Abstract
Psychological co-morbidities common in polycystic ovary syndrome (PCOS) may contribute to disordered eating and subsequent weight gain. This cross-sectional study aimed to determine the prevalence of disordered eating and a range of eating disorders and demographic risk factors associated with these behaviours within an Australian group of women with and without PCOS. Data from 899 women with (n = 501) and without (n = 398) PCOS were analysed as possibly indicative of disordered eating or eating disorders using the Eating Disorder Examination Questionnaire (EDE-Q) and The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) criteria. Disordered eating (p = 0.012) but not eating disorders (p = 0.076) were more prevalent in women with PCOS compared to controls. Increased body mass index (BMI) [Odds Ratio (OR): 1.03; 95%; Confidence Interval (CI): 1.01, 1.05, p = 0.012] and older age [OR: 1.05; 95%CI: 1.02, 1.08, p = 0.002] but not PCOS diagnosis [OR: 1.43; 95%CI: 0.96, 2.13 p = 0.078] increased the odds of disordered eating. Increased BMI [OR: 1.04; 95%CI: 1.02, 1.06, p < 0.001] and younger age [OR: -0.95; 95%CI: 0.93–0.95, p < 0.001] but not PCOS diagnosis [OR: 1.38; 95%CI: 0.97, 1.95, p = 0.076] increased the odds of an eating disorder. Clinicians are recommended to screen all women with PCOS for possible disordered eating behaviours, with particular attention to women with elevated BMI.
Highlights
Polycystic ovary syndrome is one of the most common endocrinopathies, affecting 8–13% of women [1] and is associated with a variety of reproductive [2], metabolic [3] and psychological symptoms
The sample of women with polycystic ovary syndrome (PCOS) was significantly older, had higher body mass index (BMI), had a greater portion of Indigenous or Torres Strait Islander people, was more likely to be from European descent and less likely from Asia when compared to controls (Table 1)
Australian women with PCOS were found to have a higher prevalence of disordered eating but not eating disorders when compared to women without PCOS
Summary
Polycystic ovary syndrome is one of the most common endocrinopathies, affecting 8–13% of women [1] and is associated with a variety of reproductive [2], metabolic [3] and psychological symptoms. Women are vulnerable to heightened perceived stress, body dissatisfaction, low self-esteem, disordered eating, anxiety and depression [4,5,6]. Factors such as infertility, hyperandrogenism, elevated body mass index (BMI), metabolic disorders and poor self-esteem have been suggested as possible contributors to adverse psychological outcomes among this population [6,7]. Disturbed eating behaviours have been found to be related to low self-worth or self-esteem primarily based on body weight or shape, disturbed experience of one’s own body, and anxiety towards particular foods and food groups [9]. The EDE-Q is the recommended clinical gold standard screening tool to assess the presence of key cognitive and behavioural features present in both disordered eating and eating disorders, highlighting the need for further psychological assessment
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