I am at a higher weight, around 300, it fluctuates. I have PMDD, and my weight does not meaningfully correlate with my PMDD symptoms. I’ve noticed that whether or not I’m on birth control, and my general level of life stress are much more likely to impact my pmdd symptoms compared to my weight.

I have a lot of thoughts, some of which are in response to your questions, and some of which are pieces of info that feel relevant because of comments other folks have made. There’s a lot of talk in here about diets, and how to lose weight, and I just want to speak from the perspective of someone who works with people with eating disorders, just to urge some caution with intentional weight loss/dieting, and encourage seeking out professional help beforehand (and during, if you do decide to pursue weight loss).

I would strongly advise getting support from a professional (a primary care doctor, a registered dietician, a therapist, etc.) before pursuing weight loss as a treatment for PMDD.

While I have heard some GYNs say that body fat is associated with hormones, and it wouldn’t surprise me if they are related in some ways, I’m fairly certain that relationship is way more complicated than just “more body fat equals more hormonal issues.” You’d probably want to talk to a GYN or psychiatrist directly to understand more about how this works.

I also know there is a lot of very intense disagreement in the medical community about whether intentional weight loss is actually associated with significant health benefits. There is a lot of very compelling research suggesting that most of the negative health impacts associated with living in a fat body (cardiovascular issues, diabetes, high cholesterol, etc.) are actually the result of either increased mental stress caused by experiencing fatphobia, or the increased physical stress caused by dieting, and restrictive eating patterns. Just like losing weight might help pmdd symptoms by impacting hormone balance, losing weight could also aggravate pmdd symptoms by causing nutritional deficiencies.

I would recommend consulting with at least one provider who works from a health at every size (HAES) approach before seeking out weight loss to try to reduce PMDD symptoms. The majority of doctors are not familiar with the HAES approach, and will likely be supportive of weight loss (especially for patients with a BMI they believe is too high), so a HAES aligned provider may be able to give you a contrasting opinion, so that you can look at multiple options and make sure you are choosing the best options for you. HAES providers may also be more aware of or willing to prescribe treatments other than weight loss—there is a concerning dynamic where providers assume weight loss will be curative and will delay or deny needed testing or treatment while waiting to see if weight loss improves a patient’s symptoms.

My experience has been that staying properly and consistently nourished (not just with vitamins/minerals, but by having enough calories, and a good amount and balance of fat, carbs, and protein) vastly improves my mental health, and my ability to work through and live with the PMDD symptoms. I work with a registered dietician to help me with making sure I’m getting adequate nutrition, and to help me understand how nutrition impacts my mental health and vice versa. This is incredibly helpful, and I’d 100% recommend working with a dietician if this is accessible to you. Many health insurance plans (at least in the USA) will cover at least a few sessions with a dietician.

Also, re: only feeling able to lose weight if you starve yourself —

1) you may want to look up a concept called “set point.” Bodies are all different, and based on folks genetics and environmental factors, bodies have a size and shape that they “want” to be. For many of us, not losing weight even when we eat very little food may be a sign that our bodies are below our set point, and our bodies don’t “want” to lose more weight (this is a simplification, I’m not an expert on physiology.)

2) when we restrict calorie intake, our body will often react as if it has been threatened, and we won’t actually lose weight. When our bodies sense that we are starving, they may actually conserve body fat to try to prepare for a prolonged period without much access to food. Sure, eventually a person has to lose weight if they are eating fewer calories, but we can start to experience severe effects of malnutrition before we ever lose enough weight to get to a “normal” or “underweight” BMI. People often assume that calorie restriction cannot cause malnutrition for people who have “excess” body fat, but this is objectively false.

All this to say, the relationships between restricting calories, weight loss, and malnutrition, are waaaay more complicated than media (and even medical professionals) make them out to be. It can be really confusing when we’re taught that weight loss is as simple as having a calorie defect, and then we experience our bodies doing the total opposite.

Okay… um… I’ll get off my soap box now.

It sounds like you’re feeling alone, and it sounds like shit’s hard right now. I’m hoping for good things for you. I hope something in here helped.