Loss of excess weight may reduce the severity of some symptoms and will reduce the risk of developing further complications associated with PCOS. Even a small weight loss can reap large benefits.
Do women with PCOS have a greater risk of being overweight?
It is currently not clear if there are any biological factors that could lead to women with PCOS having more difficulties with weight management. However, research has suggested that hormones involved in controlling appetite and hunger aren't regulated properly in some women with PCOS. If this is the case, it may mean that some women with PCOS are more likely to gain weight and have more difficulty losing weight.
Benefits of weight loss with PCOS
Modest weight loss will not cure PCOS, but it will help. Weight loss can restore the normal function of the ovaries and result in normal hormone production. This may in turn lead to improvements in symptoms of PCOS, such as excess hair growth, acne or scalp hair loss.
A large number of research studies have shown it only takes a modest amount of weight loss of 5-10 kg or 5-10 per cent of initial body weight to:
- reduce insulin resistance by about 50%
- restore ovulation
- regulate menstrual cycles
- reduce pregnancy complications
- improve fertility
- improve health during pregnancy
- improve the health of a child during pregnancy
- improve emotional health (self-esteem, anxiety, depression)
- reduce risk factors for diabetes and heart disease
Weight loss is best achieved through a combination of lifestyle changes – a healthy diet and physical activity. It is not always easy to make changes to your lifestyle so that you eat more healthy foods and make exercise a regular part of life. Learning and understanding about goal setting can be helpful along with how to make changes to your behaviour. For further information and advice, talk to an accredited practising dietitian (APD) and/or your doctor.
Medical management & surgery for weight loss
Some women with PCOS may need medical assistance to help with weight loss.
Surgery to assist weight loss
The effect of obesity surgery has been assessed in women who have PCOS. Weight loss surgery is generally only considered if you meet certain criteria including:
- You have a BMI (body mass index) over 40 (or over 35 and a related condition such as diabetes, high blood pressure or arthritis)
- You have been unsuccessful at losing weight with alternative treatments
- You are aged between 18 and 65
There are two main types of surgical procedures:
- Gastric bypass – where a smaller stomach pouch is made from the stomach and the intestine joined to it (a fairly major operation)
- Gastric banding – where the size of the stomach is reduced by a band around the upper part of the stomach (a minor procedure done via keyhole surgery)
Surgical procedures improve many of the symptoms of PCOS however there are some things to consider including:
- the risk of vitamin and mineral deficiencies – since food intake is reduced and food absorption is affected, vitamin and minerals can become deficient (e.g. iron, folate and iodine)
- timing and pregnancy – it is not recommended for women to become pregnant until 12-18 months after weight loss surgery
- appropriate contraception: effective contraception after surgery is important as fertility may improve but pregnancy is not recommended until 12-18 months after surgery
- potential post-operative complications
- cost – The procedure is expensive and it is very rarely available in public hospitals in Australia Costs are partly covered by private health insurance.
Weight loss medications
As yet, there is no evidence that weight loss medications are any better than having a healthy lifestyle. They are generally expensive, only work whilst being taken, lead only to small weight loss and have side effects. Sibutramine (sold as Reductil) has been withdrawn from the market in many countries including Australia due to concerns about it increasing the risk of stroke or cardiovascular disease.
Actions you can take
Talking with your doctor and also understanding what influences weight change for you will help you to make decisions about what is the best way of managing your weight. You may like to speak with a psychologist, dietitian or exercise physiologist who may be able to help you with changes to the way you think about eating and activity. Further information on managing a healthy weight is also available here.
This web page is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your health practitioner. The information above is based on current medical knowledge, evidence and practice as at March 2014.