone was born knowing how be a healthy eater, including how much, when, and which foods. The body doesn’t need good versus bad food lists or portion sizes. It doesn’t need to be controlled. Looking at the bigger picture, the body was made to experience a rhythm with food. The body considers its total needs and communicates needs via hunger, fullness, and satiety signals. It will adjust, accordingly, to promote health and to keep the body at the weight it prefers.

Dieting keeps women with PCOS from this natural adjustment to bodily needs because diets disconnect them from hunger and fullness cues. Dieting also promotes a chaotic food relationship where self-talk focuses on feelings of failure and shame.

Moving away from dieting and the scale reconnects the body to its innate wisdom. Think of it this way: When one goes a great distance from the city lights, the nighttime sky will be filled with more stars. Does this mean the stars only exist out-of-town? Of course not; but it does take distancing oneself from the chaos of town to really see what’s already there.

Diets are the city lights, smog and skyscrapers. They keep women with PCOS from seeing and experiencing the mechanisms that their body has for providing health naturally that innate wisdom I was talking about. And, to experience this, one has to distance oneself from all the pollution. Making these steps toward trusting the body and healing body-shame is hard work and doesn’t happen overnight; yet it is possible! Connecting with a skilled non-diet PCOS dietitian can help make that happen.

I encourage women with PCOS to try something different this holiday season. Try permission on for size.
Since diets don’t work, and focusing on weight-loss just distances one from health, why keep going down that path? If diets worked, why do we have to keep going on them? Give away the scale, and move away from diets. Keep in mind that it’s not letting yourself go, it’s letting yourself be. And, that’s where you’ll experience health.