Ep 82. Weight Loss + Cutting Carbs Won't Solve Your PCOS: Ending Body Blame with Kimmie Singh

In this episode of The Body GrieversⓇ Club, Bri sits down with Kimmie Singh, a registered dietitian specializing in PCOS and eating disorders, to discuss the complex journey of body liberation. They explore the societal assumptions faced by fat dietitians, the challenges of navigating professional spaces, and the stigmas around PCOS and body image. Kim breaks down her unique approach to nutrition, which emphasizes body liberation and destigmatizing food and body size. They delve into the importance of self-care, the limitations of behavior change alone, and the nuanced role of medications like GLP-1 in managing PCOS. The conversation also touches on their personal friendship dynamics, the diversity in movement preferences, and the importance of creating supportive and non-judgmental spaces for clients. Whether you're managing PCOS, grappling with body acceptance, or just looking to learn more about holistic and compassionate health care, this episode is packed with insights and practical advice.

 
TIMESTAMPS:

01:59 The Role of a Non-Traditional Dietician
03:52 Personal Stories and Professional Challenges
07:07 Understanding PCOS: Personal Journey
15:07 Common Misconceptions and Myths about PCOS
22:20 Weight Neutral Management for PCOS
28:44 Healing Relationship with Movement
31:23 Gentle Encouragement vs. Pressure
39:03 Explaining PCOS in Simple Terms
42:06 Behavior Change and Medication
48:11 Final Thoughts and Resources
 

WANT MORE OF KIMMIE SINGH?

https://www.bodyhonornutrition.com/
https://www.instagram.com/bodyhonornutrition/ 
 

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*Website: https://bodyimagewithbri.com/
*Bri’s Free Resource: 7-Step Guide to Shift Body Grief to Radical Body Acceptance

TRANSCRIPT:

Hey girl.

Hi Bri. Oh, it’s such an honor to be here with you today. I feel like we’ve been trying to schedule this for so long — and it can be hard. I’m so ADHD that it’s been on the books forever.

Well first, tell everybody who you are and what you do.

Yeah. So I’m a fat registered dietitian. I always like to say I’m a non-traditional dietitian — I’m not going to recommend weight loss and I’m not going to recommend diets. We talk about a lot more than food. We talk about body liberation, fatphobia, and weight stigma. I specialize in PCOS (polycystic ovarian syndrome), and I also specialize in eating disorders.

I feel really lucky because I love what I do and I love the folks I get to work with.

I love that. In our friend group, we call ourselves the BFAs — I might cut that — but we have a group of providers in this area who are also our friends, and most of us are therapists. We always say Kim is basically an honorary therapist. Her clinical skills are out of this world. I’m not even saying that because she’s my friend — I’ve never seen dietitians approach food the way you do.

I’ve seen firsthand how life-changing the skills you teach clients are, and the therapeutic skills you bring into the work. It’s an honor to witness.

Thank you. I feel like that’s what makes the work fun. If I was only talking about food in a really rigid way… I shouldn’t say “solid,” but what comes to mind is those little plastic fruits and vegetables some dietitians keep in their offices.

I don’t have plastic fruits and vegetables — I have a nice bowl of fidgets. I have a lot of other things. I like that the work can be more fluid.

I love that. This is anecdotal, but you remember how we met, right?

Yes — but I think we should compare notes. It was WIND, right?

Yes, yes — WIND. I think it was the mixer. I remember being on my way out, and I’d just watched your presentation. You came up to me afterwards, and then we went to dinner together. I was still newer in the body liberation world, and all these dietitians were ordering salads… and you were like, “I’ll get the mac and cheese.”

And I was like, that’s my girl right there.

LOL. Especially around dietitians, there can be so much pressure to eat a certain way in certain spaces. And I’m like — hey, I’m going to listen to my body. I’m not just going to tell clients to do it. I’m going to practice it.

I love that. I’ve worked with other providers, including dietitians in larger bodies who may still identify as body grievers too. There’s this undertone in the professional world of still feeling expected to eat the salad.

Even when you’re practicing body acceptance or body liberation, being a fat provider among a bunch of thin providers can feel daunting.

Oh, definitely. And it’s something that’s changed and evolved for me over time. I knew I wanted to be a different kind of dietitian back in grad school. My undergrad was in physics — I was headed in a totally different direction.

