A retrospective analysis of a community based weight loss programme in conjunction with group behavioural change sessions in women with polycystic ovary syndrome (PCOS).
Nikokavoura, Efsevia Anastasia
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Polycystic Ovary Syndrome (PCOS) is variously reported to affect between 5-26 % of reproductive age women in the UK and it accounts for up to to 75% of women attending fertility clinics due to anovulation. The major symptoms include ovarian disruption, hyperandrogenism, insulin resistance and polycystic ovaries. Interestingly, at least half of the women with PCOS are obese, with the excess weight playing a pathogenic role in the development and/or progress of the syndrome. In addition, PCOS is associated with negative psycho-social symptoms and overall a poorer quality of life. Despite the increasing prevalence of PCOS, there is still a lack of consensus over the diagnostic criteria and large scale, well planned trials are limited. The first-line treatment option for overweight/obese women with PCOS is diet and lifestyle interventions, however optimal dietary guidelines are missing. Although a number of different dietary approaches have been investigated, data on the efficacy of very low calorie diets (VLCDs) on PCOS, are still lacking and further investigations both in the short and longer term data are needed. The aim of this project is to investigate how overweight/obese women with PCOS respond to a commercial VLCD in conjunction with group behavioural change sessions, as compared to overweight/obese women without PCOS. Weight loss was achieved via a VLCD with an average intake of 630 kcal (57g protein, 57 g carbohydrate, 18g fat , 16g fibre and ≥100% recommended daily allowances (RDA) for vitamins and minerals). Data from women recruited into LighterLife Total from 2006 to 2011, were analysed at baseline, 12 weeks and 1 year. The baseline analysis from the overweight/obese female participants, revealed significant differences in anthropometric parameters between women with and without PCOS. Women with PCOS were younger (mean ±SD) (34.5 ±8.2 versus 41.8±11.3, p<0.001), had greater body weight (105.7±19.3 versus 97.8±17.0, p<0.001), BMI (39.01±6.6 versus 36.4±5.8, p<0.001 and waist circumference (115.9±15.0 versus 109.9±12.9, p<0.001). A subset of these participants was matched for age and BMI, and their analysis showed no significant differences at weight change at 12 weeks and 1 year. In more detail, a completers analysis after 12 weeks of VLCD, showed that the total weight change did not differ significantly between the PCOS group (n=137) and the non-PCOS group (n=137) (-10.4kg ±10.6 versus -10.4 kg ± 10.4, p=0.938) and the percentage of weight loss achieved by PCOS women was 17.1% ±5.6 versus 18.2% ±4.4 by the non PCOS group (p=0.08). Also, there were no differences after 1 year in weight (94.2 ± 19.9, n=41, versus 90.3 ± 27.6, n=35,p=0.476) and in BMI (33.4 ± 8.5, n=41, versus 35.2 ± 7.6, n=35, p=0.476). Moreover, the percentage of weight loss achieved by PCOS women at 1 year was similar with the one achieved by the non PCOS women (-15.6%±15.6 versus -12.4% ± 13.3, p=0.35). Overall, it appears that this commercial VLCD alongside behavioural therapy, can be an effective strategy for achieving weight reduction in cases of excess weight in women with PCOS. However, further investigations are needed to achieve a thorough way of understanding the physiology of weight loss in PCOS via a VLCD approach.