Weight loss interventions ease symptoms, improve biomarkers of PCOS

Weight loss interventions help improve some features of polycystic ovary syndrome (PCOS), making it a potential treatment option for women with PCOS, suggests a study.

A team of investigators searched the databases of Medline, Embase, PsycINFO, CINAHL, Cochrane, Web of Science, and trial registries from inception through June 2024. They identified randomized controlled trials comparing interventions for weight loss against usual care, including lower-intensity weight loss interventions in people with PCOS. Conversations with PCOS patients informed the outcomes.

Twenty-nine studies including 1,529 participants were included in the primary analyses. Of the studies, 13 were deemed to have high risk of bias (RoB), while 12 and 4 had some or low RoB, respectively. In addition, 12 used behavioural interventions, nine glucagon-like peptide agonists, and eight other weight loss medications.

Undergoing weight loss interventions resulted in significantly greater improvements in HOMA-IR (mean difference [MD], –0.45, 95 percent confidence interval [CI], –0.75 to –0.15; I², 24 percent), free androgen index (MD, –2.03, 95 percent CI, –3.0 to –1.07; I², 48 percent), and menstrual frequency (MD, 2.64, 95 percent CI, 0.65–4.63; I², 43 percent).

No evidence suggested the association of weight loss interventions with clinically or statistically significant improvements in hirsutism, quality of life, or other sex hormones, which could be possibly explained by the limited power of the available data.

In terms of limitations, “[t]here was high statistical heterogeneity in the interventions, comparators, and outcomes, largely unexplained by sensitivity and subgroup analyses,” the investigators said.