The prevalence of eating disorders in women with facial hirsutism: an epidemiological cohort study.

OBJECTIVE: The prevalence of DSM IV-defined eating disorders is evaluated in a population of women with facial hirsutism.

METHOD: The Structured Clinical Interview (SCID) for the Diagnostic and Statistical Manual for Mental Disorders, fourth edition (DSM IV) and the Eating Disorder Evaluation (EDE) were administered to 80 hirsute women presenting routinely to an endocrine outpatient clinic. Objective phenotypic severity of hyperandrogenic symptoms, gender role, self-esteem, and social adjustment were quantified using validated measures and weight, height, and fertility were assessed during interview.

RESULTS: The prevalence of eating disorders was 36.3% (22.5% EDNOS, 12.6% Bulimia Nervosa, 1.3% Anorexia Nervosa). Depression, anxiety, low self-esteem, and poor social adjustment were more common in participants suffering from an eating disorder, and co-morbidity of PCOS was universal in eating disordered cases.

CONCLUSION: Our study demonstrates that hirsute women are at high risk of developing an eating disorder. Factors associated with eating disorders are examined and explanatory hypotheses are suggested for the possible underlying mechanisms in these women.