WEIGHT loss interventions significantly improve insulin resistance, free androgen levels, and menstrual frequency in patients with polycystic ovary syndrome (PCOS), according to new research from the University of Oxford, UK. However, effects on hirsutism and quality of life were less clear. PCOS is a common endocrine disorder in reproductive-age women, often linked to obesity and characterised by symptoms like irregular menstrual cycles, insulin resistance, and elevated androgen levels. Clinical guidelines suggest weight loss to help manage PCOS symptoms, but the specific impact of weight reduction on the clinical manifestations of PCOS has not been fully established. Thus this study aimed to quantify the effects of weight loss interventions on PCOS-related outcomes compared to usual care.
To assess this, a meta-analysis of randomised controlled trials including studies from MEDLINE, Embase, PsycINFO, CINAHL, Cochrane, and Web of Science databases. A total of 29 trials with 1529 participants were analysed, comparing various weight loss interventions, such as behavioural modifications, glucagon-like peptide-1 (GLP1) agonists, and other medications, against standard care or lower-intensity interventions. Key outcomes measured were glycaemic control (HOMA-IR, fasting insulin, glucose), hormonal markers (free androgen index [FAI]), menstrual regularity, hirsutism, and PCOS-specific quality of life (QoL). Pooled mean differences were calculated using random-effects meta-analysis with Knapp–Hartung adjustments.
Results showed significant improvements in HOMA-IR (mean difference, 0.45; I² = 24%), FAI (mean difference, 2.03; I² = 48%), and menstrual frequency (mean difference, 2.64; I² = 43%). However, there was no significant improvement observed in hirsutism, QoL, or other sex hormones.
These findings suggest that weight loss interventions can positively impact certain key features of PCOS, especially insulin resistance and menstrual frequency, supporting weight loss as a recommended management approach for patients with PCOS. The lack of significant improvement in hirsutism and QoL underscores the need for further studies with larger samples to better understand the breadth of benefits and limitations of weight loss in PCOS management. Clinically, these results reinforce that weight loss interventions can be an effective part of routine care for PCOS, although additional supportive treatments may be required for comprehensive symptom management.
Reference
Scragg J et al. Effect of weight loss interventions on the symptomatic burden and biomarkers of polycystic ovary syndrome: A systematic review of randomized controlled trials. Ann Intern Med. 2024; DOI:10.7326/M23-3179.
