Book Review: The Dietitian’s Guide to Polycystic Ovary Syndrome

By Amy Medling

PCOSA Today – Summer 2008

Many women with Polycystic Ovarian Syndrome (PCOS) have tried to shed a few pounds. Research has shown that weight loss of only 5% can improve insulin resistance, leading to lower levels of male hormones and the return of menstrual function.

And, to help women with PCOS lose weight, doctors often refer their patients to dietitians for nutrition counseling. However, many dietitians may not have the training they need to effectively treat patients with PCOS. Believe it or not, some dietitians may have never even heard of PCOS!

Angela Grassi, a licensed dietician who practices in Haverford, Pennsylvania USA was compelled to write “The Dietitian’s Guide to Polycystic Ovary Syndrome” in hopes that, “dietetic professionals will gain the necessary knowledge and training to work with the PCOS population.”

Ms. Grassi states that, “Currently, PCOS may be diagnosed more often than in the past because it has recently been classified as an endocrine disorder not just a reproductive disorder. It is expected that dietitians will treat more patients with PCOS, yet little attention has been given to the syndrome in professional publications where dietitians are the main audience.” To date, only three articles and no scientific studies on PCOS have ever been published in the Journal of the American Dietetic Association.

What makes this book particularly unique is that Ms. Grassi struggles with PCOS. She was misdiagnosed until she was in her late 20’s.

She explains, “When I was diagnosed with PCOS I was already familiar with the syndrome. As a dietitian, I had treated numerous women with PCOS, yet was unable to fully recognize it for myself. This led me to question: if I hadn’t been able to recognize PCOS for myself when I was already familiar with it, how are other dieticians, health professionals, or even patients going to be able to recognize it?”

This book is written to give dieticians the knowledge and training needed to recognize PCOS.

“The Dietitian’s Guide to Polycystic Ovary Syndrome” covers topics including both the physical and psychological aspects of PCOS, dietary strategies, alternative treatments, PCOS in adolescence, pregnancy, lactation and post-partum, eating disorders, case studies and sample menu plans. The book is well referenced and following each chapter is a summary and complete list of references.

Ms. Grassi acknowledges that there is much confusion regarding the proper dietary approach women with PCOS should implement to improve their symptoms and decrease risk of chronic diseases. Currently no formal dietary guidelines for PCOS exist. She recommends a moderately low GI diet (based upon the Glycemic Index) to improving PCOS symptoms.

The most eye-opening information contained in Ms. Grassi’s book outlines the connection between PCOS and eating disorders. “It is common for some to take the extreme belief that they should limit their carbohydrate intake as much as possible in order to lose weight. Unfortunately, this leads to an unhealthy preoccupation with food that often comes with dieting,” Ms. Grassi states.

Studies have shown that women with PCOS may engage in more excessive eating than women without this diagnosis because of the potential amplified physiological affect of stress on PCOS women. Ms. Grassi explains, “stress and increased eating behavior may be part of a vicious perpetual cycle that may be difficult for women with PCOS to combat, due to the fact that these women produce more of the stress hormone cortisol under repeated stress.”

New research also suggests that women who have PCOS have impaired secretion of cholecystokinin, as well as lower levels of leptin and ghrelin. These hormones affect appetite regulation. This could further explain why women with PCOS tend to crave sweets, binge eat or become overweight because of their impaired ability to feel full.

Ms Grassi recommends that dieticians screen patients with PCOS for eating disorders before recommending dieting or changes in eating behavior. If distorted eating is suspected, dieticians can help clients normalize their eating by providing conscious eating exercises, coping skills, cognitive restructuring techniques and reality checks. She wants dieticians to remember to “stress with your PCOS clients the goal is ‘healthy choices’ rather than ‘healthy weight.'”

Although the book is a bit clinical, it can certainly be helpful for a lay person. But with its hefty price tag, ($48.95 list price) this 238 page book may be a bit pricey for someone looking for just an everyday reference book (like myself). However, the book is truly a must-read for all dieticians and doctors who treat women with PCOS. I firmly believe that if they were to read “The Dietitian’s Guide to Polycystic Ovary Syndrome” Ms. Grassi could realize her goal: “It is my hope that you use this knowledge to provide effective medical nutrition therapy to help women improve their symptoms, prevent further medical complications and live better lives.”
About the author

Amy Medling is a stay-at-home wife and mother of two boys ages 8 and 4 who lives in Nashua, NH. She continues on her journey for relief from her PCOS through a low GI diet, exercise, and the use of herbs and dietary supplements such as those found in the Insulite PCOS System.

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