Controversial PCOS Opinions- Is it all genetics, does it keep getting worse and is it your fault? Season 3 Episode 6

Today we are talking about a few PCOS opinions I've seen recently that have made me really roll my eyes- 

Does PCOS only stem from genetics?  Will PCOS keep getting worse and worse forever because it's a chronic health condition?  Is PCOS your fault?

Find my professional opinions on this and more during this week's episode.

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Transcript

Amber Fischer: 0:38

Hello, hello, welcome back to an Amber Day, the functional nutrition podcast. I'm your host, amber Fisher, and I've got a little bit of a nutrition rant for you today. I was tagged in a couple of pieces of content recently and asked for my opinion on them, and I'd like to go over it with you. I'd like to give you my opinion here. So what we're going to talk about today is the concept of does PCOS just keep getting worse? Is it a loss cause? Can you really do anything about it, or is it just kind of like something genetic that you've inherited, what's going to get worse over time because it's a chronic health condition and has no cure, etc. Etc. So a little background. I was tagged a few times by some different people on different social media platforms. I'm not going to go into specifics because I really don't want to call out any specific creators. This is stuff I've seen before from multiple people, so I don't really want to like get into it with anybody in particular. I just feel like it was something that I watched some of these videos And then I was just like in the backyard gardening, like talking out loud to myself.

Amber Fischer: 2:01

You ever have like an argument with yourself, like with a made-up person, right, i do this a lot, and so this is, like you know, classic people pleaser stuff, where I like don't like to confront people face to face, but I will sure have an argument with them in my head. But I just could not stop my mind running about this particular piece of content that I saw and just rebutting it, like my debate days. I don't know if you guys know this, but I was on the debate team in college And so I thought you know what I'm going to stop. I'm just going to stop ruining my night by going over and over this. I'm just going to stop and make a podcast about this, because I feel like this is actually a topic that you guys would find interesting too. So let me start out by listing some of the arguments that I've seen. I'm going to talk about some stuff that I saw from one person, but also pull in some things that I've seen from other people.

Amber Fischer: 2:55

So the concept that I'm wanting to kind of talk about a few things. Number one did you do anything to cause PCOS? Like. Do you have any responsibility in the fact that you developed PCOS? Like are you at fault somehow? The second concept is PCOS is a chronic health condition And so, like most other chronic health conditions, it tends to worsen with time, worsen with age, and you know your symptoms from it will continue to get worse and worse as you get older, because it's a chronic health condition. And then the third thing was there's no potential for you to really you know, to cure PCOS, right, like it's not curable, there is no cure for it And you can not do anything in that regard. Okay so, let's talk about each one of these three things, because there's some, some correct stuff about this in my opinion my professional opinion and there's some incorrect stuff about this. Okay so, starting off with the first one, did you do anything to cause your PCOS? By and large, the answer to this question is no.

Amber Fischer: 4:07

Pcos is genetic. In some aspects, however, it is worsened by lifestyle and environment issues. So there are things that happen genetically that we inherit And then our genes can sort of express positively or negatively, depending on what our like early childhood looks like, even like the situation that we were in in the womb can impact our genetics. So there's a lot of factors besides just the genes you inherit, but at its core, like, there is probably a PCOS gene or a set of genes we haven't like quite identified what exactly those are, that we do have some genes that we know are like associated with PCOS and stuff, but there's no like this is the PCOS gene, you know, like that hasn't been discovered yet. I don't think it will be, because my personal opinion on PCOS is that it's actually a variety of different health conditions sort of expressing in a similar way and getting categorized in the same box, but that is another topic for another time. So there is some genetic stuff that's going on with PCOS, right, and then the way that you were raised, your experience growing up, like impacts, the way that those genetics express, and so a few things that you know.

Amber Fischer: 5:24

Impact that environment is a big word, right, but it means a lot of different things. It means the amount of stress that you're under, trauma you experience. A lot of folks with PCOS have childhood trauma histories And we know that that worsened symptoms. Environment also includes your diet And the diet that you ate growing up, the diet that you ate as a young adult. You know a lot of people are diagnosed with PCOS later in life. We don't talk about that population as much, but I know I've had many clients who had perfectly normal menstrual cycles into their 20s And then all of a sudden they develop PCOS or seemed sudden at least. So there are environmental factors, including the food that one eats, that could potentially, you know, start turning that gene on or making it express more visibly, i guess or start really impacting and creating symptoms in a person who maybe didn't have as many of those symptoms before or had none of those symptoms. I have seen that firsthand. So that's part of this.

