Increased prevalence of eating disorders, low self-esteem, and psychological distress in women with polycystic ovary syndrome: a community-based cohort study

Polycystic ovary syndrome is positively associated with eating disorders, low self-esteem, and psychological distress. Concurrent low self-esteem and severe psychological distress further increased the risk of eat- ing disorders.

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Volume 112, Issue 2, Pages 353–361


Chau T. Tay, F.R.A.C.P., Helena J. Teede, Ph.D., Briony Hill, Ph.D., Deborah Loxton, Ph.D., Anju E. Joham, Ph.D.



To evaluate the prevalence of eating disorders in women with polycystic ovary syndrome (PCOS) compared with women without PCOS and examine the relationship between PCOS, body mass index, self-esteem, and psychological distress scores.


Cross-sectional, community-based study.


Not applicable.


A total of 8,467 participants born between 1989 and 1995 in the Australian Longitudinal Study on Women's Health with self-reported PCOS status (PCOS n = 875 vs. non-PCOS n = 7,592).



Main Outcome Measures(s)

Self-reported eating disorders, Rosenberg Self-Esteem Scale, and Kessler psychological distress scale.


Compared with women not reporting PCOS, women reporting PCOS had higher prevalence of eating disorders (11.0% vs. 7.6%), low self-esteem (31.7% vs. 24.2%), and psychological distress (severe psychological distress: 21.0% vs. 13.5%). After adjusting for confounders, women reporting PCOS were more likely to report eating disorders (adjusted odds ratio [OR] 1.6, 95% confidence interval [CI] 1.2–2.0). Low self-esteem and psychological distress were highly correlated and further increased the odds of eating disorders in women reporting PCOS. Polycystic ovary syndrome was significantly associated with low self-esteem and psychological distress but not after adjusting for confounders. Obesity was associated with low self-esteem (adjusted OR 1.5, 95% CI 1.2–1.8) and psychological distress (adjusted OR 1.2, 95% CI 1.0–1.4) but not eating disorders. Underweight women had increased odds for eating disorders (adjusted OR 2.5, 95% CI 1.8–3.4).


Women with PCOS are more likely to report low self-esteem, psychological distress, and eating disorders. Low self-esteem and psychological distress are highly correlated and further increased the risk for eating disorders.

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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.