Binge eating in patients with polycystic ovary syndrome: prevalence, causes, and management strategies

Figures & data

Table 1 Prevalence of binge eating symptoms and EDs in PCOS

Study	Sample size	PCOS Criteria		ED Screening tool	ED’s type	Age (years), Mean ± SD	BMI (kg/m^2), Mean ± SD	Prevalence rate of EDs in PCOS (%)	Prevalence of subclinical ED symptoms (%)
PCOS		Comparison							PCOS	Comparison
Annagur et al 2015^Citation17	88	0	PCOS Rotterdam criteria	SCID	ED’s	P:22.26 ±3.55	P: 25 ±5.35	BED: 6.8% AN: 0% BN: 2.30%	Not reported	Not reported
Barr et al 2011^Citation43	210	N/A	Self-reported diagnosis of PCOS	EMA	Eating behavior	P: 32.6±6.3	P: 27.4±7.3	Not reported	Fat consumption was significantly higher in women with PCOS; Mean dietary GI
Barry et al 2011^Citation48	24	299	PCOS Rotterdam criteria	Eating behavior interview^c	Subclinical EDs	P:31.3±7.7 C: 24.5±9.1	P: 29.5±6.3 C: 21.1±3.6	Not reported	Binge and/or comfort eating: 58%	Binge and/or comfort eating: 32%
Batcheller et al 2013^Citation38	6 (PCOS Group BMI >30) 5 (PCOS Group BMI <25)	10	PCOS Rotterdam criteria	DSM-IV Criteria for BED	BED	29.7±3.0 (not separated by group)	28.0±7.5 (not separated by group)	BED: 0%^a	Subclinical BED 50% (BMI >30) Subclinical BED 0% for BMI <25)	Subclinical BED: 0%
Berenson et al 2014^Citation51	24	N/A	PCOS Questionnaire	BES	BED			Not reported	Moderate/severe BED symptoms: 50%	N/A
Bernadett et al 2016^Citation35	95	100	PCOS Rotterdam criteria	EAT-26	Eating behavior	P:29.8±4.9 C:27.6±6.6	P: 26.1±2.6 C: 22.1±3.6	AN: 0%^a BN: 5.3%^a	Abnormal score: 43.0%	Abnormal score: 12.4%
Cesta et al 2016^Citation18	24,385	243,850	ICD codes in the Swedish National Patient Register ^d	ICD	EDs	Not reported	Not reported	Any ED: 2.45% AN:0.57% BN: 0.73%	Not reported	Not reported
Hollinrake et al 2007^Citation15	103	103	PCOS Rotterdam criteria	PRIME-MD PHQ	Eating behavior	P: 29.8±6.2 C: 30.7±8.5	P: 34.9±8.5 C: 25.4±4.7	BED: 12.6%^a	Not reported	Not reported
Jahanfar et al 1995^Citation49	42	52	Transabdominal ultrasound examination	BITE	BN	P: 27.55±9.31 C: 30.42±8.59	P: 23.23±5.06 C:23.22±3.67	Not reported	Abnormal BITE score: 21%	Abnormal BITE score: 2.5%
Jeanes et al 2017^Citation34	45	40	Self-reported diagnosis of PCOS	BITE	Binge eating symptoms	P: 31.3±5.6 C: 28.3±8.5	P: 22.5±1.8 C: 21.8±1.6	Not reported	Abnormal BITE Score: 36%	Abnormal BITE Score: 12%
Jensterle et al 2015^Citation45	36	N/A	Established diagnosis according to National Institute of Child Health and Human Development (NICHD) criteria^e	TFEQ-R18	Subclinical EDs	P:31.2±7.8	P:38.7±0.1	Not reported	High scoring in Three-Factor Eating Questionnaire (TFEQR18) in all the sample: Uncontrolled eating score 36.8±24.5 Emotional eating score 49.9±33.3
Karacan et al 2014^Citation37	42	50	PCOS Rotterdam criteria	EAT-26	Eating behavior	P: 19.1±2.3 C: 19.7±2.1	P: 22.4±3.8 C: 21.0±3.82	Not reported	EAT-26 Abnormal Score: 35.7%	EAT-26 Abnormal Score: 30.8%
Kerchner et al 2009^Citation46	60	N/A	PCOS Rotterdam criteria	PHQ	BED	P:32±6.0	P: 33.9±8.3	BED: 23.3%	Not reported	Not reported
Larsson et al 2016^Citation36	72	30	PCOS Rotterdam criteria	EAT-40	Eating behavior	P:30.2±4.4 C:27.8±3.6	P: 28.5±7.2 C: 24.6±5.0	Not reported	EAT-40 Abnormal Score: 8.3%	EAT-40 Abnormal Score: (3.3%
Lee et al 2017^Citation8	148	106	PCOS Rotterdam criteria	EDE-Q NEQ	Eating behavior Night Eating Syndrome	P: 28.1±5.2 C: 31.9±8.1	P: 33.9±9.9 C: 26.8±7.5	AN: 0%^a BN: 6.1%^a BED:17.6%^a NES:12.9%^a	Abnormal EDE-Q Score: 12.2% Abnormal NEQ Score: 12.9%	Abnormal EDE-Q Score: 2.8% Abnormal NEQ Score 6.6%
Mansson et al 2008^Citation39	49	49	PCOS Rotterdam criteria	MINI	Eating Disorders	P: 35.9±10.4 C: 35.9±10.4	P: 29.1±7.4 C: 23.5±3.0	Any ED: 21%^b BN: 12%	Not reported	Not reported
McCluskey et al 1991^Citation42	152	109	Transabdominal ultrasound scan plus one additional feature including: menstrual irregularity, acne, hirsutism, BMI >25 kg/m^2, raised serum testosterone (>3 nmol/L), or raised LH (>10 IU/L)	BITE	BN	P:27.5±6.4 C:32.3±8.4	P:24.4±5.1 C: 25.4±5.4	BN: 6%^a	Abnormal BITE score: 33.33%	Abnormal BITE score: 14%
Michelmore et al 2001^Citation44	74	150	Transabdominal ultrasound scan plus one additional feature including: menstrual irregularity, acne, hirsutism, BMI >25 kg/m^2, raised serum testosterone (>3 nmol/l), or raised LH (>10 IU/l)	EDE	Eating behavior	21.5 (not separated by group)	22.9 (not separated by group)	AN: 0% BN: 0% BED: 4%	Not reported	Not reported
Morgan et al 2008^Citation54	80	N/A	Not reported	SCID	EDs	P: 29.0±5.0	Not reported	BN: 12.6% EDNOS: 22.5% AN: 1.3%	Not reported	Not reported
Sbaragli et al 2008^Citation52	81 infertile women (5 with PCO)	70	Not reported	SCID	BED	P: 35.0±5.0 (not separated by clinical groups) C: 31.0±4.0	Not reported	BED: 15% (in PCOS subgroup)	Not reported	Not reported
Wylie et al 2009^Citation47	131	N/A	Not reported	Food diary	Eating behavior	P: 32.0±6.1	P: 27.9±7.9	Not reported	Consumed significantly more sweet snacks compared to savory snacks over 7-day period.