Amber Fischer: 6:27

And so, like the question is like are you at fault here? And like that's a good question to ask, because so many of us take the shame and the blame of PCOS onto ourselves. Right, i know that I've been there, i'm sure you've been there, you know if I'm sure you guys know that I have PCOS as well, but I always mention it because sometimes people think that I just like talk about PCOS. I don't know why, but yeah, i have PCOS too. So this is something that I've had to, you know, go through myself.

Amber Fischer: 6:53

There's a lot of shame that comes with the PCOS diagnosis, a lot of feeling like why me? Like, what did I do? Like you know, you start thinking back like, oh my gosh, i used to drink a lot of soda, i used a lot of candy bars, like I think about my childhood and stuff, and the reality is that it's a little bit of a mixed bag. But the fundamental question of whether you are at fault or you should carry shame over your PCOS diagnosis the answer is no, because no matter what, even if there were environmental factors that sort of created the conditions where your genes, your genetic predisposition, started to express itself, no matter if that was something that related to your diet, to whatever, likely it's more than just your diet, right Like? there are a lot of environmental factors at play. Diet is just one of the things that can kind of like exacerbate stuff that's already going on. Trauma is a big one, but likely a lot of this stuff happened before you knew any better, right? So you should carry absolutely no shame and no guilt over having a PCOS diagnosis, because you know you never understand that you need to change anything until something's wrong. Right Like you have a chronic health condition, that's true. And so now you know you have this chronic health condition and look at you right now you are listening to a nutrition podcast I'm assuming you're listening to a. I'm assuming trying to get tips for, like how to improve your health, how to improve your symptoms. So you're on the path, like you are on the path to better health and a better life experience, and now you know better, right, and everything you learn is something that you build on.

Amber Fischer: 8:34

And Getting diagnosed with any kind of chronic health condition, like PCOS, is a grieving process. I always say this you have to take the time to grieve. If you just got diagnosed, let's say, or even if you got diagnosed 10 years ago, everybody grieves differently. Everybody's timeline is different, and many of the first stages of grief have nothing to do with making life changes. They're all about just wrestling with the whole concept and just getting comfortable with the fact that, like, yes, i do have this and this is my life And I have to deal with this, you know. And so that takes different people different lengths of time to work through before they're really ready to make lifestyle changes. So take the pressure off of yourself. If you know you've been working at this a while and you feel like gosh, i can't seem to get the ball rolling on making all these lifestyle changes that I know I need to make. That's normal. That is totally normal. I'm a friggin license nutrition professional and I still struggle with a lot of this stuff. It's taken me it probably took a solid decade from the time that I started learning about nutrition and how it could impact PCOS to the time that I actually felt like I got into a rhythm where I was really like actually making positive differences via diet and lifestyle changes. So it takes time, is what I'm saying.

Amber Fischer: 9:56

So the pressure and the guilt and all that stuff, it's really it's not, it's counterproductive to your purposes. It doesn't help Guilts. I had a mentor once who told me guilt is only a useful reaction if it motivates change, and if it's no longer motivating change, then you know it's, it's, it's worthless, like it doesn't do anything for you. And that's true, you know. So if guilt is helping motivate you to change and that's working for you right now, great, wonderful, so it's a long term. Usually that's not the best way to do it. Usually the best way to do it is to kind of just like let yourself grieve, let yourself come to terms and then start really making changes from a place of love, from a place of care, nurturing yourself, mothering yourself I talk about that a lot too. So should you have guilt and shame. Is it your fault? No, it's not your fault.

