(P28-014-23) Food Decision Making Among Women With Polycystic Ovary Syndrome (PCOS): A Listening Guide Analysis

Objectives: The purpose of this pilot qualitative study was to understand how women with PCOS make decisions about food.

Methods: Women with PCOS (n=3; 20-30 y; PCOS diagnosis >1 y) completed semi-structured interviews. Interviews were analyzed utilizing the Listening Guide Method of Psychological Inquiry (LG), a novel approach in nutritional sciences to understand food decision making. The LG is a relational method of narrative analysis used to answer questions with a psychological component. The first step listens for the plot, the overall story being told across the interview. The second step listens for the “I,” following the first-person pronoun, and “I” poems are created. The third step listens for contrapuntal voices, the various voices one speaks and their relation to one another. The final step is to compose an analysis, synthesizing the data generated in each step.

Results: Findings demonstrated an immense struggle for women with PCOS in food decision making. Landscapes were filled with restriction (“limiting calories,” “restrictive,” “starve”), contradiction (“eat/don’t eat,” “should/shouldn’t,” “know/don’t know”) , and moral language (“guilt,” “shame,” “regret”).  Listening revealed a juxtaposition (“I do/I don’t;” “I don’t know/I know”) and a struggle (“I like crave, I don’t eat;” “I try, I just try;” “I do want, I don’t know”). These women attempt to navigate the terrain between their feelings around food and the restrictive diet they follow to lose weight. Their “I’s” predominantly thought (“I think”) rather than felt (“I feel”). Participants’ voices distanced themselves from feeling hunger to avoid weight gain and being judged as unattractive or lazy.

Conclusions: Through the LG method, restriction, contradiction, and moral language were identified as playing prominent roles in food decision making for women with PCOS. Providers should be aware of the food struggles women with PCOS experience. Nutrition interventions that encourage individuals to connect to feelings around hunger, such as Intuitive Eating, may improve health outcomes for women with PCOS.

Funding Sources: Funding provided by Academy of Nutrition and Dietetics' Sports, Cardiovascular and Wellness Nutrition Dietetic Practice Group Graduate Student Research Grant.