Prevalence and Etiology of Eating Disorders in Polycystic Ovary Syndrome: A Scoping Review

Sophie Lalonde-Bester; Mishal Malik; Reihaneh Masoumi; Katie Ng; Simran Sidhu; Mahua Ghosh; Donna Vine

doi:10.1016/j.advnut.2024.100193

Prevalence and Etiology of Eating Disorders in Polycystic Ovary Syndrome: A Scoping Review

Adv Nutr. 2024 Apr;15(4):100193. doi: 10.1016/j.advnut.2024.100193. Epub 2024 Feb 24.

Authors

Sophie Lalonde-Bester¹, Mishal Malik¹, Reihaneh Masoumi¹, Katie Ng¹, Simran Sidhu¹, Mahua Ghosh², Donna Vine³

Affiliations

¹ Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Alberta, Canada.
² Division of Endocrinology and Metabolism, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
³ Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Alberta, Canada. Electronic address: donna.vine@ualberta.ca.

Abstract

Polycystic ovary syndrome (PCOS) is the most common endocrine-metabolic disorder affecting females across the lifespan. Eating disorders (EDs) are psychiatric conditions that may impact the development of PCOS and comorbidities including obesity, metabolic syndrome, and type 2 diabetes. The aim of this scoping review was to determine the prevalence of EDs and disordered eating, and to review the etiology of EDs in PCOS. The review was conducted using search terms addressing PCOS, EDs, and disordered eating in databases, including PubMed, Scopus, PsycINFO, and CINAHL. Structured interviews, self-administered questionnaires, chart review, or self-reported diagnosis were used to identify EDs in 38 studies included in the review. The prevalence of any ED in those with PCOS ranged from 0% to 62%. Those with PCOS were 3-6-fold more likely to have an ED and higher odds ratios (ORs) of an elevated ED score compared with controls. In those with PCOS, 30% had a higher OR of bulimia nervosa and binge ED was 3-fold higher compared with controls. Studies were limited on anorexia nervosa and other specified feeding or ED (such as night eating syndrome) and these were not reported to be higher in PCOS. To our knowledge, no studies reported on avoidant/restrictive food intake disorder, rumination disorder, or pica in PCOS. Studies showed strong associations between overweight, body dissatisfaction, and disordered eating in PCOS. The etiologic development of EDs in PCOS remains unclear; however, psychological, metabolic, hypothalamic, and genetic factors are implicated. The prevalence of any ED in PCOS varied because of the use of different diagnostic and screening tools. Screening of all individuals with PCOS for EDs is recommended and high-quality studies on the prevalence, pathogenesis of specific EDs, relationship to comorbidities, and effective interventions to treat ED in those with PCOS are needed.

Keywords: anorexia nervosa; binge eating disorder; bulimia nervosa; eating disorder; hyperandrogenism; insulin resistance; polycystic ovary syndrome.

Publication types

Review

MeSH terms

Bulimia Nervosa* / epidemiology
Bulimia Nervosa* / psychology
Diabetes Mellitus, Type 2*
Feeding and Eating Disorders* / complications
Feeding and Eating Disorders* / epidemiology
Female
Humans
Polycystic Ovary Syndrome* / complications
Polycystic Ovary Syndrome* / epidemiology
Prevalence