Warning: This post contains mentions of disordered eating.
I’ve been overweight pretty much all my life. I was a fat baby, a fat toddler, a fat teenager, and now a fat adult. It runs in the blood, as many of my cousins also have weight issues, but more than that, it’s a result of a combination of unhealthy diets and an equally problematic relationship with food.
My periods have also been irregular since I started getting them when I was fourteen. They were long, heavy, and painful, so I hated getting them. When I was twenty five, I finally went to an OB-GYN to find out why I don’t get my periods regularly and was diagnosed with Polycystic Ovarian Syndrome.
So, what the hell is PCOS?
Simply put, it’s a condition that affects women’s hormone levels, and thus it is referred to as an endocrine disorder. Our bodies produce abnormally high amounts of male hormones, thus affecting our periods and fertility. That’s not all. PCOS also causes hirsutism (excessive body hair on parts where there should be minimal hair or none at all) and, apparently, if left untreated, could also lead to Type 2 Diabetes.
When I was diagnosed, my OB told me I had to get pregnant ASAP. I wish that were as simple as it sounds. I wasn’t in a sexual relationship then, first and foremost, and neither was I in a position to mother another human being. I was also told to lose weight.
But here’s the thing about PCOS: it makes you gain weight and at the same time makes losing weight seemingly impossible. We already know that losing weight is as easy as getting a job that comes with a six digit paycheck. PCOS lowers your chances further. I know. Fun, right?
Anyway, a few years passed with me losing a few pounds and gaining them all back. I tried dieting, but my impatience got the better of me, and I gave up after a couple of weeks without progress. Last year, I decided to give boxing a try and did it a few times a week. I also ate considerably less during that period, but still the scale didn’t budge.
It’s disheartening, to say the least.
One more thing I forgot to mention: when I was diagnosed, my OB put me on birth control pills to regulate my period. I thought this was supposed to cure me, but I learned that the period I got from getting off the pill (I took 21 day combination pills) was withdrawal bleeding, which was induced by the changes in the hormone levels in the body once all 21 pills had been taken. Real periods occur when we ovulate and the lining of the uterus thickens as preparation for pregnancy. If the mature egg is not fertilized by a sperm cell, the thick lining of the uterus leaves our bodies in the form of our menstrual periods.
I thought I was getting a normal period from being on the pill, only to find out it was a fake period all along.
So late last year, I decided to get off the pill and find a way to properly deal with PCOS. I started reading up on the condition and found out there are different types of PCOS. The two major types are insulin-resistant PCOS and non-insulin resistant PCOS. This is something that unfortunately was not explained to me by the doctor and I only found out about it by doing my own research. Sometimes it really does pay off to be a nerd.
I learned that I was insulin-resistant and that this meant I was at greater risk of developing diabetes. This made so much sense because early last year, I had my blood sugar tested and my glucose levels were already higher than normal. I also learned about leptin—the satiety hormone. Leptin is responsible for telling the body to stop eating because it’s full, but apparently, eating too much carbs (sugar is a carb) and processed foods, causes the body to resist leptin, leading to insatiable hunger. To deal with this hunger, we, of course, eat more and gain more weight. Fuuuck.
From personal experience, I know that restricting calories doesn’t work. Not only is it a futile attempt, it’s also, needless to say, unhealthy. There was a period in my early twenties where I struggled with disordered eating, motivated mostly by my desire to be at an acceptable weight and not be fat anymore. I limited my calorie intake on most days to just 500 and fasted on others. This happened during the time when I was working on my undergraduate thesis (not incidentally, it was about starvation and anorexia, because back then I had become part of a community of girls on Tumblr with eating disorders), so I also did not get much sleep then. Despite eating so little, I exercised nearly every day, and dropped about forty pounds in a few months. I subsisted on water, apples, fruit juice, and cigarettes. Looking back, I was slowly killing myself, wasn’t I?
After graduating, however, I moved back to Pampanga and started eating normally again. Needless to say, I gained back the weight I lost, but at least I wasn’t constantly at war with myself. People lauded my efforts to lose weight without knowing what was going on inside my head. Even members of my own family asked why “I let myself go” again and at some point I retorted that at least I wasn’t driving myself crazy anymore.
