Body image indirectly explains the relationship between symptom distress and mental health in women with polycystic ovary syndrome

Objective Women with polycystic ovary syndrome (PCOS) are vulnerable to poor mental health. Limited work suggests that body image explains this increased risk, but studies have yet to assess these relationships holistically. This study examined the mediating role of two protective body image indices – appearance satisfaction and functionality appreciation – in the relationship between PCOS-symptom distress, psychological distress and eating pathology.Method The cross-sectional sample comprised 204 women aged 19 to 57 years, M (SD) = 32.3 (7.56), with a self-reported PCOS diagnosis. Participants completed an online questionnaire measuring PCOS-symptom frequency and distress, psychological distress, eating restraint and concern, appearance satisfaction and functionality appreciation.Results Multiple mediation models supported the hypothesis that body image explained the relationship between PCOS-symptom distress and mental health. However, although the unique indirect effect of appearance satisfaction was significant for both psychological distress and eating pathology, functionality appreciation was significant only in psychological distress.Conclusions The overall distress associated with PCOS symptoms was negatively associated with body image across both appearance and function, which was associated with concomitant mental health risks. This study provides a foundation for future prospective studies examining body image holistically to guide treatment and promote well-being in this population.