TOP LINE:
Women with polycystic ovary syndrome (PCOS) are more likely to have some eating disorders, including bulimia nervosa, binge eating, and disordered eating, regardless of their weight.
METHODOLOGY:
- A small systematic review and meta-analysis showed that adult women with PCOS were more likely to have eating disorders and eating disorder scores than women without PCOS.
- As part of the 2023 update of the international evidence-based guideline for the assessment and treatment of PCOS, the same researchers updated and expanded their analysis to include adolescents and certain eating disorders and to assess the impact of body mass index (BMI) on these risks.
- They included 20 cross-sectional studies with 28,922 women with PCOS and 258,619 women without PCOS; PCOS was diagnosed using either the National Institutes of Health or Rotterdam criteria and by patient self-report or hospital records.
- Screening for eating disorders was performed using a validated eating disorder screening tool or diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorders.
- Outcomes of interest included prevalence of any eating disorder, individual eating disorders, eating disorder scores, and average eating disorder scores.
TAKE AWAY:
- Women with PCOS were 53% more likely to have an eating disorder (odds ratio (OR): 1.53; 95% CI: 1.29–1.82; 8 studies) than controls without PCOS.
- The odds of bulimia nervosa (OR 1.34; 95% CI 1.17–1.54; 5 studies) and binge eating disorder (OR 2.09; 95% CI 1.18–3.72; 4 studies) were higher in women with PCOS, but no significant association was found for anorexia nervosa.
- Mean eating disorder scores and the odds of having an eating disorder were higher in women with PCOS (standardized mean difference (SMD): 0.52; 95% CI: 0.28–0.77; 13 studies; and OR: 2.84; 95% CI: 1.0–8.04; 8 studies, respectively).
- Eating disorders were higher in both the normal weight and overweight categories (BMI
IN PRACTICE:
“Our findings underscore the importance of screening for eating disorders in women with PCOS before physicians provide lifestyle advice,” the lead author said in a press release. “The lifestyle changes we often recommend to women with PCOS – including physical activity, healthy eating, and behavioral changes – could hinder the recovery process from eating disorders.”
SOURCE:
The study was led by Laura G. Cooney, MD, MSCE, University of Wisconsin, Madison, Wisconsin, and published online August 8, 2024 in The Journal of Clinical Endocrinology and Metabolism.
RESTRICTIONS:
The included studies were observational, which limited the ability to account for potential confounding factors. The cross-sectional design of the included studies prevented the determination of whether the diagnosis of PCOS or eating disorder symptoms occurred first. Studies from 10 countries were included, but limited data from developing or Asian countries limit the generalizability of the results.
DISCLOSURE:
This study was conducted to support recommendations for the International Evidence-Based Guideline on PCOS 2023, funded by the Australian National Health and Medical Research Council, the Centre for Research Excellence in Polycystic Ovary Syndrome and other sources. The authors declared no conflicts of interest.
Several editorial tools, including AI, were used to create this article. Human editors reviewed the content before publication.
