Research published in The Journal of Clinical Endocrinology & Metabolism shows that women with polycystic ovary syndrome (PCOS) are at a higher risk of developing bulimia, binge eating disorder and other forms of disordered eating. PCOS is one of the most common reproductive and metabolic conditions: it affects roughly one in eight women and is associated with increased risks of diabetes, fertility challenges, anxiety and depression.
Women are diagnosed with PCOS when they have at least two of its three defining features:
-
Higher numbers of ovarian follicles containing immature eggs: known as polycystic ovaries: visible on ultrasound
-
Elevated testosterone levels or clinical signs of excess testosterone, such as increased body hair
-
Irregular or absent menstrual periods
The new findings come from a large systematic review and meta-analysis examining 20 cross-sectional studies across nine countries. In total, the research analyzed data from 28,922 women with PCOS and 258,619 women without the condition.
“This analysis is the first time we’ve been able to confirm an increased risk of specific eating disorders, including bulimia nervosa: commonly called bulimia: and binge eating disorder,” says lead author Laura Cooney, M.D., M.S.C.E., associate professor at the University of Wisconsin in Madison. “Many women with PCOS experience weight stigma, and that can be detrimental to mental health generally and contribute to disordered eating.”
When researchers compared women by body-mass index (BMI), both normal-weight women and those with higher weight had elevated disordered eating scores compared to women without PCOS. Cooney explains that this pattern suggests the association is not dependent on BMI.
“Our findings emphasize the importance of screening women with PCOS for eating disorders before clinicians share any lifestyle advice,” Cooney says. Lifestyle recommendations often given to women with PCOS: including exercise, nutrition changes and behavioral modifications: could complicate recovery for those already experiencing disordered eating. “Health care providers need to be vigilant about screening for eating disorders in this population.”
The analysis did not find a clear association between PCOS and anorexia. However, the researchers note that fewer studies have focused on anorexia in women with PCOS, and clinicians should always maintain a high level of awareness for any type of disordered eating during PCOS evaluation.
This research was conducted to inform the 2023 International Evidence-based Guideline in PCOS, funded by the Australian National Health and Medical Research Council. Partner organizations include the Endocrine Society, the American Society for Reproductive Medicine, the European Society of Endocrinology and the European Society of Human Reproduction and Embryology.