Amber Fischer: 10:53

Are there some things that probably happened during your childhood? or you know the environment that you were in, things that you went through, whatever that maybe worsened your odds or were part of the snowball of things that sort of created the environment for these genetics to express? Maybe maybe we don't know enough to say yes or no for sure on that, but like one of the arguments that I saw was that you know PCOS is primarily genetic And so everyone with PCOS inherits genes and then those genes you know express. So everyone with PCOS can probably identify a family figure who had, like, diabetes or or PCOS or infertility or something like that. And you know, wouldn't it be nice if that were the case. But I don't know about you guys. I have worked with a lot of people who have been the very first person in their whole family to be diagnosed with anything akin to PCOS, even to be the first person to diagnose with diabetes.

Amber Fischer: 12:05

You know to say that there's no genetic component at all is probably not true as well. Like there probably is something inherited. You know, sometimes people don't have diabetes but they have insulin resistance and they can pass those genes, on things like that. But I think trying to blame it on genetics fully and just say like, oh well, it's just your genes, you just inherited that. Look at the draw. It kind of negates these people like myself, for example, who you know? I have PCOS, but I have a sister and she doesn't have PCOS. You know, none of the women in my family have had PCOS. Have there been some other things in my genetics that probably contributed? Sure, but like it's not just this very set in stone thing where everybody's just like getting it passed down through the family, like it is a bit mysterious where it comes from and why, and so the mystery of it needs to be held right, like we need to.

Amber Fischer: 13:11

I think my point here is we needed to stop trying to say this is exactly the answer and like on either direction, either from like a functional nutrition, like let me help you with this, like let's improve this standpoint, like this is exactly where PCOS comes from. These are the exact root causes And we need to stop doing so much of that. And then we need to stop also just being like oh, it's just your genes, like too bad, too bad, so sad, because that's not. Neither of those are fair responses when that's not accurate to like the actual science of what's going on here. We don't know enough to say exactly where PCOS comes from. We know there is a genetic component, but that doesn't mean that it is fully and totally just a genetic thing. So yeah, that's point number one.

Amber Fischer: 14:01

I just want to clear that up. I don't think that you should take any blame or any shame or any fault, but I do believe it, looking at my situation with fully open eyes And you know I can look back on my childhood and stuff and see some things that probably contributed to my hormonal experience growing up, and that's just because I understand very well how PCOS works. Now I've been working with it a long time. I've been living with it a long time. I've had tons and tons of guinea pigs nutrition, guinea pigs to kind of like test out different modalities and different things on, and I've seen what works, what doesn't work and what works in some people but on other people. Like you know, i've been watching this condition for a long time. I feel very hopeful about it And I don't think any of us should take the blame for things that were outside of our control. But were there some things that, if we had known better, could have maybe like changed our expression of PCOS. Yeah, probably, is diet one of those things? Yeah, probably, but that's neither here nor there, because that's the past, that's behind us And here we are now.

Amber Fischer: 15:09

So the next one is the one that really just like got me riled up And I don't think maybe I'm misunderstanding what this person was intending with this point, but what they said was that PCOS is a chronic health condition And so, as with most chronic health conditions, it continues to get worse with time. And the attitude I felt that was coming from this was sort of this just like apathetic vibe of like you've got a chronic health condition. It's just going to keep getting worse The older you get. It's going to get worse, like you know, and so you got to just kind of sort of live with that and do the best you can to just, like you know, not blame yourself and it's all good. And it bothered me so much And you know this is probably some of this is, i'm sure, some of my own internal stuff coming up But I hate being told that there's nothing I can do.

Amber Fischer: 16:10

I hate being told that there's nothing, that there's absolutely nothing about this. That's in my control. I refuse to believe that. In fact, i don't think that that's an accurate reading of the current like understanding of PCOS. Yes, pcos is a chronic health condition and, left untreated, left unchecked, i absolutely think it will get worse with time because as people get older, their insulin resistance tends to get worse. If they've got insulin resistance, you know that they've got digestive issues that are causing like inflammation that tends to get worse with time. Like things do tend to get worse with time if they're not managed.