When I started studying nutrition, the whole space felt so rigid and performative. Like people drinking from a very specific water bottle and eating a very specific granola bar. It felt bananas. I felt that pressure in training, and I didn’t want to keep living in that energy, so I started challenging it then.

And honestly, it still comes back to being okay with people being wrong about you. They’re going to make assumptions if you’re the only fat dietitian and you’re the only one not ordering the salad. Some people will knowingly assume, some will do it unconsciously. Either way, that’s on them. I don’t need to control it.

This is what I mean, folks. The weak people might make assumptions about us — and that gets to suck.

And there’s a different level of pressure when it comes from professional settings. I even remember this tiny fear like, what if they all throw tomatoes at me? Dietitians throwing vegetables at me.

But I was received with kindness and adoration… and still, there was this undertone of, wow — there are a lot of thin white people in this room.

Definitely. It can be hard because you can do all the work and it can still feel uncomfortable to be in a space with so little diversity — including around size.

So tell us about PCOS. How did you become known as the PCOS expert… or at least how I think of you?

Well, I have PCOS, and I’m super transparent about it. When I was first diagnosed, I was 19. My doctor told me, “You have polycystic ovarian syndrome and you might have trouble conceiving one day,” literally while walking out of the room.

I didn’t even understand what she said. I stopped her and asked for more, and she was like, “Oh honey, don’t worry — the nurse will give you a pamphlet.” The pamphlet was scary and intimidating, and this was 2009. Google was different back then. I went home, googled it, saw all these symptoms, and I was like… is my life doomed?

Part of me compartmentalized it and stayed in denial for a while. But as my PCOS evolved, I realized I’d benefit from learning more — and from accepting that I actually do have it.

I was fortunate because where I went to grad school is also where Julie Duffy Dillon practices. She’s such an incredible mentor and I still consider her one. She taught me there’s so much more than the pamphlet. She even has something like “PCOS is not a pamphlet,” which speaks to how universal that experience is.

As I learned more, I got really passionate about helping people understand how complex PCOS is — how it impacts everything from mood to cravings to how you’re treated at the doctor. Fertility can be a part of it, but it’s not the only part, and I wish more providers understood that.

So if fertility isn’t the only part, what are the parts people don’t talk about?

A few come to mind that surprise clients the most. One is the link between PCOS and mood disorders — depression, anxiety — and there’s still a lot we don’t fully understand, but we see the correlation.

Another is the correlation between PCOS and more ADHD-like symptoms. A lot of folks I work with either have ADHD or have a lot of traits like I do. Neurodivergence and PCOS can be connected.

Cravings are another big one, and how our bodies can metabolize carbohydrates differently. That doesn’t mean you shouldn’t eat carbs. It means if you restrict them, you may have a bigger mental and physical response than someone without PCOS — which is actually more reason not to restrict.

And one of my “fun-but-boring-to-everyone-else” facts is that PCOS can impact dry eyes. I used to wear contacts and my eyes were dry all the time. When I learned that connection, my mind was blown.

There are so many subtle ways it’s connected. And sometimes when people try to explain it to family, the response is like, “Oh, you’re blaming everything on your PCOS,” the same way people say, “Oh, you’re blaming your ADHD.” But it really can impact everything.

Right. And it can be so subtle you can’t always see how it’s impacting things — you have to trust the person when they say it is.

I feel like I met you right after I saw an endocrinologist who was one of the most fat-friendly fatphobic doctors I’ve ever encountered. Trigger warning — I’m going to talk about fatphobia.

Was WIND 2017 or 2018?

Okay, so I saw this endocrinologist because I didn’t meet the standard PCOS qualifications at the time, but it felt like PCOS made so much sense. I kept saying I had it. I remember at dinner you ended up educating me and I was like, I need to talk with you more.

This doctor… I tried to lead with Health at Every Size. Like, please don’t just recommend weight loss. And she goes, “Oh, PCOS — you love your carbs. You guys love your carbs.”

And then I tried to explain Health at Every Size and she said, “Honey, this has nothing to do with how you look. You’re adorable. You’re adorable. This has to do with your health.”

I was too stunned to speak. Like… okay, we’re not going anywhere.

Then she tried to tell me increased adipose tissue increases my risk of ovarian cancer. But the baseline risk of ovarian cancer is already small — like 2–3% — and the way she was presenting it felt cherry-picked and fear-based.

