TL;DR: I (29F) have PCOS and progressively worsening low appetite that is not helped or stimulated by drinking water, exercise, or other external/behavioral factors. It feels like I can't eat enough to maintain living with any real quality of life, and I feel chronically satiated. I do not have the energy to function as a human person.
I (29F) was officially diagnosed with PCOS within the past year after eliminating a few other potential conditions. Among the host of symptoms I have with PCOS, I actually have a very LOW appetite to the point where I usually have to make myself eat once or twice per day, normally in the evening. When I say "make myself eat", I mean literally force myself to consume something against my own will, and a lot of times, even the idea of food is enough to make me feel incredibly nauseous. Most of the time, I am only physically capable of eating anywhere from a few bites to about half of what is on my plate without feeling like I'm gorging myself and making myself sick, even when the portion sizes are small to moderate. If I go out to eat, I bring home leftovers without fail and usually have enough to squeeze 2-4 meals out of a single, normal-sized restaurant portion. I can easily go 24-48 hours without eating at all because my hunger and thirst cues are garbage (drinking a sufficient amount of water does not increase my appetite either, by the way). I have tried Metformin to treat the insulin resistance symptoms, but it saps the tiny bit of appetite I have left, and makes eating impossible and nausea unbearable with no real results, so I was never on it for very long.
I have tried to look into the subject more online, but all the resources I find are about insatiable/overly high appetite seen with PCOS/IR most of the time. This whole phenomenon started about 5-6 years ago, about 3-4 years before I started exhibiting the bulk of my PCOS symptoms. This has gradually worsened over time, and I'm starting to feel absolutely miserable. It has never been this bad before. I never have any energy to do anything, yet my weight from not really eating stays the same. It feels like I am chronically full (as in "in a state of constant satiety"). I used to suffer from constipation for a long time, but that hasn't really been a problem in the last few years. I thought that fixing that would make things better, but it hasn't.
I don't know what to do anymore. I know that going to the doctor will start the good old "diet and exercise" convo again, but I can't maintain any such routine when it is physically impossible for me to consume enough calories to function at all as a normal adult human. I tried to start it up again about a month or two ago and failed shortly thereafter because I was so exhausted, and exercise was doing nothing to stimulate my appetite. I couldn't eat anywhere near the amount of protein that I needed to build muscle mass.
I love food, and even eating healthy and exercising, but I'm the most depressed I've ever been. I have lost all motivation to eat due to this. I'm irritable as hell, sad all the time, and feel exasperated and drained from the moment I wake up. I can barely do anything anymore outside of forcing myself to go to work five days a week. I come home and lie in bed and don't do much else. I'm also throwing away so much money and wasting so much food because I can't eat enough fast enough to keep things from going bad (I live alone).
Any help or advice would be useful. I'm happy to answer any follow-up questions. I just can't live this way anymore.