Women with polycystic ovary syndrome struggle with their body image – weight-loss attempts and body dissatisfaction also common among normal weight women

PCOS is the most common hormonal disorder among women of reproductive age with diagnostic criteria including irregular menstrual cycles, the overproduction of male hormones as well as polycystic ovaries. As many as 50–70 per cent of women suffering from PCOS have overweight.

“The results of our study show that women with PCOS do their best to lose weight but, despite their efforts, they continue to have a clearly higher body mass index and waist circumference than other women,” says Doctoral Researcher Emilia Pesonen from the University of Oulu.

Having overweight adds to these women’s risk of developing comorbidities such as type 2 diabetes, which is why the importance of losing weight and weight management is emphasised in the treatment of the condition. However, practical support for losing weight is usually not available.

“Women suffering from PCOS would need more comprehensive support, such as nutritional therapy and psychotherapy. Unsuccessful weight-loss attempts may have detrimental effects on their eating habits, self-esteem and sense of self-efficacy,” says Postdoctoral Researcher and Authorised Nutritionist Marjukka Nurkkala from the University of Oulu.

Previous studies have shown that women with PCOS are more likely to be dissatisfied with their bodies than other women, and their risk of developing an eating disorder is up to three times as high as that of other women. The recently published study shows that normal-weight women with PCOS also struggle with their body image.

“The syndrome itself increased the risk of both several weight-loss attempts and the feeling of being overweight at midlife, and the observed link could not be explained by issues such as body mass index or psychological distress,” Pesonen says.

Doctors often warn women suffering from the syndrome not to gain weight. “Matters related to weight should always be discussed in a positive light, without blaming the women. It is a good idea to focus on health rather than weight during medical appointments. It is also important to keep in mind that not all women with PCOS have overweight,” says Terhi Piltonen, Professor of Obstetrics and Gynaecology at the University of Oulu.

According to researchers, healthcare professionals should pay attention not to add to the stress that women with PCOS experience regarding their weight. “We need additional research to find whether these women would benefit more from a weight-neutral approach to making lifestyle changes. We are also hoping that bariatric surgery and medical treatment will be introduced as part of the treatment among women with PCOS who have suffered from obesity for a long time,” Piltonen continues.

The study involved 1,828 women in the Northern Finland Birth Cohort 1966, of whom 278, or 15 per cent, had been diagnosed with PCOS. The women’s weight-loss attempts and feelings of their own weight were studied using surveys when they were 31 years old and again when they were 46.

The study was published in Obesity journal. It was funded by the Jenny and Antti Wihuri Foundation, the Sigrid Jusélius Foundation, the Academy of Finland, Novo Nordisk and the Ministry of Education and Culture.

Research article: Pesonen E, Nurkkala M, Niemelä M, Morin-Papunen L, Tapanainen J.S, Jämsä T, Korpelainen R, Ollila M-M, Piltonen T.T. Polycystic ovary syndrome is associated with weight-loss attempts and perception of overweight independent of BMI: a population-based cohort study. Obesity (Silver Spring). 2023;1–13. doi:10.1002/oby.23681