SAT373 A Systematic Review and Meta-Analysis Show Body Image Concerns Are Significantly Higher in Women and Individuals With Polycystic Ovary Syndrome
Authors: Kempegowda Punith , Malhotra Kashish , Khalil Halimah , Davitadze Meri , Tay Chau Thien , Mousa Aya ,   PCOS SEva Team, Teede Helena Jane , Brennan Leah , Stener-Victorin Elisabet 
Published: October 2023

Abstract
Disclosure: P. Kempegowda: None. K. Malhotra: None. H. Khalil: None. M. Davitadze: None. C. Tay: None. A. Mousa: None. P. Team: None. H.J. Teede: None. L. Brennan: None. E. Stener-Victorin: None.
Background: While several studies have established the increased prevalence of depression and anxiety among those with polycystic ovary syndrome (PCOS), the association between PCOS and body image remains unclear. These body image concerns can lead to Body Dysmorphic Disorder (a mental health condition where a person spends a lot of time worrying about flaws in their appearance) and/or also predispose to eating disorders such as anorexia or bulimia. Objective: To assess differences in body image concerns among women and individuals with and without PCOS in the context of updating International Guidelines in PCOS. Methods: A systematic review and meta-analysis was completed with a registered protocol a priori on the National Institute of Health Research Prospective Register of Systematic Reviews PROSPERO (CRD42021272367). Electronic databases (MEDLINE, EMBASE, APA PsycInfo, PUBMED, Web-of-Science Core Collection, and CENTRAL) were searched through July 2022. Outcome measures included validated questionnaires reporting on body dysmorphic disorders. Methodological quality was assessed by GRADE (Grading of Recommendations, Assessment, Development and Evaluations) system. Meta-analyses were performed using the inverse variance method, based on random- or fixed-effects models (Review Manager, Version 5). For dichotomous outcomes, we estimated odds ratios (OR) with 95% confidence intervals (CI) using fixed-effects models. For continuous outcomes, we estimated the weighted mean difference in scores with 95% confidence interval if the mean and SD of the outcomes were presented in the original article. Results: A total of 918 women with PCOS and 865 women without PCOS from nine studies were included, with sample sizes ranging from 33 to 201 for those with PCOS and from 22 to 225 for those without PCOS. Meta-analysis of three studies using Multidimensional Body-Self Relations Questionnaire Appearance Scales (MBSRQ-AS) showed those with PCOS reported worse on appearance evaluation and appearance orientation compared to those without PCOS (MD= -0.78, I2=0%, p&lt;0.00001 and MD= 0.22, I2=54%, p=0.004, respectively). Meta-analysis of two studies showed higher overweight preoccupation, body areas satisfaction, and body weight classification on MBSRQ-AS subscales in those with PCOS compared to those without (all p&lt;0.001). Meta-analysis of two studies using Body Esteem Scale for Adolescents and Adults (BESAA) showed significantly lower scores for the weight subscale in those with PCOS, compared to those without, whereas differences in the BESAA appearance and attribution subscales were not statistically significant between the two groups (p=0.03 vs p=0.73 and p=0.36, respectively).
Conclusion: Those with PCOS experience greater body image concerns emphasising importance of awareness in clinical care of PCOS. Further studies are needed to identify drivers and mitigating factors.
Presentation Date: Saturday, June 17, 2023