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

Nour El Achkar,1 Verginia Moubarak,1 Sahar Obeid,2 Diana Malaeb,3 Fouad Sakr,4 Mariam Dabbous,4 Patrick Zaarour,1,5 Souheil Hallit,1,6 Feten Fekih-Romdhane7,8 1School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon; 2Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon; 3College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates; 4School of Pharmacy, Lebanese International University, Beirut, Lebanon; 5Department of Obstetrics and Gynecology, Notre Dame Des Secours University Hospital, Byblos, Lebanon; 6Applied Science Research Center, Applied Science Private University, Amman, Jordan; 7The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry “ibn Omrane”, Razi Hospital, Manouba, Tunisia; 8Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, TunisiaCorrespondence: Souheil Hallit, Email souheilhallit@usek.edu.lbBackground: 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