Fast forward to the present, I’m thirty and about to get married. A and I want children, so of course I had to do something about PCOS. As I read and read about the condition, I eventually discovered the ketogenic diet.
Keep Calm and Keto On
You may have heard of the ketogenic diet. There has recently been a surge in its popularity here and abroad as more and more famous people started mentioning and crediting it for their astounding weight loss achievements. Of course, it also received a lot of criticism for being too restrictive and completely against what we are taught about the healthy diet.
First, a definition: a ketogenic diet is a low carb, moderate protein, and high fat diet that puts the body in a metabolic state called ketosis, where it burns ketones rather than glucose for energy. Where do ketones come from? They are produced in the liver from fat. When the body runs out of glucose, it runs on fat.
Again, when the body runs out of glucose, it runs on fat.
This FAQ on the keto subreddit is my go-to for keto questions. It won’t answer all, but it covers the basics pretty well, so read it if you’re interested in learning more.
So, why keto?
We’ve already established that I have insulin-resistant PCOS. When you’re insulin resistant, your body does not respond properly to insulin. Insulin is the hormone responsible for controlling blood sugar, which is why being resistant to it puts one at risk of Type 2 diabetes.
Type 2 diabetes is a condition of insulin resistance, meaning that muscle, fat, and liver cells do not respond properly to insulin, and they can’t easily absorb glucose from the bloodstream. As a result, the body needs higher levels of insulin to help glucose enter cells. Those beta cells in the pancreas start to work overtime to keep up with the increased demand for insulin by making more and more. Insulin levels in the bloodstream may be high. But eventually, the beta cells exhaust themselves and can no longer keep up with the body’s demand. Glucose levels in the bloodsteam build up, and prediabetes or Type 2 diabetes can set in.
I started wondering what kind of diet would break through the barrier of PCOS and consulted my best friend Google for answers. I discovered a blog called My PCOS Kitchen, run by a young woman who was also diagnosed with PCOS. She wrote extensively about her experience with PCOS and how she managed to reverse it by changing her lifestyle. I also read about low carb high fat diets benefiting women with PCOS and read more accounts of women reversing PCOS by switching to a ketogenic diet.
What?! PCOS can be reversed?! Apparently so.
My first attempt at doing keto was in October 2017. To make sure I started it properly, I subscribed to a food delivery service called Fitness Gourmet that had a ketogenic menu and did it for a couple of weeks. I dropped some weight immediately, but found out this was just water weight. Fitness Gourmet turned out to be disappointing (costly, so-so food quality, poor service), so I cancelled my subscription and decided to try doing lazy keto instead.
Anyway, I failed to stick to keto last year. The holidays came, during which I stuffed my face with carbs again and this went on until my birthday in March. Needless to say, I gained back what little weight I lost when I started keto. Come April, I was still a carb eater but felt worse and worse every day, so I decided it had to stop once and for all.
I begged Aki—the biggest sugar lover I know—to do keto with me and finally got him to agree in early May (by then I’ve been on keto for a week). I also convinced him to purge the house of carbs—cookies, peanut butter, jams, candy, and soda, to name a few—which he ended up giving away to his colleagues. He has so far lost about about 12 pounds. I, on the other hand, managed to lose all the weight I gained back from the period where I reintroduced carbs into my diet and in total have lost more or less 20 pounds since my initial attempt.
Six Weeks on Keto
People’s experiences with keto vary; some adapt pretty easily, while others have it harder. Fortunately, I adjusted to it well. I didn’t get the dreaded keto flu and have so far only seen improvements in my body. When I was a carb-eater, I was always bloated and gassy and had tension headaches nearly every afternoon. There was even a period where the headaches hit at 3PM every day and sometimes persisted until the early evening. On keto, I only get headaches when I’m about to get my period.
Speaking of my period, it’s still not regular, but I’m hoping it would eventually normalize. My cycle is still abnormally long, but I’m happy that I’m making progress, albeit slowly. Between 2015 and 2016, I didn’t get my period for nine freaking months, so to menstruate nearly every month is already a huge achievement for me.
