Myth: If you have PCOS or diabetes, you should be on a low-carb diet
Cutting carbs is often the first thing people are told to do when diagnosed with diabetes or PCOS. And while it’s true that carbs impact blood sugar, the story isn’t that simple, which can be incredibly confusing, especially when this advice is given by a doctor. The vast majority of medical doctors are not equipped to give sound nutritional guidance.Low-carb diets may look appealing on the surface—but they’re not a magic bullet, and they often come with serious downsides, especially for mental health and long-term sustainability.
✅ The Truth About Carbs, Diabetes, and PCOS
Carbohydrates are not inherently harmful—even for people with diabetes or PCOS. What matters most is the type, timing, and overall context of carbohydrate intake—not total elimination. Studies that have shown potential benefits of a low carb diet are done in very small groups of people (5-40 participants) so it’s hard to know if that will truly apply to everyone and not just the few people in those studies (Greenwell et al., 2024). These studies also state that while a low carb diet may be beneficial for a short amount of time, it’s not sustainable long term, can have negative impacts on how you feel and it can increase your mortality risk (Goldenberg at al., 2021) and can even lead to bingeing (Colombarolli et. al, 2022). Research shows that structured, moderate-carbohydrate eating patterns (like the Mediterranean diet) are just as effective as low-carb diets for improving insulin sensitivity and managing blood sugar—without the emotional, social, or metabolic side effects that can come with rigid restriction (Churuangsuk et al., 2021; Vitale & Kim, 2020). For individuals with PCOS, fiber-rich carbs and regular meals can support hormone balance, reduce inflammation, and stabilize energy and mood—especially when paired with a consistent eating pattern (Barrea et al., 2022).
⚖️ The Nuance: It’s Not All or Nothing
Some people do notice fewer blood sugar spikes with lower-carb meals, and it’s okay to consider how your body responds. But there’s a big difference between being curious and being restrictive. PCOS and diabetes are both sensitive to stress, inflammation, and hormone disruption—all of which can worsen with undereating or cutting out entire food groups. A sustainable, inclusive, and flexible approach to carbs is key. For those in eating disorder recovery, any “good vs bad” carb narrative can quickly become a slippery slope.
📚 Scientific References
Churuangsuk, C., et al. (2021). Low-carbohydrate diets for overweight and obesity: a systematic review of the systematic reviews. Obesity Reviews, 22(7), e13266. https://doi.org/10.1111/obr.13266
Colombarolli, M. S., de Oliveira, J., & Cordás, T. A. (2022). Craving for carbs: food craving and disordered eating in low-carb dieters and its association with intermittent fasting. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 27(8), 3109-3117.
Greenwell, S., Jones, A., Smith, Y. R., Marriott, D., Aikens, J. E., Padmanabhan, V., & Saslow, L. R. (2024). Protocol for a randomized comparative effectiveness trial comparing a very low-carbohydrate diet to DASH diet for polycystic ovary syndrome: the SUPER (Supporting Understanding of PCOS Education and Research) trial. Trials, 25(1), 750.
Goldenberg, J. Z., Day, A., Brinkworth, G. D., Sato, J., Yamada, S., Jönsson, T., ... & Johnston, B. C. (2021). Efficacy and safety of low and very low carbohydrate diets for type 2 diabetes remission: systematic review and meta-analysis of published and unpublished randomized trial data. bmj, 372.
Vitale, M., & Kim, Y. (2020). The effect of carbohydrate restriction on glycemic control in individuals with type 2 diabetes. Nutrition, 72, 110717. https://doi.org/10.1016/j.nut.2019.110717
Barrea, L., et al. (2022). Nutrition in PCOS: the role of the Mediterranean diet. Nutrients, 14(13), 2661. https://doi.org/10.3390/nu14132661