Notes: ^{a =}Diagnosis established by fulfillment of questionnaire criteria – not structured diagnostic assessment. ^b=Any ED based on MINI DSM-IV criteria (includes AN, BN, and AN binge/purge type). ^c=Eating behavior was assessed by asking (a) kind of diet and (b) to classifying eating behavior in: healthy eating, unhealthy, binge and/or comfort eating, or “other”. ^d=Identified by having at least one of the PCOS ICD codes recorded in the Swedish National Patient Register (ICD-9: 256E; ICD10: E28.2) between 1990 and 2013. ^e=PCOS was defined as the combined presence of androgen excess and oligo-anovulation in the absence of all other reasons for anovulatory infertility.

Abbreviations: AN, Anorexia Nervosa; BED, Binge Eating Disorder; BN, Bulimia Nervosa; BES, Binge Eating Scale; BITE, Bulimia Investigation Test (Edinburgh); C, Comparison group; EDE, Eating Disorder Examination; EDE-Q, Eating Disorder Examination Questionnaire; EAT, Eating Attitudes Test; MINI, Mini-International Neuropsychiatric Interview; NES, Night Eating Syndrome; P, PCOS group; NEQ, Night Eating Questionnaire; PHQ, Patient Health Questionnaire; PCO, Polycystic Ovaries; SCID, Structured Clinical Interview for DSM; TFEQ, Three-Factor Eating Questionnaire.

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