Weight Management Strategies to Reduce Metabolic Morbidity in Women With Polycystic Ovary Syndrome

Abstract

Purpose of review: Polycystic Ovary Syndrome (PCOS) affects 10-15% of women of reproductive age and is associated with a heightened risk of metabolic morbidity, exacerbated by insulin resistance and obesity. Current weight management strategies have limited effectiveness in reducing metabolic morbidity in this subgroup. This review examines the potential of Intensive Weight Management Programmes (IWMPs) and Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) to reduce metabolic risks in women with PCOS, drawing from studies in both PCOS-specific and related populations.

Recent findings: IWMPs, including total diet replacement, achieve substantial and sustained weight loss (5-15% over 1-5 years) in individuals with obesity and type 2 diabetes, alongside improvements in metabolic markers like blood pressure and glycemic control. GLP-1 RAs, particularly semaglutide, similarly deliver significant weight loss (10-15% over 1-2 years) and metabolic benefits. While there is limited data specifically targeting PCOS, emerging studies suggest GLP-1 RAs can improve weight, insulin sensitivity, and menstrual regularity in this group. However, evidence for both interventions in PCOS remains insufficient. Women with PCOS face unique metabolic challenges, including heightened insulin resistance, compounded by obesity. While IWMPs and GLP-1 RAs are promising interventions, evidence for their effectiveness in PCOS-specific populations is insufficient. Addressing this research gap through targeted trials is essential to improve outcomes in individuals affected by PCOS and metabolic disorders.

Keywords: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs); Insulin resistance; Intensive weight management programmes (IWMPs); Metabolic risk; Obesity; Obesity management; Polycystic ovary syndrome (PCOS).