Disordered Eating Behaviours and Eating Disorders in Women in Australia with and Without Polycystic Ovary Syndrome: A Cross-Sectional Study

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.

Providing lifestyle advice to women with PCOS: an overview of practical issues affecting success

“…A recent Australian study explored the cross-sectional relationship between disordered eating or eating disorders and a range of demographic risk factors (PCOS diagnosis, body mass index [BMI], age, country of birth). Authors reported that disordered eating, but not eating disorders, were more prevalent in women with PCOS when compared with controls [57]. Of the disorders, binge-eating disorder (BED) was the most commonly reported but not significantly different to controls.…”

“…BED is the most common form of eating disorders within the general population and may explain the frequency and lack of significance between the two groups [58]. The crosssectional study also reported higher BMI and older age increased the odds of disordered eating whilst increased BMI and younger age increased the odds of an eating disorder [57]. It is important to highlight that the controls were psychology university students and may not be a true representation of the general population.…”

Obesity and the Risk of Infertility, Gestational Diabetes, and Type 2 Diabetes in Polycystic Ovary Syndrome

“…This highlights that lean women with PCOS have an intrinsic IR, 43 which is compounded by an extrinsic/lifestyle-related IR in overweight/obese women with PCOS. 7,8 Finally, chronic inflammation is known to contribute to HA among women with PCOS, which itself has been reported to exacerbate hyperglycemia. [106][107][108] Cellular stress triggers cellular inflammation, causing immunity cells to mitigate, infiltrate, and amplify β-cells inflammation.…”

“…1-3 PCOS is associated with a variety of reproductive, 4 metabolic, 5 and psychological symptoms. [6][7][8] Women diagnosed with PCOS are also likely to experience excess weight, with 60% being overweight or with obesity. 9 The exact etiology of PCOS is yet to be determined; however, insulin resistance (IR) and hyperandrogenism (HA) are thought to underpin the disorder, all of which are exacerbated by obesity.…”

An Analysis on the Implementation of the Evidence-based PCOS Lifestyle Guideline: Recommendations from Women with PCOS

“…2 Women with PCOS could experience a range of symptoms, including metabolic, reproductive and psychological health challenges. [3][4][5][6][7][8] There are also longer-term health consequences, such as increased risks of metabolic syndrome, type 2 diabetes and cardiovascular disease. 4,9 Women with PCOS are more likely to be overweight and obese compared with age-matched controls.…”