Increased risk of disordered eating in polycystic ovary syndrome

Compared with healthy controls, women with polycystic ovary syndrome are at increased risk of abnormal eating disorder scores, especially when comorbid anxiety is present. We recommend routine screening in this population.

Volume 107, Issue 3, Pages 796–802


Iris Lee, B.A., Laura G. Cooney, M.D., Shailly Saini, M.D., Maria E. Smith, B.S., Mary D. Sammel, Sc.D., Kelly C. Allison, Ph.D., Anuja Dokras, M.D., Ph.D.



To determine the prevalence of eating disorders (EDs) in women with polycystic ovary syndrome (PCOS) and the effects of EDs on health-related quality of life.


Cross-sectional study.


University practice.


Women with PCOS (Rotterdam criteria; n = 148) and controls seen for routine gynecologic care (n = 106) from 2015 to 2016.


Eating Disorder Examination-Questionnaire (EDE-Q), Night Eating Questionnaire (NEQ), Hospital Anxiety and Depression Scale, and Health-Related Quality of Life Questionnaire (PCOSQ).

Main Outcome Measure(s)

EDE-Q and NEQ scores, prevalence of bulimia nervosa (BN), binge eating disorder (BED), and night eating syndrome (NES).


Women with PCOS were at an increased risk for overall abnormal EDE-Q scores compared with controls (12.16% vs. 2.83%; odds ratio [OR], 4.75; 95% confidence interval [CI], 1.36, 16.58). Clinically significant elevated scores were noted for shape and weight concern. In unadjusted analysis, body mass index (OR, 1.06; 95% CI, 1.01, 1.11), elevated depression score (OR, 5.43; 95% CI, 1.85, 15.88), and elevated anxiety score (OR, 6.60; 95% CI, 2.45, 17.76) were associated with an abnormal EDE-Q global score. In the multivariable model, PCOS was associated with abnormal EDE-Q global score (adjusted OR, 4.67; 95% CI, 1.16, 18.80). Elevated EDE-Q scores inversely correlated with PCOSQ scores (r = −0.57). The prevalence of BN was 6.1%, of BED was 17.6%, and of NES was 12.9% in women with PCOS, with no differences compared with controls.


Women with PCOS, especially those with concurrent anxiety symptoms but independent of obesity, have a significantly increased risk of abnormal EDE-Q scores. Our findings suggest the need for routine screening for ED in this population.

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