Polycystic Ovary Syndrome and Eating and Weight Disorders

Polycystic ovary syndrome (PCOS) is a complex and multifactorial condition that involves both metabolic and hormonal dysfunctions. Although different diagnostic criteria have been proposed, Rotterdam Consensus in 2003 defined PCOS as a syndrome characterized by at least two among clinical/biochemical hyperandrogenism, oligo-anovulation, and specific ovary ultrasound polycystic appearance. A sometimes overlooked aspect of PCOS is the association with eating disorders (EDs) which is still a matter of debate: in fact, PCOS women have a higher prevalence of reduced mood/depression and anxiety disorders, which are often associated with EDs. Likewise, the ED prevalence increases with obesity, which is part of the PCOS spectrum of clinical manifestations. Several EDs have been reported in PCOS women ranging from anorexia/bulimia to binge eating disorders. Data is scarce, but these may be associated to low levels of self-esteem, strengthening the abnormal eating behavior, and may also be linked to ovary and metabolic dysfunctions and hyperandrogenism which may either cause or exacerbate an underlying PCOS condition. Recognizing these conditions in PCOS women may allow the clinician to optimize treatments for this syndrome.