PCOS & Eating Disorders
Polycystic ovary syndrome, known as PCOS, is a chronic endocrine disorder with reproductive and metabolic consequences. It is a common condition which impacts 1 in 10 women in the UK although, as it is an under-funded and under-researched condition, many more women may have PCOS and not yet know it (1).
PCOS Symptoms
The symptoms of PCOS include oily skin, acne, excessive hair growth, male pattern hair loss, lack of/irregular periods and trouble getting pregnant although symptoms vary from person to person so everyone’s PCOS can look different (2).
PCOS & Mental Health
Alongside “physical” symptoms, there are a variety of psychological symptoms also associated with PCOS such as anxiety, depression, low self-esteem and poor body image. Plus, people with PCOS are more likely to have an eating disorder; in one study 21% of women with PCOS reported eating disorders compared to 4% of those without PCOS (3).
This increased prevalence could be linked to some of the symptoms of PCOS, such as weight, excessive hair growth, hair loss on the head and acne which may impact one’s self-esteem. Combine this with the slow diagnostic journey and the lack of clear treatment, someone with PCOS’ mental health is very likely to be impacted. The complex interaction between metabolic, hormonal and psychological factors associated with PCOS is likely to exacerbate eating disorder risk (4).
PCOS - Why Dieting is Not the Answer
The common recommendation to lose weight from GPs and other healthcare professionals to manage PCOS can exacerbate disordered eating and eating disorders such as binge eating disorder (BED) and bulimia nervosa (BN) which appear to be the most prevalent disorders in people with PCOS. We know that dieting is a well-established risk factor for developing an eating disorder (5), so despite people with PCOS having an increased risk of developing an eating disorder, people still recommend dieting for women with PCOS - not considering the impact on physical and mental health.
Binge eating disorder is characterised by:
Eating, within any 2-hour period, an amount of food that is larger than what most people would eat in similar periods of time
The binge episode is accompanied by a loss of control over eating
Whereas bulimia’s main features are recurrent episodes of binges and compensatory behaviours such as purging behaviour, excessive exercise and/or dieting which individuals employ to control their body shape and size (4).
The sooner that people with PCOS are diagnosed and treated effectively, using a whole-body approach i.e. looking at stress, sleep, nutrition and movement, the better their quality of life and may preempt someone’s mental health from declining. Although, research has indicated that both PCOS and eating disorder diagnoses are often delayed, involve a large number of health professionals to reach a diagnosis plus leave women confused and underinformed about their diagnosis (6, 7).
If you think you or a loved one has an eating disorder, please contact BEAT.
References
BDA, 2016. Polycystic Ovary Syndrome – the fundamentals[online]. Available from: https://www.bda.uk.com/resource/polycystic-ovary-syndrome-the-fundamentals.html
NHS, 2019. Symptoms Polycystic ovary syndrome[online]. Available from: https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/symptoms/
Månsson M, Holte J, Landin-Wilhelmsen K, Dahlgren E, Johansson A, Landén M. Women with polycystic ovary syndrome are often depressed or anxious—a case control study. Psychoneuroendocrinology. 2008; 33: 1132-1138
Krug I, Giles S, Paganini C. Binge eating in patients with polycystic ovary syndrome: prevalence, causes, and management strategies. Neuropsychiatr Dis Treat. 2019;15:1273-1285.
Hilbert A, Pike KM, Goldschmidt AB, et al. Risk factors across the eating disorders. Psychiatry Res. 2014;220(1-2):500-506. doi:10.1016/j.psychres.2014.05.054
Gibson-Helm M, Teede H, Dunaif A, Dokras A. Delayed Diagnosis and a lack of information associated with dissatisfaction in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2017;102(2):604–612
Hart LM, Granillo MT, Jorm AF, Paxton S. Unmet need for treatment in the eating disorders: a systematic review of eating disorder specific treatment seeking among community cases. Clin Psychol Rev. 2011;31(5):727–735
