Disordered eating more common in PCOS, regardless of body weight
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Key takeaways:
- Women with polycystic ovary syndrome are at greater risk for developing any form of disordered eating.
- Risk for disordered eating was high independent of BMI.
Women with polycystic ovary syndrome are more likely to have any form of disordered eating, particularly bulimia or binge eating disorder, suggesting a weight-neutral treatment plan could be beneficial, data show.
“We found that women with PCOS have an increased risk of eating disorders, in particular binge eating disorder and bulimia nervosa,” Laura Cooney, MD, MSCE, associate professor in the department of obstetrics and gynecology at the University of Wisconsin School of Medicine, told Healio. “Importantly, this was found in both women with overweight/obesity and women with a normal weight, suggesting that it is not just excess weight that is driving this association.”
For the systematic review and meta-analysis, researchers evaluated the prevalence of disordered eating or eating disorders among adolescent or adult women with PCOS (n = 28,922) and controls without PCOS (n = 258,619) across 20 studies conducted through 2024. Studies included women diagnosed with PCOS using NIH or Rotterdam diagnostic criteria. Researchers used random effects meta-analyses to estimate pooled ORs or standardized mean differences (SMD) of outcomes in women with PCOS compared with controls.
The findings were published in The Journal of Clinical Endocrinology & Metabolism.
Compared with controls, women with PCOS had higher odds for any eating disorder (OR = 1.53; 95% CI, 1.29-1.82; eight studies), though in sensitivity analyses the finding only persisted for women who were diagnosed with PCOS by Rotterdam criteria (OR = 2.88; 95% CI, 1.55-5.34; four studies).
In analyses stratified by eating disorder type, women with PCOS had higher odds of developing bulimia nervosa, binge eating disorder and disordered eating, but not anorexia nervosa compared with controls. The mean disordered eating scores were higher among women with PCOS vs. controls, with an SMD of 0.52 (95% CI, 0.28-0.77; 13 studies), including when stratified by normal and higher weight BMI.
“Our study informed the updated international PCOS guideline which recommend that clinicians who take care of women with PCOS are aware of the increased risk for disordered eating and that this is taken into account when recommending lifestyle interventions for weight loss to women with PCOS,” Cooney told Healio. “In women with an eating disorder or disordered eating, focusing on diet and exercise can be counterproductive and even worsen the disordered eating. Early screening of at-risk women and referral to providers who specialize in treatment of eating disorders should help improve long-term health of women with PCOS.”
Cooney said more research is needed on the risk factors associated with eating disorders for women with PCOS to allow for earlier diagnosis and treatment.
For more information:
Laura Cooney, MD, MSCE, can be reached at lcooney2@wisc.edu.