Amber Fischer: 16:47

But to say like that there's nothing that can be done for PCOS or that it's just gonna keep getting worse, it's kind of like saying, like well, why even try? You know? like what's the point? It was just gonna keep getting worse. Like and honestly, if that were the case, like why you know it wouldn't negate my entire existence as a practitioner. So that's probably where a lot of the like frustration comes from, right Cause it kind of calls up my work and says, like well, my work is useless. And I don't believe that to be true. I think that it really comes down to it comes down to your understanding of chronic health conditions and what you believe is possible for them. So you know, the conventional medical world at the moment sees chronic health conditions as these like incurable but maybe manageable to some degree, conditions that are gonna be lifelong. And you know in part that's true for PCOS. It's a lifelong condition. There's no known cure for it. There's no pill you can take that can cure it. On the other hand, to say like oh, it's just gonna keep getting worse is really frustrating because that's not true, like it's just not.

Amber Fischer: 18:06

We have research that shows plenty of different lifestyle interventions make a big impact on PCOS. There's a ton of research. If you go on PubMed and search Mediterranean diet in PCOS, there's a ton of research studies specifically on that diet as an intervention for PCOS. There are studies. There are weight loss studies, there are insulin resistant studies. There's even like mindfulness meditation studies that show improvements in PCOS symptoms.

Amber Fischer: 18:35

And there's just the anecdotal evidence, which, yes, anecdotal evidence is like the lowest form of evidence, right? And for those of you who don't know what anecdotal evidence means, it means like firsthand knowledge. So like an anecdote is like somebody's story, right, so one person's story. Or like me as a practitioner, if I'm telling you this is what happens with my clients, that's anecdotal evidence And so it's like one of the least respected forms of evidence because it could be so easily manipulated by opinion and bias and et cetera, et cetera. But like there is a lot of anecdotal evidence that that's not the case, i mean, i've had plenty of clients who have completely regulated their cycles, gotten pregnant naturally, lost weight, gotten to their you know their healthy weight for their body, do a great job of managing their symptoms every day. And it's not just a short term. Like you know, i did it for a year or I did it for six months and then I'm done. No, this is like long-term positive change. I've had a lot of long-term positive change in my body And I work with other practitioners who have had a lot of long-term positive change in their body, and that's one reason why a lot of us become practitioners in the first place is because we've had these, you know, beautiful experiences and we want to see how we can build on our knowledge and share.

Amber Fischer: 19:59

And like to say that here I am getting riled up to say that a chronic health condition is only gonna get worse with time. It's a really defeating way to look at it, like what a way to live your life, like no hope, right? That would just be such a fearful way to live. And that's telling a diabetic like, oh well, your diabetes is only gonna get worse with time, so don't even bother. Like, just eat what you want. You know like what That's not every single intervention that exists for diabetes is always paired with lifestyle changes too, because there's plenty of research to show that, like, long-term lifestyle changes impact the body long-term, improve the body long-term, like better end of life outcomes, you know, reduced risk of Alzheimer's and neurodegenerative issues, like all kinds of the consequences of aging, are improved when we take care of our health.

Amber Fischer: 21:01

And the younger we can start, the better. And that is with people without chronic health conditions. And it's with people with chronic health conditions too, yeah, i mean, it's essentially like telling a, you know, i mean, look at somebody with type two diabetes, for example, like somebody who's actively managing their care, they're having a much better experience of life, they're having a better quality of life, they have improved health outcomes than somebody who's not. And not only that, but even if they're on medications to help which there are obviously some great medications that are helpful they're almost paired with lifestyle changes too, because we know that that, you know, amplifies the effect of those medications. So it's just kind of a confusing point, to the point where I'm like wondering if that was really the intention of the point. I may be misunderstanding it, and so that's why I don't wanna like specifically talk about this specific person because I may be completely misunderstanding their intention. I think a lot of their intention was just to like, have you take some of the pressure off of yourself, which is positive, right, and I appreciate that.

Amber Fischer: 22:36

To say that it just keeps getting worse, i just really don't believe that. I don't believe that And I wouldn't be doing the work that I do if I believed that. I don't think that that's accurate. It is something that you do live with. You know you can't.

