The Overlap Between Binge Eating Behaviors and Polycystic Ovarian Syndrome: An Etiological Integrative Model

Abstract

Studies indicate that Polycystic Ovarian Syndrome (PCOS) features (e.g. insulin instability, food cravings, overproduction of androgens and menstrual irregularities) are associated with increased appetite, impaired impulse control and feelings of body dissatisfaction. Counter intuitively, binge eating behaviors have been shown to reinforce PCOS symptomatology, precipitating concurrently body dissatisfaction, weight gain, insulin instability and overproduction of androgens. The present systematic literature review aspires to investigate the relationship between binge eating, in the broader context of eating disorder behaviors, and Polycystic Ovarian Syndrome (PCOS), taking into account shared characteristics between EDs (Eating Disorders) and PCOS. To address this aim, the PRISMA guidelines are adopted. A total of 21 studies, which investigated the presence of binge eating in PCOS population and the presence of PCOS in EDs population, were synthesized. Findings suggested that an increased prevalence of binge eating has been reported in women with Polycystic Ovarian Syndrome (PCOS); and that women suffering from BN (Bulimia Nervosa) and BED (Binge Eating Disorder) are more likely to display polycystic ovaries. Further research on their shared liability is required in order to inform more efficient prevention and treatment initiatives for populations presenting with comorbid features.

<p>Binge eating in patients with polycystic ovary syndrome: prevalence, causes, and management strategies</p>

“…To conclude, the current review has shown that women with PCOS have elevated prevalence and risk factors for binge eating behavior, such as overweight and/or obesity,negative body image, depression and anxiety37,80 The suggested links between PCOS and binge eating are not yet well understood,67 but it is likely that they may include metabolic (hyperandrogenism), hormonal (insulin resistance), and psychological (body dissatisfaction, depression, anxiety) factors. The interaction of these factors likely is complex in nature.…”

“…Hyperandrogenism is implicated in PCOS9 and binge eating behavior63,64 and has frequently been linked to the causation of menstrual irregularities, including amenorrhea, and a delay and/or lack of ovulation 65,66. These menstrual irregularities may lead to increased hunger and psychological distress, potentially resulting in an increase in binge eating frequency 61,67…”

“…Most attempts to explain the relationship between PCOS and ED symptomatology, especially binge eating, have rested on the role of insulin 67. This has resulted in the proposition of a hyperglycemia hypothesis.…”

“…Researchers have made a connection between weight cycling, inflammation, and higher insulin levels. High levels of insulin have been shown to cause low blood sugar, which at times can lead to an appetite stimulant and strong cravings for carbohydrates 34,67. The body craves carbohydrates as a physiological need to raise blood sugar to normal levels 36,62,75…”

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

“…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.…”