Disordered Eating Behaviors During Adolescence and Risk of Polycystic Ovary Syndrome: A Prospective Cohort Study

Context Disordered eating behaviors are linked to reproductive health and are more common in women with polycystic ovary syndrome (PCOS). However, it remains unclear whether they are risk factors for PCOS. Objective To investigate the associations of disordered eating behaviors during adolescence and PCOS in adulthood. Design Prospective, longitudinal cohort (1996-2021). Setting United States. Patients or Other Participants Female participants (n = 6208) from the Growing Up Today Study. Disordered eating behaviors were self-reported on repeated questionnaires during follow-up. Main Outcome Measures Physician-diagnosed PCOS was reported on each questionnaire starting in 2010. Multivariable logistic regression with generalized estimating equations to calculate the adjusted odds ratios (aOR) and 95% confidence intervals (CIs) for the association between past-year frequency of binge eating, laxative use, and self-induced vomiting and PCOS. Results We identified 410 cases (7%) of PCOS. Binge eating was the most common behavior, with 2331 (38%) girls binge eating at least once during follow-up. Additionally, 1103 (18%) girls reported self-induced vomiting and 701 (11%) reported using laxatives for weight control at least once. Compared to girls who never binge ate, cumulative binge eating more than monthly was associated with higher odds of PCOS (aOR: 1.59, 95% CI: 1.09, 2.33). Cumulative laxative use less than monthly was associated with lower odds of PCOS (aOR: 0.45, 95% CI: 0.29, 0.72) while at least monthly laxative use was associated with higher odds of PCOS (aOR: 1.67, 95% CI: 0.89, 3.14). Self-induced vomiting was not associated with PCOS. Conclusion Girls who binge eat during adolescence may have increased odds of developing PCOS.