Amber Fischer: 22:49

The next point is true, there is no cure for PCOS, but there are a ton of things that can manage the symptoms, and I've seen symptoms managed to the point where the person doesn't even look like they have PCOS anymore, you know. So those kinds of results are possible. Are they gonna happen for everybody? No, like some of us have just worse luck with this stuff. Some of us are navel or some of us diet is not the main component, like there's a lot of things going on, but but to act like it's just going to keep getting worse as you age, i don't think that's a fair understanding of PCOS. Not to mention that, like there, there is some evidence that those with PCOS like when it comes to infertility for example, like as they age, actually sometimes become more fertile because, like their AMH kind of lowered, like their egg reserve lowers, naturally that kind of shifts the hormone balance. So there's a lot of like late in life babies in PCOS. Not that fertility is the only marker that we should be looking at, but I don't know.

Amber Fischer: 23:53

I just I don't think that that's a fair understanding of the current research on PCOS to say that that there's nothing that can be done and it's just chronic, untreatable condition, especially when, like the current consensus is and to be fair, this hasn't necessarily trickled down to conventional medicine yet, but this is what is coming up in the research is that a lot of these scientific opinions are that a nutrition professional, licensed nutrition professionals, should be the first line therapy for PCOS, meaning that there's so much evidence that nutrition changes can improve PCOS and PCOS symptoms and quality of life, etc. Etc. That that should be the very first thing that a person is referred to do over and above taking metformin, taking birth control, etc. Etc. So there's huge possibility in nutrition for PCOS and it kind of gets into like the whole understanding of chronic health conditions in the first place. You know, in functional nutrition we kind of look at like history and we say like, okay, sure, maybe some of the way that we understand chronic conditions is more advanced now, so maybe there's more reporting of things, maybe people are diagnosed more simply because we have more knowledge. But also we have strong evidence that the health of developed countries, particularly the United States, over the last 50, and especially 30 years, has nearly rapidly declined. Like our outcomes are so much worse than they were even, you know, less than a century ago.

Amber Fischer: 25:35

And what are some of the things that have changed the most? Well, our lifestyles have changed a lot, sure, but our diets have changed a lot too. And those are all part of our environment. And we know that environment plays such a big role in everything in our health, in our mental health and in the way that our genetics express. Like. Look up the concept of epigenetics. If you've never heard of this before, that's a fascinating field, right? It's the field that's doing research on the understanding of like. Why do you inherit genes and genetic mutations and then sometimes they express and sometimes they don't, or they can express more severely or less severely. Your environment plays a big role in how your genetics express. This is all standard stuff.

Amber Fischer: 26:28

So, you know, in functional nutrition we sort of believe that, like, chronic health conditions are modern problems caused in part by the way that our changing lifestyles and environments are impacting our more primal genetics. And those of us with chronic health conditions often are carrying these genetics that are maybe just a little bit more slippy. They haven't, like, really altered to fit our new lives and our new environments. The way that we work, the way that we live, the way that we sit around instead of working in the fields, like all these things are so different than they were just a couple of generations ago And that changes the way that we age and the way that we experience health.

Amber Fischer: 27:19

And so, with that understanding, we don't believe that chronic health conditions are just this thing where you're just like it's just luck of the draw and you have it and there's nothing you can do. You know, we believe that, like number one, it can be managed And that lifestyle changes and diet changes help manage them, but then also that there may be something that can be done to address this more systemic root issue of why so many of us are getting chronic health issues, like there's something deeper going on here. So I guess the whole concept here is that we hold out hope, hope for continued research, hope that there will be something that we can do, hope that there will be things that we have some control over and that we can manage, even as we go up against this giant of you know. Systemic changes, environment changes, lifestyle changes, food system issues, like issues with the way our food is grown and the nutrient density of the soil. I mean, it gets really complex and there's so much about it The average person can do nothing about.

Amber Fischer: 28:33

But the difference here is where you sit in that moment and you realize there are all these systemic issues that I have no control over. But am I going to just give up right here and say, all right, well, guess YOLO. Or am I going to try to handle and control the things that I do have some control over diet, being a big one, right? Am I going to try my best to like, do what I can to improve my health with the things that are in my power. And that's just two different groups of people And I don't know that either one is really wrong at the end of the day. You know, we all have a different experience of life, we all have different things that we're here to do. But for those of us like me and probably like you, i think that that's the answer that we give to that question. I don't want to be defeated, i don't want to give up, i don't want to say, oh, there's nothing that can be done. I'm just like going to roll the dice and just deal. No, i want to set myself up for as much success as I can have.

