Women with polycystic ovary syndrome showed higher scores for emotional and uncontrolled eating at midlife compared with women without polycystic ovary syndrome, according to a population-based cohort study.

In the study, published in Fertility and Sterility, investigators analyzed the eating behaviors of 251 women with polycystic ovary syndrome (PCOS) and 935 women without PCOS at age 46 years.

The study utilized data from the Northern Finland Birth Cohort 1966, identifying women with PCOS at age 31years using the Rotterdam criteria. PCOS diagnosis required at least two of the following: clinical or biochemical hyperandrogenism, oligomenorrhea, or elevated antimüllerian hormone levels (≥ 3.2 ng/mL). The investigators assessed eating behaviors at age 46 years using the Three-Factor Eating Questionnaire-18.

Women with PCOS scored higher on emotional eating (39.0 ± 29.9 vs 33.1 ± 27.8) and uncontrolled eating (30.7 ± 19.4 vs 26.7 ± 18.2) compared with women without PCOS. Cognitive restraint scores showed no statistically significant difference (45.9 ± 18.5 vs 46.6 ± 18.6).

Different PCOS phenotypes demonstrated distinct patterns. Women with A+B phenotype (hyperandrogenism and oligomenorrhea) exhibited elevated scores in both emotional and uncontrolled eating. The C-phenotype (hyperandrogenism with elevated antimüllerian hormone) showed higher uncontrolled eating scores compared with both women without PCOS and those with D-phenotype (oligomenorrhea with elevated antimüllerian hormone).

Among women with PCOS at age 46 years:

• Perception of overweight predicted emotional eating (B = 11.96, 95% confidence interval [CI] = 2.81–20.29)
• History of weight loss attempts predicted uncontrolled eating (B = 6.06, 95% CI = 1.05–10.83)
• Higher psychological distress at age 31 predicted scoring in the highest quartile of emotional eating (adjusted odds ratio [OR] = 2.85, 95% CI = 1.19–6.85) and uncontrolled eating (adjusted OR = 4.37, 95% CI = 1.77–10.80) at age 46 years.

The study population showed metabolic differences:

• Women with PCOS had higher BMI, waist circumference, free androgen index, and HOMA-IR values
• 67% of A+B phenotype women reported multiple weight loss attempts vs 47% of women without PCOS
• 90% of A+B phenotype women reported perception of being overweight vs 70% of women without PCOS.

Among participants with waist circumference ≥ 80 cm, women with PCOS demonstrated higher scores for emotional eating (43.1 ± 30.5 vs 38.1 ± 28.6) and uncontrolled eating (33.0 ± 20.5 vs 29.2 ± 18.4) compared with women without PCOS.

Study limitations included:

• Exclusively Caucasian participants
• Unequal group sizes
• Single TFEQ-R18 administration at age 46 years
• Data collection occurred in 2012.

Declarations of interests can be found in the study.