Body image concerns in women with polycystic ovary syndrome: a systematic review and meta-analysis

Meri Davitadze; Kashish Malhotra; Halimah Khalil; Meghnaa Hebbar; Chau Thien Tay; Aya Mousa; PCOS SEva team; Helena Teede; Leah Brennan; Elisabet Stener-Victorin; Punith Kempegowda

doi:10.1093/ejendo/lvad110

Body image concerns in women with polycystic ovary syndrome: a systematic review and meta-analysis

Eur J Endocrinol. 2023 Aug 2;189(2):R1-R9. doi: 10.1093/ejendo/lvad110.

Authors

Meri Davitadze^{1

2}, Kashish Malhotra^{2

3}, Halimah Khalil⁴, Meghnaa Hebbar⁵, Chau Thien Tay⁶, Aya Mousa⁶; PCOS SEva team; Helena Teede⁶, Leah Brennan⁷, Elisabet Stener-Victorin⁸, Punith Kempegowda^{2

9}

Collaborators

PCOS SEva team:
Lynne Robinson, Jameela Sheikh, Eka Melson, Tejal Lathia, Chitra Selvan

Affiliations

¹ Department of Endocrinology and diabetes, Clinic NeoLab, Tbilisi, Georgia.
² Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom.
³ Department of Surgery, Dayanand Medical College and Hospital, Punjab, India.
⁴ College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom.
⁵ Department of Endocrinology and diabetes, The Dudley Group NHS Foundation Trust, Dudley, United Kingdom.
⁶ Monash Centre for Health Research and Implementation, Monash University, Melbourne, Australia.
⁷ School of Psychology and Public Health, La Trobe University, Melbourne, Australia.
⁸ Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden.
⁹ Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.

PMID: 37619990
DOI: 10.1093/ejendo/lvad110

Abstract

Objective: To assess differences in body image concerns among women with and without polycystic ovary syndrome (PCOS).

Design: This is a systematic review and meta-analysis.

Methods: Electronic databases (MEDLINE, EMBASE, APA PsychInfo, PUBMED, Web-of-Science Core Collection, and Cochrane Controlled Register of Trials [CENTRAL]) were searched from inception through July 2022. Outcome measures included validated questionnaires reporting on body image concerns. Methodological quality was assessed by the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) system, and included studies were assessed for risk of bias. Meta-analyses were performed using the inverse variance method based on random or fixed effects models (Review Manager, Version 5).

Results: A total of 918 women with PCOS and 865 women without PCOS from 9 studies were included. Meta-analysis of 3 studies using Multidimensional Body-Self Relations Questionnaire Appearance Scale (MBSRQ-AS) showed those with PCOS reported higher dissatisfaction with appearance evaluation and appearance orientation compared to those without PCOS (mean difference [MD] = -0.78, I2 = 0%, P < .00001, and MD = 0.22, I2 = 54%, P = .004, respectively). Meta-analysis of 2 studies showed higher dissatisfaction with overweight preoccupation, lower body area satisfaction, and body weight classification on MBSRQ-AS subscales in those with PCOS compared to those without PCOS (all P < .001). Meta-analysis of 2 studies using the Body Esteem Scale for Adolescents and Adults (BESAA) showed significantly lower scores for the weight subscale in those with PCOS compared to those without PCOS (P = .03).

Conclusions: Those with PCOS experience more significant body image concerns, emphasising the importance of awareness in the clinical care of PCOS. Considering the limited evidence, further studies are warranted to identify drivers and mitigating factors.

Keywords: body dissatisfaction; body dysmorphia; body image concerns; polycystic ovary syndrome.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Adolescent
Adult
Body Image*
Databases, Factual
Female
Humans
Overweight
Polycystic Ovary Syndrome*
PubMed

Grants and funding

National Health and Medical Research Council