My weight has stalled for a few weeks now, but I’m trying very hard not to be discouraged. To plateau is human! I keep telling myself that weight loss is not linear and that my body is simply adapting to the changes. I found out that a lot of people on keto also go through what they call a Post Induction Stall Syndrome and it seems I’m at that point too. They say it’s the time after a few weeks of the initial, consistent weight loss, where the body familiarizes itself with your new way of eating and retains water.
Cheating on keto is actually not very attractive anymore as I get extremely bloated and flatulent when I eat too many carbs. Surely, that’s nothing to be excited about. Admittedly, I do miss noodles, pizza, and cake sometimes, but on the whole, restricting carbs wasn’t as difficult as it was the first time around. A lot of people say they can’t live without rice, and, believe me, I LOVED rice, but I don’t crave it anymore. In fact, I think keto has eliminated cravings, period. The last time I badly wanted to eat something specific was two weeks ago when shark week was approaching and I desperately craved sisig.
And because I’m on a low carb diet, my body seems to be responding normally to leptin again. I feel satiated for much longer that I can fast intermittently without feeling like I’m going to keel over. I also don’t get hangry anymore, which I experienced quite often back when I still devoured carbs. Also, on a high carb diet, I would tremble whenever I felt extremely hungry. I don’t experience that on the ketogenic diet.
As much as I would like to talk more about keto, I’m afraid I’m not an expert on the subject and you are better off reading about it from those who are. I love reading about other people’s experience on keto and seeing their progress photos, so I frequent r/keto and r/xxketo (the keto sub for women), along with some keto-related pages on Facebook, one of which is specific to women with PCOS.
One important thing I almost forgot to mention: I had my blood sugar and lipid profile checked recently. The last test I had prior to this was way back in February 2017 and these were my results:
Glucose: HIGH – 103.62 mg/dL, 5.75 mmol/L
Cholesterol: NORMAL – 191.75 mg/dL, 4.96 mmol/L
Triglycerides: HIGH – 190.28 mg/dL, 2.15 mmol/L
LDL: HIGH – 111.73 mg/dL, 2.89 mmol/L
HDL: LOW – 52.19 mg/dL, 1.35 mmol/L
And from my last test two weeks ago:
Glucose: NORMAL – 90.82 mg/dL, 5.04 mmol/L
Cholesterol: NORMAL – 198.46 mg/dL, 5.14 mmol/L
Triglycerides: NORMAL – 92.04 mg/dL, 1.04 mmol/L
LDL: NORMAL – 136.29 mg/dL, 3.53 mmol/L
HDL: LOW – 43.63 mg/dL, 1.13 mmol/L
As you can see, the results of my bloodwork have greatly improved. Unfortunately, my HDL is still low (HDL is the good cholesterol!), but I think I can bring this figure up by eating properly. Note that fasting plasma glucose between 100mg/dL and 125mg/dL is already considered pre-diabetic, which means I was pre-diabetic last year. Scary.
A word of caution, however: keto is not for everyone, so make sure to consult a doctor prior to starting it. Read and learn as much as you can. Keto is more than just eating bacon and butter and skipping rice and bread. You will need to learn more about the food you’re consuming and in turn also learn to make better choices. A high school friend who’s a doctor read my post about being on keto and sent me a message asking me to tell people who might go to me for advice on keto to get their kidney function checked, as well as their blood sugar before going on the diet.
Keto is also on the receiving end of a lot of hate from people who still insist that fat is bad and that the body cannot function properly without carbs. Please, please, please do some reading beyond news articles and blogs. Contrary to what some of these articles say, there is plenty of research backing low carb and ketogenic diets. This article on Healthline can help.
I still have a long, long way to go on a my journey and I am brimming with hope that keto also reverses my PCOS symptoms as it did for many other women. PCOS is shit, yes, but your body is yours and you have control over what you do with it. What we eat affects so much more than just our weight.
I wish I knew everything I’ve written here years ago, but I didn’t, so I can only move forward and hope that my efforts to become better and healthier will eventually pay off.