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

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 co-morbidities 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%-62%. Those with PCOS were 3-6-fold more likely to have an ED and higher odds ratios of an elevated ED score compared to controls. In those with PCOS, 30% had a higher odds ratio of bulimia nervosa and binge eating disorder was 3-fold higher compared to controls. Studies were limited on anorexia nervosa and other specified feeding or eating disorder (such as night eating syndrome) and these were not reported to be higher in PCOS. 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 etiological development of EDs in PCOS remains unclear however psychological, metabolic, hypothalamic, and genetic factors are implicated. The prevalence of any ED in PCOS varied due to 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 co-morbidities, and effective interventions to treat ED in those with PCOS are needed.