Amber Fischer: 29:40

You know, this is often the case when I work with people one-on-one with PCOS, and they come in and they're like Look, i know that the odds are stacked against me when it comes to like getting to the goal weight that I had in my mind Right, like I have PCOS. I know I probably will never be as I do or whatever it is, but I want to eat, to be the best version of me I want to have. I want to be the weight that is comfortable for my body, that makes my body feel good, energetic, that helps with my joints, etc. Etc. Like, whatever it is, whatever the goal is, but the goal is health, not aesthetics, not to look a certain way, and these are like conversations that we have to and understanding that we have to come to with ourselves.

Amber Fischer: 30:31

I've had to do some serious internal work body image work that I think many of us have to do when it came to understanding that, like you know that very thing, i'm not going to look like other people, like I'm going to look like me and I'm going to be the weight that I'm going to be, and all I can really do is just get comfortable in my own skin and accept myself for how I am and love myself and then, out of that love, treat myself right. That's a hard journey to go down And I know firsthand how hard that is. But that's not a giving up. It's a giving up of some expectations that are like influenced by diet, culture and family and friend expectations and whatever we think society wants from us. It's giving up that, but it's not giving up on ourselves. It's not giving up and saying, oh well, i can't do anything about this. I'm rambling, i know, but you know it just gets me riled up. Just gets me riled up, guys, because there is so much that you can do. I mean, i just like to say there's nothing that can be done is just like so I rolly, i can't even. Yeah, i don't know, you know? another point that was made that I saw was I've seen some people say that when you lose weight like that, we have research that says that the losing weight helps with PCOS symptoms, but in the short term and in the long term it makes things worse because, like, the more you die it, like the more you're going to regain and blah, blah, blah, blah, et cetera, et cetera.

Amber Fischer: 32:15

And you know, when it comes to, specifically, weight loss only there's some truth in that right. Like, usually not always, but a large percentage of the time people who diet lose weight. They will regain it And over time that's hard on your body and it's hard on your mental health and things like that. But again, it's a defeatist way of looking at things. It's essentially just saying like well, there's no point in working on weight at all because it's not going to matter. And it's also misunderstanding of, like what diet means for PCOS, and I guess that's the difference is that some of us have different definitions of what the word diet even means. Like you know, when most people say diet, they're thinking diet to lose weight. But when a nutrition professional says diet, they're oftentimes just talking about, like, the manner in which we eat, the way that we eat, the foods that we eat. It's not necessarily about your weight or anything like that. It's just what you eat, like your usual diet.

Amber Fischer: 33:20

And for PCOS that's a gray area, because I would say that there is a lot of research showing positive improvements with weight loss. And so you know, to just throw that out the window and say, like well, we really probably shouldn't pay any attention to that because, like, we're not going to keep it off anyway, so it's not even helpful to even think about that, i don't know kind of a defeating way to look at it because, like I said, anecdotally, i've had a lot of clients who have maintained their weight loss and asking somebody to lose 10% of their body weight is different than asking them to lose, you know, 30% or something like that. Like, 10% of your body weight is what a lot of these research studies show And that's, you know, depends on the person. But it's not that much weight, it's a reasonable amount of weight to lose for a lot of people and can really help with symptoms and can be maintainable if you have the right, you know, understanding of how to maintain. And I think that's where the problem comes in for a lot of people with weight loss is they? they don't really have a good understanding of number one, how to maintain but number two they don't have like the support that they need for that maintenance process Because it takes a long time to for your body to get comfortable in a new weight.

Amber Fischer: 34:34

But diet changes for PCOS are not just about weight loss And I would argue that there's enough evidence to kind of show that like changes improve PCOS symptoms regardless of weight loss, that it's worth doing even if weight loss is not a goal for you. So I don't like to villainize anybody who wants to lose weight, because I can understand wanting to lose a little bit of weight. You know, throughout my life I've had times where I've weighed more, i've had times where I've weighed less and I certainly like my clothes to fit. I don't like buying new clothes. Yeah, i mean I who doesn't like buying new clothes. But you know what I mean. I don't like buying going home, buy new wardrobe for a new size, like that sucks.

