Increased risk of disordered eating in polycystic ovary syndrome

Fertil Steril. 2017 Mar;107(3):796-802. doi: 10.1016/j.fertnstert.2016.12.014. Epub 2017 Jan 16.


Objective: To determine the prevalence of eating disorders (EDs) in women with polycystic ovary syndrome (PCOS) and the effects of EDs on health-related quality of life.

Design: Cross-sectional study.

Setting: University practice.

Patient(s): Women with PCOS (Rotterdam criteria; n = 148) and controls seen for routine gynecologic care (n = 106) from 2015 to 2016.

Intervention(s): Eating Disorder Examination-Questionnaire (EDE-Q), Night Eating Questionnaire (NEQ), Hospital Anxiety and Depression Scale, and Health-Related Quality of Life Questionnaire (PCOSQ).

Main outcome measure(s): EDE-Q and NEQ scores, prevalence of bulimia nervosa (BN), binge eating disorder (BED), and night eating syndrome (NES).

Result(s): Women with PCOS were at an increased risk for overall abnormal EDE-Q scores compared with controls (12.16% vs. 2.83%; odds ratio [OR], 4.75; 95% confidence interval [CI], 1.36, 16.58). Clinically significant elevated scores were noted for shape and weight concern. In unadjusted analysis, body mass index (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) were associated with an abnormal EDE-Q global score. In the multivariable model, PCOS was associated with abnormal EDE-Q global score (adjusted OR, 4.67; 95% CI, 1.16, 18.80). Elevated EDE-Q scores inversely correlated with PCOSQ scores (r = -0.57). The prevalence of BN was 6.1%, of BED was 17.6%, and of NES was 12.9% in women with PCOS, with no differences compared with controls.

Conclusion(s): Women with PCOS, especially those with concurrent anxiety symptoms but independent of obesity, have a significantly increased risk of abnormal EDE-Q scores. Our findings suggest the need for routine screening for ED in this population.

Keywords: Polycystic ovary syndrome; anxiety; depression; eating disorder.

MeSH terms

  • Adolescent
  • Adult
  • Anxiety / epidemiology
  • Anxiety / psychology
  • Binge-Eating Disorder / diagnosis
  • Binge-Eating Disorder / epidemiology*
  • Binge-Eating Disorder / psychology
  • Bulimia Nervosa / diagnosis
  • Bulimia Nervosa / epidemiology*
  • Bulimia Nervosa / psychology
  • Case-Control Studies
  • Chi-Square Distribution
  • Comorbidity
  • Cross-Sectional Studies
  • Feeding Behavior*
  • Female
  • Humans
  • Logistic Models
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Pennsylvania / epidemiology
  • Polycystic Ovary Syndrome / diagnosis
  • Polycystic Ovary Syndrome / epidemiology*
  • Prevalence
  • Psychiatric Status Rating Scales
  • Quality of Life
  • Risk Assessment
  • Risk Factors
  • Surveys and Questionnaires
  • Young Adult