She prescribed me a GLP-1 and didn’t explain what it was. This was before the GLP-1 craze. She was like, “You’re going to have to jab yourself.” I’m sitting there thinking, I’m not going to jab myself in the leg.

And the kicker: I leave the appointment, they give me the medication for free, and the person at the front desk goes, “Oh honey, you’re going to look so good.”

I was like… I have to get out of here.

Oh my gosh. I have so much secondhand embarrassment for these people. Commenting on your appearance in a professional healthcare setting — “you’re adorable,” “you’re going to look good” — that is beyond me.

And the reason I was going was because they couldn’t figure out why I had digestive distress and I was on 1000 mg of metformin.

Oh yeah. And even when you’re not on metformin, you’ve had digestive stuff. That metformin symptom life.

Exactly — and now I know it’s probably a long-term complication from my bariatric surgery. But I came in for GI distress… and she sends me out with a GLP-1, which can cause GI distress. It’s asinine.

Yeah, it is.

So, what are some common myths or things doctors miss about PCOS?

I’ll answer that, but first — because I’m fired up — something a lot of people don’t know is that physicians report reluctance to perform pelvic exams on people assigned female at birth in larger bodies. Same with colorectal cancer screenings. I can’t remember the exact statistic on delays, but we don’t fully know how weight stigma affects outcomes, including ovarian cancer outcomes.

We do know there’s a lot of healthcare avoidance because of how people are treated. There’s so much beneath the surface.

And yeah — to your question — one of the biggest harms is doctors telling people to “just cut carbs.” It’s confusing and it often causes more harm, because people then feel out of control with starchy foods. They feel like it’s the last time they can have them, or that they’re “doing it wrong,” and it turns into an all-or-nothing relationship with carbs.

And from the ADHD perspective, trying to figure out the “perfect” meal with fat, carbs, and protein can be overwhelming. So you end up grabbing whatever is easiest — often a carb — and then you layer shame on top of that. That’s where PCOS, neurodivergence, and disordered eating can overlap hard.

Absolutely. And the stakes can feel high with PCOS. If someone is trying to get pregnant and they’re told carbs are “the key,” that pressure intensifies. And if your symptoms don’t feel gender-affirming, that can complicate body image and eating. Irregular cycles can add pressure too. For folks with dieting history, it can become an extremely chaotic and lonely experience.

And Google being different in 2009… I think that’s when Instagram was created.

Oh, interesting. What a fun fact.

Now anyone with a phone can brand themselves as an expert and sell something — even if it’s garbage science.

Yes. Even some big PCOS platforms — including ones backed by doctors and dietitians who I don’t think are practicing ethically — aren’t discussing weight cycling, aren’t discussing the harms of cutting out food groups, and sometimes they promote those behaviors. People end up feeling like they’re failing because they can’t “do it right.”

For me, PCOS was sort of a bridge into body acceptance. It moved me into acceptance faster — like maybe this is just my body, maybe I can’t reverse it. And then when I was told I didn’t actually have PCOS, I was like… wait, now I’m confused. I felt lost.

Body grief is like a cake with layers, and any chronic illness or diagnosis adds another layer.

Yes. That’s often why people work with me. They might feel good about their relationship with food, then get a new diagnosis, and suddenly they’re like, I don’t know how to eat anymore. I don’t know how this impacts everything.

For me, learning about PCOS made things make sense. It helped me understand my body. Approaching it with curiosity — wanting to work with your body instead of being mad at it — can be powerful.

One question from my community: what’s the best weight-neutral management for PCOS? For someone newly diagnosed and overwhelmed, where do you recommend they start?

This is general — it varies person to person — but one foundational step is eating regularly. A lot of people with PCOS struggle with this for many reasons. It doesn’t have to be overnight — it can be gradual.

Another is looking at variety in a neutral way. Not like “eat your fruits and vegetables,” but more like: does what you’re eating feel satisfying? Do you have different components? Sometimes adding more protein can help with energy crashes.

But also — take it with a grain of salt. For some people, focusing on food can be overwhelming or triggering. Context matters.

It’s such a fine line — it can slip into disordered patterns fast.

Yes. If there’s a history of disordered eating or an eating disorder, it’s best to work with someone trained in PCOS and eating disorders, because you can have great intentions and then real life happens and it all falls apart.

