Obstetrics and Gynaecology

How Does Body Weight Play A Significant Role in PCOS?

Dr. Neema Sharma Nov 06, 2023

Polycystic ovary syndrome (PCOS) is a lifestyle disease. It cannot be cured but symptoms can be managed by lifestyle modifications. It is unclear if obesity causes PCOS or if PCOS causes obesity. Women with PCOS develop insulin resistance which cause weight gain which further increases the insulin resistance and worsen the features of PCOS like prolonged cycles, acne, facial hair, hair fall and weight gain. Weight loss of just 5% improves the insulin resistance and can lead to a significant improvement in PCOS symptoms like restoring the normal menstrual cycle and ovulation
Weight management requires patience as losing a few kgs of weight around the waist is a challenging job and is more difficult with hormonal imbalance. It requires multidisciplinary lifestyle management, comprising dietary, exercise and behavioral therapy, as well as attention to psychosocial stress.
Diet restricted in calories ranging from 1000–1500 kilocalories (kcal) per day have proven useful for weight loss and improves cardiometabolic parameters. Magnesium, vitamin E, Vitamin D3 co-supplementation and probiotics have proved to be beneficial
Adolescents with PCOS should engage in 60 minutes of moderate to vigorous activity three times a week and should include musculoskeletal strengthening
Metformin has been shown to decrease the insulin levels which reduces the level of androgens, and control the menstrual cycle.Orlistat leads to significant reduction in BMI/body weight in PCOS.
Bariatric surgery is promising for decreasing weight in adults and youth, and reversing type 2 diabetes in youth, though PCOS data are lacking
Behavioral therapy and treatment of depression in adolescents with insulin resistance and women with PCOS is associated with improved weight loss.
Comprehensive treatment of PCOS and weight management require multidisciplinary team where dietitian, exercise specialist, clinical psychologist, gynecologist, and/or dermatologist can work together to tailor her needs.