Obese women with PCOS can lose weight with a doctor’s help

Simple weight-loss advice from a physician and regular follow-up helped obese women with polycystic ovary syndrome lose a substantial amount of weight, a new study found. The results were presented at The Endocrine Society’s 91st Annual Meeting in Washington, D.C.

Polycystic ovary syndrome, or PCOS, is a common hormone imbalance in young women that raises the risk of infertility, obesity, type 2 diabetes and heart disease. Past research shows that modest weight loss — at least 5 percent of body weight — can significantly improve PCOS symptoms and reduce the risk of diabetes and heart disease.

However, medical management of obesity tends to be neglected, said study co-author Jean-Patrice Baillargeon, MD, MSc, an endocrinologist with the University of Sherbrooke Faculty of Medicine, Sherbrooke, Quebec, Canada.

“Research shows that primary care physicians are usually reluctant to manage their patients’ obesity because they feel poorly equipped to do so and their success is limited,” Baillargeon said. “But our study demonstrates that it is possible, with a doctor’s weight-loss advice and follow-up, for obese women with PCOS to achieve clinically significant and sustained weight loss.”

Baillargeon stressed that this study did not involve multidisciplinary care from a team of different health care specialists, which many doctors view as the most effective approach to weight loss but which is costly. Instead, as is usually the case in real life, study patients saw only a doctor. The physician gave them general advice on losing weight and on diet and exercise.

The investigators reviewed the medical records of 117 obese women with PCOS who had an initial doctor’s visit and follow-up care for at least 2 months at the medical center’s reproductive endocrinology clinic between May 2002 and September 2008. These women had an average weight of 231 pounds (104 kilograms) and an average body mass index, or BMI, of 38.7, which is close to morbidly obese. Follow-up visits, usually every 6 months, consisted of PCOS management as well as a weigh-in and discussion of weight loss, which Baillargeon said helped maintain patients’ motivation.

Of the 74 women who had 6 to 12 months of follow-up, 32 patients (43.2 percent) lost 5 percent or more of their body weight, which is considered clinically significant, the authors reported. Among 35 women with 3 years of follow-up or longer, 16 (nearly 46 percent) lost that much weight, and seven (20 percent) lost at least 10 percent of their body weight.

If needed, women received the diabetes drug metformin, which is often used to treat problems related to PCOS. Although past studies of whether metformin affects weight loss have shown mixed results, women in this study who took metformin lost more weight than those who did not.

“Medical management of these women is an opportunity to improve their future metabolic health,” Baillargeon said. “Any physician who sees obese women with PCOS should at least discuss the importance of weight loss and lifestyle modifications.”

This study was presented by Lysanne Pelletier, MD, a trainee at the University of Sherbrooke.

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