Women with PCOS at higher risk developing disordered eating, study finds

Women with hormonal condition PCOS could be at about 50% more risk of developing eating disorders, including bingeing, according to a new study. Affecting roughly one in eight to 10 women in their reproductive ages globally, polycystic ovarian syndrome (PCOS) is marked by higher-than-usual testosterone levels and related symptoms, including irregular menstrual cycles and excess body hair.

The analysis is the first to confirm "an increased risk of specific eating disorders, including bulimia nervosa, commonly called bulimia, and binge eating disorder" among women affected by the hormonal condition, according to first author Laura Cooney, an associate professor at the University of Wisconsin, US.

Bulimia is marked by episodes of binge-eating, followed by resorting to means to avoid weight gain, which can include induced vomiting, excessive exercising or fasting.

Women having PCOS are known to be at a higher risk of experiencing metabolic disorders, such as diabetes, and reproductive issues, including infertility. "Many women with PCOS experience weight stigma, and that can be detrimental to mental health generally, and contribute to disordered eating," Cooney said.

For the study, published in The Journal of Clinical Endocrinology and Metabolism, the authors looked at results from 20 cross-sectional studies across nine countries. Data from close to 29,000 women with PCOS and over 2.5 lakh women not having the condition were included in the analysis.

"Individuals with PCOS had higher odds of any eating disorder, which persisted in studies where PCOS was diagnosed by Rotterdam criteria," the authors wrote.

According to the Rotterdam criteria, women are diagnosed with PCOS when they have two of these three key features -- increased numbers of ovarian follicles containing immature eggs (called polycystic ovaries) seen on ultrasound, slightly higher levels of testosterone or related symptoms like excess body hair, and irregular or no menstrual periods.

Looking at the body mass indices (BMI) of women, the researchers found that both women with normal and those having a higher weight had a higher risk of disordered eating, suggesting that the risk of developing eating disorders did not depend on BMI.

"Our findings emphasise the importance of screening women with PCOS for eating disorders before clinicians share any lifestyle advice," Cooney said.

"The lifestyle modifications we often recommend for women with PCOS -- including physical activity, healthy diet and behaviour modifications -- could hinder the recovery process for eating disorders. Health care providers need to be vigilant about screening for eating disorders in this population," Cooney said.