Polycystic Ovarian Syndrome (PCOS)

"Prior to working with Carolina as my dietitian, figuring out my PCOS was stressful and confusing. She gave me recommendations that are sustainable and improved my symptoms quickly!"

Lauren, Brooklyn

 

Managing PCOS can be confusing and frustrating

Online searches, influencers, and health providers may tell you that you have to restrict food groups and lose weight to manage polycystic ovarian syndrome (PCOS).

This is absolutely not true but it's the prevailing message you've seen and it's hard to not absorb.

You've probably tried or at least contemplated different diets, cutting out carbs, pursuing weight loss.

Maybe you still don't feel great and you're wondering if there is another path that leads to peace of mind and body.

And that's why I'm here.

How a HAES PCOS dietitian is different

I help you navigate your PCOS without a focus on the scale or restricting what you eat.

As a registered dietitian nutritionist who practices through the weight-neutral lens of Health at Every Size (HAES), I will help you work toward your health goals in ways that are science-based and not restrictive. 

This means I do not provide rigid meal plans, food rules, or guidance on weight loss. 

Instead, you will work towards an eating pattern that is flexible and sustainable for you. 

This also means I will never judge you for your current or past eating habits, nor do I judge you if you desire weight loss.

Instead, we talk about what has felt hard about eating and being in your body, and how you can feel better around food and your body in the long-term.

Benefits of working with a PCOS nutritionist

We will explore the following aspects of physical and mental health and better understand where you may want to make changes:

  • Establishing regular eating patterns with all the food groups
  • Eating foods that feel satisfying and nourishing
  • Including your favorite fun foods, such as sweets or chips
  • Challenging food rules to help reduce guilt or shame around eating
  • Managing stress and sleep
  • Coping with challenging body image days
  • Engaging in movement that feels supportive
  • Incorporating helpful supplements to balance your hormones and reduce inflammation

By working together, you will become the expert in and authority of managing your PCOS, eating---you will become your own Eathority.

Meeting Frequency

We will meet by secure video every two weeks for 6 sessions. 

Pricing

$1300 for one 75-min initial assessment and five 45-minute follow-ups.

Sliding Scale

A limited number of sliding scale rates are available for BIPOC folks who demonstrate financial need. At this time, all sliding scale slots are full.

Virtual Sessions

Meetings take place via secure video --- no travel necessary.

Appointment Hours

  • Tuesday-Thursday: 8am-7pm
Carolina Guizar virtual nutritionist for PCOS in New York City. This image is of a calendar graphic.

Book Now

To begin your PCOS journey together, click on the link below.

Please note: a credit card is required to book your first appointment. Cancellations and reschedules must be made 72-business hours in advance to avoid a full fee charge.

Intake forms must be completed at least 72-business hours in advance or the appointment slot will be cancelled.

General FAQs

Health and PCOS symptom improvement can be pursued at any size, and certain health-promoting behaviors can improve physical health even in the absence of weight loss.

Research shows that a Health at Every Size (HAES) model can improve health outcomes in people of all sizes. The HAES (pronounced hayz) model accepts and respects the diversity of body shapes and sizes, supports life-enhancing movement and eating for well-being. Intuitive eating is the eating pattern that supports HAES.

Intuitive eating and HAES offer viable, evidence-based alternatives for pursuing PCOS and health improvements and experiencing less shame around food and your body.

Many studies support the use of HAES in clinical practice, with the following demonstrated outcomes:

  • Improved cholesterol
  • Decreased blood pressure
  • Increased physical activity
  • Improved blood sugars
  • Greater food variety in the diet
  • Reduced food and body preoccupation
  • Increased body satisfaction
  • Less disordered eating
  • Higher self-esteem
  • Better coping skills

If you have previously attempted weight loss in the past, I would invite you to consider the following question: where has a focus on weight and weight loss gotten you? Have you been able to keep the weight off, and if so, at what cost?

Most studies show that weight loss efforts do not result in long-term weight loss for the majority of people. My clinical experience also supports these findings, and perhaps your personal experience does, as well.

In the short-term, food and calorie restriction can cause individuals to lose weight quickly, usually peaking at 6 months after the start of the diet. Most diets result in a maximum weight loss of about 5-10%. These losses are modest, and for people in larger bodies, many remain larger bodied and at continued risk for weight stigma and discrimination.

Weight loss eventually plateaus, and once dieting ceases, weight is slowly regained, often returning to original levels. Studies have shown that 90% to 95% of dieters regain all their lost weight within a few years. Within the first year of dieting cessation, less than 20% of people are able to maintain their weight loss, and many regain 30-35% of weight that is lost. After four to five years, one-third to two-thirds of dieters regain more weight than was lost, although researchers believe this latter statistic may actually be higher.

The cycle of losing and regaining usually leads to another diet, more weight loss and eventual regain. This puts people at risk for the following:

  • Cardiovascular stress due to fluctuations and increases in cholesterol, blood sugars, insulin and blood pressure
  • Increased cravings, eating past fullness or binge eating
  • Future weight gain
  • Slower metabolism
  • Muscle loss
  • Emotional and psychological distress, including lower self-esteem
  • Premature death, especially from heart disease

For the small percentage of people who are able to maintain weight loss in the long-term, losses are usually modest. Any health benefits that are observed cannot be fully attributed to dieting because it is difficult to untangle the possible effects of other changes, such as exercise.

Based on this information and studies showing that health improvements can be attained in the absence of weight loss, there is a strong case against prescribing weight loss via food and calorie restriction.

The short answer is no.

Genetics, age, stress, childhood trauma, food insecurity, and inequitable health care, weight stigma, and anything that interferes with the ability to engage in sustainable health-promoting behaviors --- all of these impact health and your PCOS more than weight alone.

But health and weight have been conflated, and our world is very much attached to an oversimplified view on health that causes harm to those who do not fit our society’s definition of what health looks like.

The long answer is that health is a complex topic. When you layer on PCOS, it can get even more complicated.

A correlation between body size and risks for certain chronic conditions may exist, but many studies do not control for factors which we know to be independently correlated with poor health outcomes (e.g., weight stigma, yo-yo dieting, food insecurity, trauma, chronic stress, etc.). 

But just because you are a certain size does not automatically mean you will develop a chronic condition. I also believe wholeheartedly that developing a chronic condition is not a moral failing. Chronic conditions occur in people of all sizes and occur for so many reasons, and you deserve to be treated without blame and shame as you navigate that condition across your lifespan.

We have been taught to think about health in very black and white terms. Bodies are considered “healthy” or “unhealthy”, “good” or “bad”, “successes” or “failures.” There isn’t much room for exploring the gray space where health inevitably exists.

Together we can unpack what health and healthy look like to you, and I would be happy to help you explore and redefine these terms on your own terms.

Session frequency depends on your needs and how much support you want.

Sessions take place by secure video.

During the first session, we will discuss your eating history, how you feel about food and your body and any other relevant information you feel comfortable discussing. Depending on what your concerns are in session, you decide what manageable goals you want to set for the following session.

In follow-up sessions, we will begin any nutrition education you are interested in learning and how you can incorporate small changes into your life. We will also discuss any successes or challenges since the previous meeting or any topic that feels pressing to you that day.

Several insurers have recently decreased their reimbursement rates for dietitians. Because of this, I have made the difficult decision to stop accepting insurance. 

I offer various package and payment options that we can discuss.

Please contact your insurer to inquire about out-of-network coverage using the questions in this out-of-network form. I will provide you with a superbill after each session to submit to your insurer for possible reimbursement.

Yes! If you want to get to know me and my style, single initial consultation sessions are available. 

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