Avoid All or Nothing Thinking with PCOS

All or Nothing concept on the road signpost, 3D rendering

How many times have you beaten yourself up for eating something you “weren’t supposed to eat” and ended up finishing the bag? Or you “caved in” and had a piece of bread at dinner and thought you might as well order dessert since you already blew the day. I call this the all or nothing thinking and find it happens with many of my patients with PCOS. It’s not surprising that it’s so common – after all, many women with PCOS have been told (or read online) that they need to follow extremely restrictive diets including eating minimal carbs, avoiding sugar and white carbs like the plague, avoiding dairy, gluten and soy, eating organic, and hormone free. Umm, what’s left to eat? So when you venture into the “forbidden food zone”, you are bound to feel like a failure. This sets up a vicious cycle that can lead to all or nothing way of thinking, binging, and just feeling miserable. This same cycle can occur with setting unrealistic exercise goals. I know some women who feel they need to spend 2 hours a day in the gym in order to beat their PCOS. Who wants to feel that you have to live up to unrealistic standards 100% of the time? We are all human and this is just not possible (or healthy!)


Before I get into my tips to break the all or nothing thinking – here is a little food for thought. You do not HAVE to be on a very restrictive diet. A healthy diet for PCOS can include many foods in moderation (yes – even carbs and an occasional sweet!) and doesn’t have to omit any food groups. However, if you choose to follow a restrictive diet (i.e. no dairy or gluten or minimal carbs) and it makes you feel good physically and mentally, helps your symptoms and you enjoy what you are eating – then that’s great! But don’t feel you have to follow this kind of plan. Depriving yourself 100% of the time will only backfire. And “over-exercising” can be counterproductive in PCOS. It can make you hungrier, cause your body to become more efficient in holding  onto calories, increase risk of injury and lead to adrenal fatigue.


If you want to follow a very strict diet or engage in an intense exercise program for a short period of time, go for it. It can get you results which can be motivating. But trying to keep up with these behaviors long term won’t work. I can’t tell you how many clients I’ve had in my office who regained all the weight plus more after following a very rigid diet. They never learned how to live in the grey zone. The grey zone is an area that’s in between being really really strict with a behavior and eating/doing whatever you want. This is the middle ground we should strive to get to. Again, if you are happy with your current “stricter”way of eating and it’s not backfiring, keep doing what you are doing. This post is for those of you who find your current all or nothing way of thinking is NOT working for you.


Tips to break all or nothing thinking


  1.  Be aware that severely limiting your food intake and completely cutting out your favorite foods causes deprivation and increased risk of binging … and it’s just not fun! If you love bread, why can’t you have a slice of whole grain bread with mashed avocado for breakfast? Or if you love Greek yogurt, having a plain 2% with added berries and flaxseeds will not send your hormones out of whack! The same goes for other areas like exercise. Setting unrealistic exercise goals sets you up for failure. The more failures we have, the less confidence we have in ourselves. It is a known fact that a low self-efficacy will decrease our chances of being successful in health related behaviors like weight loss, maintenance after weight loss, regular exercise, etc. (pic credit)
  2. Listen to your body … carefully. If you have a piece of bread or rice in a sushi roll,  will that set you off? It’s a known fact that women with PCOS tend to have more carb cravings. But pay attention to your body. Do you feel “set off” because you ate something you feel is forbidden or is it really a physiological craving (likely due to an insulin surge)? If it’s a real physiological craving, maybe you are best off not even starting with that particular food. Or make sure you combine it with protein and fat to decrease the insulin spike. But if it’s a “I’m bad because I ate what I shouldn’t have” feeling, then you need to work on the all or writing in journalnothing mentality.
  3. Keep a journal. In addition to writing down what you eat (or drink or exercise), write down your thoughts – especially every time you catch yourself with this all or nothing mentality. It’s important to capture when these thoughts occur and exactly what you are thinking.
  4.  Analyze your thoughts. Why do you feel that way? Where did it come from? Are these thoughts valid? For example: If you ate one cookie, does this really mean you blew your chances for weight loss or your body will blow up into an inflammatory state? In reality, the one cookie has 70 calories. Not a big deal. But eating the rest of the box and beating yourself up will likely lead to poor eating the next day(s). This can be a big deal when it comes to losing weight. Why did you feel that eating a cookie was “bad”?  Or if you’ve told yourself you need to avoid all carbs at dinner, and you end up eating 1 cup pasta, why do you think you blew your “diet” for the day?
  5. Think about how the all or nothing mentality makes you feel. Strict deprivation … overindulgence … guilt … repeat the whole process. Is it working for you? How does it make you feel? Would you like to get out of this cycle? How would getting out of this cycle make your life better? It’s important to have a motivator as to why you want to make changes.Possible motivators: feel less stressed, feel less deprived, be in a better mood, feel more in control.
  6. Reframe your all or nothing thoughts. It can be difficult to change the way you think, but it can be done. Once you’ve identified these thoughts, try to find a way to reframe them.
    For example:

