Increased prevalence of eating disorders, low self-esteem, and psychological distress in women with polycystic ovary syndrome: a community-based cohort study

Abstract

Intervention(s): None. Main Outcome Measures(s): Self-reported eating disorders, Rosenberg Self-Esteem Scale, and Kessler psychological distress scale. Result(s): Compared with women not reporting PCOS, women reporting PCOS had higher prevalence of eating disorders (11.0% vs. 7.6%), low self-esteem (31.7% vs. 24.2%), and psychological distress (severe psychological distress: 21.0% vs. 13.5%). After adjusting for confounders, women reporting PCOS were more likely to report eating disorders (adjusted odds ratio [OR] 1.6, 95% confidence interval [CI] 1.2-2.0). Low self-esteem and psychological distress were highly correlated and further increased the odds of eating disorders in women reporting PCOS. Polycystic ovary syndrome was significantly associated with low self-esteem and psychological distress but not after adjusting for confounders. Obesity was associated with low self-esteem (adjusted OR 1.5, 95% CI 1.2-1.8) and psychological distress (adjusted OR 1.2, 95% CI 1.0-1.4) but not eating disorders. Underweight women had increased odds for eating disorders (adjusted OR 2.5, 95% CI 1.8-3.4). Conclusion(s): Women with PCOS are more likely to report low self-esteem, psychological distress, and eating disorders. Low selfesteem and psychological distress are highly correlated and further increased the risk for eating disorders. (Fertil Steril Ò 2019;112: 353-61. Ó2019 by American Society for Reproductive Medicine.) El resumen está disponible en Español al final del artículo.

Risk Factors of Overweight and Obesity Related to Diet and Disordered Eating Attitudes in Adolescent Girls with Clinical Features of Polycystic Ovary Syndrome

“…The aim of this study was also to assess the differences in the diet between lean and overweight and obese patients, as well as in the occurrence of DEA. As the reports of recent studies confirm that women with PCOS also have an increased risk of their occurrence [14,15,43]. The main goal of our study was to check whether the energy value of the diet and macronutrient intake, as well as the presence of DEA, are associated with an increased ratio of overweight and obesity in adolescents.…”

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

“…Polycystic ovary syndrome is one of the most common endocrinopathies, affecting 8–13% of women [1] and is associated with a variety of reproductive [2], metabolic [3] and psychological symptoms. Of the psychological outcomes, women are particularly vulnerable to heightened perceived stress, body dissatisfaction, low self-esteem, disordered eating, anxiety and depression [4,5,6]. Factors such as infertility, hyperandrogenism, elevated body mass index (BMI), metabolic disorders and poor self-esteem have been suggested as possible contributors to adverse psychological outcomes among this population [6,7].…”

“…Women with PCOS have been reported to have a higher prevalence of both disordered eating behaviours [10,11,12] and eating disorders [6,13] compared to women without PCOS in the majority of but not all [14,15,16,17] prior literature. This includes a meta-analysis reporting an odds ratio of 3.05 for women with PCOS having disordered eating behaviours [12].…”

“…Of abnormalities in disordered eating behaviours, binge eating is of particular concern, being exhibited in 58% of women with PCOS compared to 32% of controls [18]. The literature examining eating disorders has predominantly focused on particular eating disorders such as binge eating disorder [19] or bulimia nervosa [13,20], with only a few studies assessing a variety of eating disorders [6,21,22,23]. There is, therefore, a lack of research examining the prevalence of disordered eating and the range of eating disorders in women with PCOS, particularly in an Australian cohort.…”

“…Immigrants have also been reported to have a reduced risk of eating disorders compared to non-immigrant populations [28]. Within a PCOS context, current literature focuses on psychological comorbidities such as low self-esteem and severe psychological distress as plausible risk factors for the development of disordered eating and eating disorders [6,12,15,29]. There are, however, currently no studies identifying demographic factors that may link PCOS to disordered eating or eating disorders, including country of birth, Indigenous (Aboriginal or Torres Strait Islander) status, BMI or age.…”