Polycystic Ovary Syndrome and Increased Risk for Disordered Eating

The risk for reporting disordered eating behaviors was more than 4 times greater among women with polycystic ovary syndrome (PCOS) compared with controls in a recent study, leading researchers to conclude that routine screening for eating disorders may be necessary in this population.

“High scores for disordered eating in our study were associated with worsened quality-of-life scores in all [PCOS Health-Related Quality of Life Questionnaire (PCOSQ)] domains, suggesting that this psychological comorbidity negatively affects many aspects of quality of life,” the researchers wrote.

The cross-sectional study included 148 women with PCOS, as determined by the Rotterdam criteria, and 106 controls seen for routine gynecologic care between 2015 and 2016. Researchers assessed patients via the Eating Disorder Examination-Questionnaire (EDE-Q), Night Eating Questionnaire, Hospital Anxiety and Depression Scale, and PCOSQ.

EDE-Q and Night Eating Questionnaire scores, as well as rates of bulimia nervosa, binge-eating disorder, and night-eating syndrome, served as primary outcome measures.

Compared with controls, women with PCOS were at elevated risk for abnormal EDE-Q global scores, defined as ≥4 (12.16% vs 2.83%; odds ratio [OR]: 4.75; 95% CI, 1.36-16.58). In subscale analysis, women with PCOS were more likely to indicate abnormal scores on shape and weight concerns (P <.001 for both).

Furthermore, 3 factors were linked with an abnormal EDE-Q global score in unadjusted analysis: body mass index (BMI) (OR: 1.06; 95% CI, 1.01-1.11); elevated depression score (OR: 5.43; 95% CI, 1.85-15.88); and elevated anxiety score (OR: 6.60; 95% CI, 2.45-17.76).

PCOS was also associated with abnormal EDE-Q global score after multivariable analysis (adjusted OR: 4.67; 95% CI, 1.16-18.80), and elevated EDE-Q scores were inversely associated with PCOSQ scores (r: −0.57).

In other data, researchers reported that some of the PCOS group experienced bulimia nervosa (6.1%), binge-eating disorder (17.6%), and night-eating syndrome (12.9%); comparable rates of these eating disorders were reported in the control group.

The study’s findings, according to researchers, highlight the irrefutable significance of eating disorders among patients with PCOS.

“Further screening with a validated screening tool or referral to a mental health professional should follow any concerning responses,” the researchers wrote. “Although our study showed significant associations specifically with obesity, anxiety, and depressive symptoms, the high overall prevalence of [eating disorders] suggests the need to screen all women with PCOS for disordered eating.”

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