Exploring the Link Between PCOS/PMOS and Eating Disorders
Polyendocrine metabolic ovarian syndrome (PMOS), previously known as polycystic ovarian syndrome (PCOS), is a metabolic condition that affects about 10-13% of women of reproductive age. Signs of PMOS include menstrual irregularities, excess hair growth, acne, alopecia, and/or excess ovarian follicles or “cysts” shown on ultrasound.
PMOS and Eating Disorders
As you may know, PCOS/PMOS is a common cause of infertility in women. But something often overlooked is its correlation to eating disorders. A recent study found that women with PMOS were 3–6 times more likely to have an eating disorder, with binge eating disorder and bulimia nervosa being the most common. Even those without a current eating disorder remained at increased risk of developing one.¹
Why the Correlation?
The correlation between eating disorders and PMOS is right on par with the nature of this condition – that is: it’s complicated and multifactorial. Also, it’s important to note that correlation does not equal causation. No simple answers here folks!
The Mental Health Connection
One possible contributing factor is underlying psychiatric conditions. Research has shown that women with PMOS have a 2-3 times greater odds of showing symptoms of depression and a 4 times greater odds of experiencing symptoms of anxiety, and have higher rates of bipolar disorder and obsessive-compulsive disorder (OCD).² These conditions are commonly present alongside eating disorders and body dissatisfaction.¹
Also, alterations in serotonin signaling, a neurotransmitter that is important for sleep, mood, appetite, and other important neurological activities, has been observed in women with PMOS. Although psychiatric conditions arise from a complex interplay of genetic, hormonal, environmental, and psychological factors, disruptions in serotonin signaling may increase vulnerability to anxiety, depression, and eating disorders seen in women with PCOS/PMOS.
Altered Hunger-Fullness Cues
Emerging evidence suggests that PMOS is associated with brain dysregulation that may alter neurological signaling between the brain and the body. One example of this is a hormone produced by our fat cells that signals for fullness, called leptin. The PMOS brain is not as sensitive to leptin.³ This may make it more difficult for women to reach satiation, therefore, influencing appetite regulation. On the other hand, current research around PMOS and the body’s hunger hormone, ghrelin, is mixed, but there is some evidence that ghrelin may not be properly suppressed after meals. This could potentially contribute to a drive to overeat as well.³
Societal Factors
Unfortunately, unrealistic societal beauty standards can amplify the emotional burden of PCOS. Symptoms such as acne, hirsutism, and weight gain often affect appearance and may contribute to body dissatisfaction, reduced self-esteem, and a greater vulnerability to disordered eating. Women with PMOS and larger bodies often experience weight stigma when meeting with healthcare professionals about their symptoms. It is true that weight loss can improve certain PCOS symptoms, such as insulin resistance and elevated testosterone levels.⁴ However, when weight loss occurs through disordered eating behaviors, it is neither a safe nor sustainable approach and may ultimately worsen overall health.
PCOS/PMOS Misinformation Online
The influence of social media and diet culture often leads to women with PMOS restricting food or even entire food groups. Many voices online claim that cutting out gluten, dairy, sugar, and carbohydrates is necessary. While some women may find that certain foods trigger their symptoms, PMOS is a diverse disease, and there is not a one-size-fits-all approach. It is also important to note that current research does not back elimination of specific foods for everyone with PMOS. Taking on restrictive diet practices unnecessarily can create more anxiety around food and promote disordered eating behaviors.
So, do you have “a lack of self-control” around food, or are these behaviors a result of the complex interaction of hormonal imbalances, metabolic dysfunction, altered appetite signaling, and the emotional and social challenges that often accompany PMOS? This perspective helps shift the blame and focus on compassionate, evidence-based care.
If you are struggling with your relationship with food and symptoms of PMOS/PCOS, seeking individualized care from a credentialed health professional who specializes in PMOS/PCOS treatment can help you manage your symptoms while maintaining a healthy relationship with food.
1. Lalonde-Bester S, Malik M, Masoumi R, et al. Prevalence and Etiology of Eating Disorders in Polycystic Ovary Syndrome: A Scoping Review. Adv Nutr. 2024;15(4):100193. doi:10.1016/j.advnut.2024.100193
2. Chan JL, Masini I, Pisarska MD. Polyendocrine metabolic ovarian syndrome (PMOS)/polycystic ovary syndrome (PCOS): current and future trends. J Clin Invest. 2026;136(12):e202824. doi:10.1172/JCI202824
3. Xu W, Lu C, Xu J, Wang L. The neuroendocrine-appetite-mental health triangle in PMOS: Implications for GLP-1 receptor agonist therapy. Neurosci Biobehav Rev. 2026;189:106846. doi:10.1016/j.neubiorev.2026.106846
4. Gautam R, Maan P, Jyoti A, Kumar A, Malhotra N, Arora T. The Role of Lifestyle Interventions in PCOS Management: A Systematic Review. Nutrients. 2025;17(2):310. doi:10.3390/nu17020310