And there’s more to management than food. Sleep quality, stress levels, joy, support systems, therapy, body image work. Sometimes people want a formula that’s only food-and-movement focused, but good providers will tell you it’s bigger than that.

And it’s easy to want a formula because rules feel like structure.

Right — and if PCOS has comorbid depression, anxiety, ADHD… those things can be barriers even without PCOS. So it’s not as simple as “pull yourself up by your bootstraps and exercise.” That kind of messaging misses reality.

What helped me turn a corner was shifting away from trying to hack food and movement, and instead prioritizing meeting my needs. Giving myself permission to look at all the ways my needs had to be met.

And the term “self-care” matters here — like Audre Lorde’s framing: self-care as resistance, not the whitewashed “get a mani-pedi” version.

Yes. Social media can sell self-care as shopping and candles and notebooks. You can do those things, sure — but you don’t need to buy things to feel better. Same with trying to hack the system through food and movement. Sustainable change has to be autonomous.

There’s information in the resistance. If it’s hard to do these things, that’s data — not a moral failure. We can build strategy from that. We can’t do that if we’re shaming ourselves into it.

And if you find yourself waiting for the perfect conditions — the perfect notebook, the perfect outfit, the perfect “start” — it’s never going to feel perfect. Sometimes waiting feels safer than doing the hard thing.

Speaking of movement — we hear “joyful movement” everywhere. We know movement can support PCOS management. How would you approach someone who’s still healing their relationship with movement?

It’s okay to be where you are. We don’t need to set a bunch of goals and fix it overnight. With PCOS, I’d say that advice on steroids — because your body may feel better with regular meals, sleep, and stress care, and then movement becomes more accessible when you’re in less pain, less inflamed, and your insulin levels are better supported.

Hold space for where you are.

And even as someone who’s healed my relationship with movement, I feel held by that. Movement isn’t always the thing that brings me joy — hanging out with you does. But movement helps me access joy more often. And as someone with ADHD and decision fatigue, a more regulated movement practice helps my sleep and hunger and reduces the “what should I do” spiral.

Yes. The way joyful movement is often sold is like you’ll always want to move and it’ll always feel exciting. That’s not true for most people. Sometimes I go on a walk and I’m excited. Sometimes I’d rather nap. But I know I usually feel better after, and it doesn’t feel punitive — it feels supportive.

And there’s a difference between pushing yourself and trusting your body. If movement is loaded with guilt and shame — if it’s tied to your humanity or goodness — you may not even get the benefits, because the whole experience is shame-driven.

Exactly. With a history of punitive movement, a “push” can feel like a shove — no autonomy. What we’re talking about is more like an offering: you can do it or you don’t have to. You might feel better after. And it’s okay if you don’t want to.

Some days you still have to throw your body onto the yoga mat, though.

Yes — and that’s real. It’s like laundry. Some days I don’t want to. Some days I’m just not doing it. And for a long time I felt shame about that — like why am I broken? But it’s really about making the system work for me, not forcing myself to work for the system.

And we’re different in this too. Kim will have plans after we hang out and plans tomorrow, and I’m like… this hits my plan quota for the week, I’m done.

I love plans. I love talking on the phone. And in the beginning of our friendship, if I called, Bri would be like, “What’s wrong?” And I’d be like, “I’m just calling to talk.”

And I felt bad when I didn’t answer, but you were like, “I don’t care if you don’t answer. I don’t take it personally. Don’t answer. Just don’t feel bad.”

That was so healing. It made me realize I don’t like phone calls because I hit a breaking point and feel trapped, like I can’t end the conversation. You created an environment where I can say when my energy shifts, and that I can take care of me while you take care of you.

And apparently not everyone uses Instagram with sound on. I did a poll and most people said they watch without sound.

Wait — am I in the majority?

Yes! It blew my mind too.

Anyway — big tangent to come back to this: not everyone is like me. Not everyone wants sound, not everyone loves walking, not everyone experiences movement the same.

So… if you had to explain PCOS like I’m five or ten, how would you explain it?

Okay — I use a visual. Think of your cells like hotels. Your bloodstream is the sidewalk. Glucose is like people trying to get inside the hotel. Insulin is like the doorman who lets them in.

With PCOS, it’s like the doorman is slacking — maybe they’re on TikTok. So upper management looks out and sees all these people stuck on the sidewalk and goes, “Why aren’t they inside?!” So they call in extra doormen from a temp agency. That’s like your body producing more insulin.