    All or nothing thought: I need to exercise 6-7 times a week for 1 ½ hours in order to lose weight and control my
    PCOS. Exercising less than this won’t burn enough calories. My body needs this in order to lose weight
    My reframing suggestion: I don’t need to exercise this much. I feel tired a lot and have many cravings. I think my exercise program is contributing to this. I choose to give my body a break and will exercise 5 times a week. I will incorporate shorter intense sessions, High Intensity Interval Training (HIIT) for 30 minutes into my workout routine versus the 90 minute sessions. I have read that these can be just as beneficial (if not more so) as longer sessions.

    -All or nothing thought:
    I can’t have any carbs at dinner if I want to lower insulin levels and lose weight. But I love carbs and feel deprived.
    My reframing suggestion: I enjoy eating carbs but know I have trouble controlling my intake. However I choose to let myself eat carbs at dinner 3 times a week. I will choose those carbs I feel confident I can control my portions of  sweet potato and quinoa. I will keep my portions to 3/4  cup.-All or nothing thought: I am not allowed to eat any dessert because carbs are not good for PCOS. I REALLY want to have some of my favorite dessert tonight for my birthday.
    My reframing suggestion: I will allow myself small portions of my favorite dessert on occasion. Tonight is a special night so I will let myself enjoy a few bites of a shared dessert with my friends. I am in control and will eat it slow and enjoy each bite
  7. Plan an “excursion” from your strict eating plan. If you find it really hard to live in the grey zone, starteating with friendspracticing.  If this makes you nervous, the trick will be to plan.
 For example,  pizza is one of your favorite foods but you made it off limits for yourself because one slice turns into three.  But … you love it and feel deprived when your friends are digging in and you’re eating a plain salad.  This usually leads to binging later in the night. So – what if you planned a night with your friends when you would have ONE slice of your favorite kind of pizza. You’ll eat it REALLY slow (“mindful”) and order a side salad to go with it. Your friends probably inhaled 2-3 slices while you ate your one slice. The key word here is to PLAN! It’s probably best not to order in a pie while home alone, but enjoy a slice with friends.
  8. Don’t beat yourself up. If you ended up putting a dent in the Girl Scout Cookie box, let it go. Does any good come out of dwelling on it and beating yourself up? Does it make you feel better? Chances are that it only makes you feel worse about yourself which will likely lead to more eating. Let it go and move on. One thing you can do is to learn from what happened. Maybe you went too long without eating, maybe you were with a “food pusher” friend, maybe your all or nothing thoughts provoked this episode, etc.
  9. Know yourself. While I’m suggesting that you allow yourself to eat your favorite foods on occasion, I’m not suggesting you open the floodgates. There may be some foods that you have serious trouble controlling your intake of. I call these trigger foods. You may be better off not keeping these foods in the house. Instead, enjoy a small portion when you go outside.
 Here is an example: I love chocolate and don’t want to deprive myself of it. But … I am REALLY bad with portion control. ( I’ve blogged many times on my other nutrition craving carbsblog about my difficulty controlling chocolate intake) . So I would never keep a box of chocolates in my apartment. But I do allow myself a few bites of a chocolate dessert in a restaurant or 1-2 mini chocolates like a Lindt truffle found in the check out lines of many NYC markets. This way I don’t feel deprived yet I’m not setting myself up for trouble. I truly believe that I would never be able to control my intake of chocolates if they were in my apartment!
  10. Get the DIET word out of your head. Do your best to drop the “good” or “bad” food mentality. All foods can fit … at least on occasion!
  11. Seek help from a therapist/counselor if you are feeling very out of control with your eating or drinking.


Bottom line

In order to develop healthy nutrition and lifestyle habits for PCOS,  you’ll need to kick the all or nothing mentality.


How many of you have the all or nothing mentality? Have you found any tricks to break this mentality? Share your experiences!





I especially love problem-solving, whether it’s helping women defeat issues plaguing them for years, helping a busy executive find practical ways to get heart healthy, or providing tips to help you reverse diabetes. That’s why I’m on a constant quest to expand my knowledge by staying on top of the latest research.

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