Amber Fischer: 35:17

At the same time, you have to be comfortable with your experience of your life and your body, and that means different things for different people. For some people it's just about health and wellness, stress reduction. For some people it includes some weight loss and that's okay. Either way is okay. But my main point here is that your diet can impact your PCOS, whether you lose weight or not. So it's still worth doing, and for a lot of people they don't even understand like a healthy way to eat for themselves.

Amber Fischer: 35:55

I know this is something that I dealt with growing up. Like I didn't really have a great understanding of what was a healthy way for me to eat, and so I just sort of like hacked it along the way and kind of figured out like I one time figured out that if I ate protein, if I ate like meat with my meals, that I wasn't getting a little blood sugar like three hours later. And that was just very eye opening for me because I thought, wow, why does that work? I didn't even know, but I just discovered that I came upon that one day experimenting with food and have built on that. You know I'm always talking about how you need to protein with your meals. Well, part of that is based on research and part of that is based on my personal experience. So it's like an 18 year old who was always getting weak and shaky between my meals and realized like, oh, if I eat breakfast and I just have cereal, then by 11 o'clock I'm like needing a snack or I'm going to pass out. If I eat some sausage with my cereal, then all of a sudden I can go to lunch, you know? So they're? wow, i lost my friends.

Amber Fischer: 36:58

There are a lot of things that can be done with diet to improve PCOS, improve your symptoms, and that are worth doing long term, whether or not they result in any weight loss or not. And a lot of us don't have the understanding of what is a healthy way to eat for our bodies. And this gets into another sphere of issue that I find that oftentimes those with PCOS we get very caught. Because we get caught between, like, on the one hand, really intense diet culture that's like you need to go keto for PCOS to improve your insulin resistance, or you need to do this strict diet, or that strict diet, you need to cut out gluten and dairy, whatever, maybe. And then on the other side, we have the like intuitive eating sphere, who has a lot of good things about it but also, i feel like, doesn't fully understand us and our bodies. And so and this is like you know, please take this, take this through your own internal filter, because I hate saying anything negative about the intuitive eating movement, because in a lot of ways I think it's doing a ton of good and it's really necessary.

Amber Fischer: 38:13

But there is a difference between what intuitive eating looks like for some people and what it looks like for those of us with PCOS, and I'll give you a great example of this for my own life. I'm a nutrition professional, so I know what I should eat, what I shouldn't eat, like, what works for my body, what doesn't work. I've done that experimentation and I also have like the scientific understanding of these things to know. But I still struggle with this a lot, and so I have gone through periods of time where I have tended to just sort of reconnect with my own body's signals and take some of that nutrition knowledge out of my head, because sometimes I feel like I get a little too logical and I forget to experience what's really happening in my body. And so what I have noticed about myself and this is true for a lot of people is that when I intuitively eat and I just sort of like really a mindful, pay attention to my body's signals, eat slowly and watch what I'm eating. I do great with meals, with regular meals, but I sure do still have sugar cravings.

Amber Fischer: 39:28

And if I indulge that sugar craving, what happens is because I'm insulin resistant, it comes back stronger the next time and sooner. So, like all of a sudden, i'll start craving sugar. You know, between lunch and dinner, let's say, i want to have an afternoon snack, no big deal Like it's. You know, i don't think it's a bad thing at all to have a little bit of a sweet snacky in the middle of the day, and so maybe I will have that sweet snack. I'll pair it with some protein or some fat or something like that, or it'll be fruit or something you know healthy or whatever. But then after dinner I'm craving the sugar again and it keeps getting worse and worse and worse. And it doesn't matter if I indulge it with a healthy version or if I go full on and just say I'm just going to eat exactly the thing I crave, exactly as much of it as I want. I've tried it both ways for long periods of time So that I'm given it the real, the real college try.