Now there’s this influx of insulin and all these people trying to get into the hotels. That helps explain some of the blood sugar ups and downs with PCOS — glucose not getting where it needs to go, energy crashes, feeling exhausted in a way that can feel random.

That’s one of many ways PCOS impacts the body — but it can be a helpful picture.

I hope someone makes a Poodle Science video of this.

Not going to be me.

That’s the difference between us. Kim’s like “I’ll do it right now,” and I’m like “never going to happen.”

Okay — rapid fire: can behavior change alone change the doorman TikTok habits?

Behavior change can help in some ways. It might reduce the number of “people” rushing the hotel, so you don’t need as many temp doormen. But medication and supplements can help too. There are lots of tools.

And that brings me to meds. Why do you think there’s so much shame around medication for PCOS?

It varies, but we live in a world that teaches: if you just do X, Y, and Z with food and movement, you can fix everything. PCOS gets framed like a lifestyle condition, so people think, “I just need to try harder.”

And it’s not like thyroid meds — where it’s obvious you can’t “behavior change” your way into producing thyroid hormone. People don’t always see PCOS that way.

Also, no — weight loss is not a behavior change. Behavior changes can sometimes impact weight, but weight is influenced by so many factors. I get frustrated when weight loss is framed as “simple.”

I want to invite questions from listeners — PCOS, eating disorders, comorbidity questions, or even questions about our friendship. Kim and I will answer in a follow-up episode.

Yes — I love a part two.

One thing I hear a lot from clients is believing they can single-handedly reverse insulin resistance. What are your thoughts?

For many people with PCOS, insulin levels are higher in a way that makes it feel like you’re running uphill in the snow while someone’s throwing tomatoes at you and your shoes are broken and goats are chasing you up the mountain. Your body is working so hard in this area.

It’s not fair to expect yourself to “fix” it alone. And it can be unrealistic — especially over time as your body changes with age.

Two rapid-fire medication questions. First: a lot of people are prescribed birth control for PCOS. Second: metformin and GLP-1s — is there research supporting them for PCOS?

Yes. And quick disclaimer: I’m not a prescriber, so check in with your prescriber.

Birth control can be helpful for some people and not great for others — it varies.

Metformin and GLP-1s can help manage blood sugar. GLP-1s were originally used for diabetes management. When prescribed for blood sugar management, dosing and approach can be different than when they’re prescribed for weight loss.

If we can neutralize GLP-1s and see them as a medication, not the “twisted into weight loss” version, they can be helpful for some people. But if your doctor is prescribing it and telling you you’ll look adorable… that’s not PCOS management.

Also: ask whether the dose is intended for weight loss or for blood sugar management. Ask what markers you should look for to know it’s helping. And if you feel uneasy, get a second opinion.

I literally asked, “How will I know it’s working?” and she said, “You’ll just know.”

That’s wild.

Before we wrap, I want to add one more thought. We talked about behavior changes — adding protein, moving your body, medication, all of it. From my body grief framework: if any of these things are tied to shame, you won’t find sustainable change long-term. That’s a sign there’s still external motivation.

So I ask clients: if you go on the walk, do the Pilates, pair carbs with protein, go on the GLP-1 — and your body size doesn’t change — will that be okay? If your health markers improve but your weight doesn’t change, will that be enough?

A lot of people say yes, and then they do the thing and feel disappointed when their body doesn’t change. Sometimes you won’t know until you’re there — like me with the scale. I avoided weighing myself for years because I didn’t want an exposure that would leave me activated. And then when I finally saw the number, I responded neutrally — but I couldn’t have known that until I did it.

So if managing PCOS feels daunting, I recommend working with a provider who can partner with you in the exploration.

Kim has a provider course for clinicians who want to provide better PCOS care. If you’re a provider in my world, there’s a supervision recording with Kim inside my Body Image Bootcamp library. If you’re a body griever, you can work with me, you can work with Kim — we share clients and we create the trifecta team. We’ll double-team you with trauma-informed PCOS and body grief care.

So with that, Kim — tell people how they can work with you.

You can find me at my website: bodyhonornutrition.com. You can also find me on Instagram at Body Honor Nutrition — and you can definitely find me on Bri’s Instagram.

The best way to reach out is to leave a message through my website.

Amazing. Thank you so much for being here, Kim. I love you.

I love you too. Thank you. Talk to you soon. Bye.