The Mediating Effect of Body Appreciation on the Association Between Undiagnosed Polycystic Ovary Syndrome (PCOS) and Eating Disorders: A Cross-Sectional Study Among Lebanese Women

Background: Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder affecting women of reproductive age who are more prone to be affected by psychological and eating disorders. Despite evidence linking PCOS to certain disordering eating patterns, research remains insufficient in this field where the majority of affected women remain undiagnosed. This study aims to investigate the association between undiagnosed PCOS and two disordered eating phenotypes (binge eating, night eating) among Lebanese women, and to evaluate whether body appreciation acts as a mediator. Methods: This is a cross-sectional study conducted among 975 Lebanese women aged 28.10 ± 8.45 years, recruited between February and September 2025. Data was procured via an online survey made with Google Forms and data was analyzed by using SPSS version 27. Results: The mediation analysis results showed that body appreciation partially mediated the association between undiagnosed PCOS and binge eating and night eating. Undiagnosed PCOS was associated with lower body appreciation, which was associated in turn with more binge and night eating. Finally, undiagnosed PCOS was significantly associated with more binge and night eating. Conclusion: In our study, body appreciation emerged as a promising psychological mechanism linking undiagnosed PCOS to binge eating and night eating. These findings suggest that body appreciation is a promising psychological goal to improve adaptive eating and reduce disordered eating features in women with undiagnosed PCOS. Keywords: undiagnosed polycystic ovary syndrome, eating disorders, binge eating, night eating, body appreciation