Amber Fischer: 40:29

And no matter what, if I am not consciously putting a stop on myself when it comes to sugar, it will and does continue to get harder and harder to manage. It becomes a thing where sugar is on my mind all the time, whereas when I am conscious of the fact that you know what, i need to put a stop around myself here, because my body is sending me signals. My mind is sending me signals that my body does not need me to fulfill right now. That's the type of intuitive eating that I think with PCOS, we sometimes have to practice. Sometimes we have to learn how to not just intuit what my craving is, which is what I think a lot of people utilize intuitive eating as Sometimes we need to look at not just what my craving is or what I'm wanting, what my body might be wanting, but we also need to think deeply about what my body needs.

Amber Fischer: 41:28

It's kind of like the concept of like tough love, right? Like you know, is it really loving to let your three-year-old have every thing that he wants? No, because you're not teaching him like real life lessons. You're not setting him up for success later. Like sometimes being a little bit, sometimes having boundaries or limits, is positive. Like structure is positive. It's a positive thing.

Amber Fischer: 41:56

Human beings like structure, we thrive on structure, and some of us, our intuitive signals and our hormone signals, like leptin, are so kind of out of balance that it's very difficult to know what's good, what's not good. Like what's right, what's not right, what do I really want? what do I really need? Like it's hard. And so that's where having structure and understanding of like what your needs are from an outsider like you know, a nutrition professional or something like that can be really helpful because it can help you to reorganize your lifestyle around your needs And then from there you can work on becoming more intuitive.

Amber Fischer: 42:37

But sometimes you have to have a place to start Like. Sometimes you need somebody, somebody objective, to say like OK, this is how you eat now And this is how we really would probably want you to be eating, because it would be better for your body to eat this way. Let's start eating this way. All of a sudden you start feeling better, like you have more energy, you're sleeping better. It becomes easier and easier for you to continue eating under that structure And then with time you can stop being so thoughtful about OK, do I have enough protein here, do I have enough fiber here? Like you can start being more intuitive And just your body will naturally start to kind of like make those better choices.

Amber Fischer: 43:15

Sometimes you need structure to start with. So with PCOS, oftentimes we get caught in the middle, right Like we're so used to doing these really like intense restrictive things that we want to just like paint all diets with the same brushstrokes and say, well, that's all bad, any diet is bad, because it's not, it's diet culture, no matter what. It's just not true. I mean some structure and diet culture. But yeah, i won't tell you that it's not a gray area. There's definitely overlap in different, different ways, but structure is not all bad And sometimes it's useful. And I will leave you with this thought, which is that if you have seen content like that out there, if you have felt like very defeated by not having answers, you know, not feeling like your doctor understands you, not feeling like you really know where to go, and just feeling like a little bit like wanting to give up, i would encourage you to just keep trying and to understand that sometimes you just have to pick a voice And follow that voice.

Amber Fischer: 44:40

There are a lot of competing voices on the internet, especially these days, especially with PCOS, and if you try to listen to everybody with letters next to their name, you can get very confused very fast. So find the people that resonate with you. If you've made it all the way to the end of this podcast, hopefully I'm one of those people for you. Find the people that resonate with you, listen to them, listen to your own intuition. Marry those two things. It doesn't have to be just one nutritionist, it doesn't have to be just me. You know there are plenty of other wonderful nutritionists out there who are saying almost the exact same thing as me. But find people that number one you resonate with and that you feel like really get you really understand you. Number two find people who agree with each other and go all in on that, because I just feel like if you let yourself get swayed by every differing opinion you hear online, it really just leads to apathy and confusion. Honestly, maybe where some of these opinions I've been refuting today even come from, just from hearing so much stuff here and there and everywhere And just feeling lost.

Amber Fischer: 46:07

My anecdotal evidence tells me that there is great hope for PCOS and that, as time goes on, in the future there will be things. We will build on the knowledge that we have already, and I expect, maybe even less than 10 years from now, for there to be major breakthroughs in how we manage this condition, in medications that we use to manage this condition, lifestyle choices that manage this condition, like, i just think that there's a lot of really beautiful things on the horizon and I just don't want you to give up. I know some of you who listen to me have been at this for a long time, so you've seen it all and I admire you. But at least for my part, i really believe that there's hope and I wouldn't say that if I didn't really truly think that that was true and feel like I wouldn't share this stuff unless I'd really experienced it firsthand. So, yeah, thanks for listening to my little Nutrition Rumble today And I love y'all and I will talk to you soon. Have a good week.