Obesity and hyperandrogenism are implicated with anxiety, depression and food cravings in women with polycystic ovary syndrome.

Abstract Introduction PCOS has been associated with mood and eating disorders. Negative body image due to obesity, acne, hirsutism seems to be implicated, but hormonal derangements may also play a significant role. Aim To address the relationship of PCOS with mood and eating disturbances and investigate the latter’s potential association with obesity and hyperandrogenism. Methods Eighty-one patients, 49(60.5%) with PCOS and 32(39.5%) age- and BMI-matched healthy controls were enrolled. Emotional and food disorders were assessed by using self-administered questionnaires: Eating Attitudes Test (EAT)-26, Beck Depression Inventory-II (BDI-II), Hamilton anxiety scale (HAS) and Food Craving Questionnaire-Trait (FCQ-T). Results The two groups had no significant differences regarding age, BMI and HOMA2-IR. PCOS women had significantly higher DHEA-S (p<0.0001), Δ4Α (p<0.0001) and Testosterone (p<0.0001). When the two groups were subclassified according to the BMI, in lean (BMI<25kg/m2) or overweight (BMI≥25kg/m2), no significant differences were found in respect to EAT-26 and HAS. BDI-II was associated with obesity (overweight vs lean PCOS:18 vs 16.5;p=0.037) and hyperandrogenism (overweight PCOS vs overweight controls: 18vs13; p<0.0001; lean PCOS vs overweight controls: 16.5vs13; p=0.01), while a significant correlation with DHEA-S (r=0.305;p=0.006), Δ4Α (r=0.259;p=0.02) and Testosterone (r=0.328;p=0.003) was reported. FCQ-T was associated with obesity (overweight PCOS vs lean PCOS: 53vs28.5; p<0.0001; overweight controls vs lean PCOS: 40vs28.5; p<0.0001), whereas a correlation with BMI (r=0.593;p=0.0001), waist circumference (r=0.554;p=0.0001) and HOMA2-IR (r=0.328;p=0.003) was documented. Conclusions Obesity, insulin resistance and hyperandrogenism increase the risk of depression and food cravings in PCOS, leading to a vicious circle of further aggravation of obesity and metabolic syndrome.