Supervised short-term nutrition and exercise promotes weight loss in overweight and obese patients with polycystic ovary syndrome

ObjectiveThe effect of metformin on weight reduction in polycystic ovary syndrome (PCOS) is often unsatisfactory. In this study, we investigated the potential add-on effect of treatment with the glucagon-like peptide-1 receptor agonist liraglutide on weight loss in obese nondiabetic women with PCOS who had lost <5% body weight during pretreatment with metformin.MethodsA total of 40 obese women with PCOS, who had been pretreated with metformin for at least 6 months, participated in a 12-week open-label, prospective study. They were randomized to one of three treatment arms: metformin (MET) arm 1000 mg BID, liraglutide (LIRA) arm 1.2 mg QD s.c., or combined MET 1000 mg BID and LIRA (COMBI) 1.2 mg QD s.c. Lifestyle intervention was not actively promoted. The primary outcome was change in body weight.ResultsThirty six patients (aged 31.3±7.1 years, BMI 37.1±4.6 kg/m2) completed the study: 14 on MET, 11 on LIRA, and 11 on combined treatment. COMBI therapy was superior to LIRA and MET monotherapy in reducing weight, BMI, and waist circumference. Subjects treated with COMBI lost on average 6.5±2.8 kg compared with a 3.8±3.7 kg loss in the LIRA group and a 1.2±1.4 kg loss in the MET group (P<0.001). The extent of weight loss was stratified: a total of 38% of subjects were high responders who lost ≥5% body weight, 22% of them in the COMBI arm compared with 16 and 0% in the LIRA and MET arm respectively. BMI decreased by 2.4±1.0 in the COMBI arm compared with 1.3±1.3 in LIRA and 0.5±0.5 in the MET arm (P<0.001). Waist circumference also decreased by 5.5±3.8 cm in the COMBI arm compared with 3.2±2.9 cm in LIRA and 1.6±2.9 cm in the MET arm (P=0.029). Subjects treated with liraglutide experienced more nausea than those treated with metformin, but severity of nausea decreased over time and did not correlate with weight loss.ConclusionsShort-term combined treatment with liraglutide and metformin was associated with significant weight loss and decrease in waist circumference in obese women with PCOS who had previously been poor responders regarding weight reduction on metformin monotherapy.

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Short-term meal replacements followed by dietary macronutrient restriction enhance weight loss in polycystic ovary syndrome

American Journal of Clinical Nutrition ◽

10.1093/ajcn/84.1.77 ◽

2006 ◽

Vol 84 (1) ◽

pp. 77-87 ◽

Cited By ~ 73

Author(s):

Lisa J Moran ◽

Manny Noakes ◽

Peter M Clifton ◽

Gary A Wittert ◽

Gemma Williams ◽

...

Keyword(s):

Weight Loss ◽

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Short Term ◽

Ovary Syndrome ◽

Meal Replacements

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Retention of estradiol negative feedback relationship to LH predicts ovulation in response to caloric restriction and weight loss in obese patients with polycystic ovary syndrome

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.00377.2003 ◽

2004 ◽

Vol 286 (4) ◽

pp. E615-E620 ◽

Cited By ~ 27

Author(s):

Eveline W. C. M. van Dam ◽

Ferdinand Roelfsema ◽

Johannes D. Veldhuis ◽

Simone Hogendoorn ◽

Jos Westenberg ◽

...

Keyword(s):

Weight Loss ◽

Body Weight ◽

Polycystic Ovary Syndrome ◽

Body Fat ◽

Negative Feedback ◽

Polycystic Ovary ◽

Obese Patients ◽

Ovary Syndrome ◽

Fat Depots ◽

Lh Secretion

The present study tests the hypothesis that specific endocrine, metabolic, and anthropometric features distinguish obese women with polycystic ovary syndrome (PCOS) who resume ovulation in response to calorie restriction and weight loss from those who do not. Fifteen obese (body mass index 39 ± 7 kg/m2) hyperandrogenemic oligoovulatory patients undertook a very low calorie diet (VLCD), wherein each lost ≥10% of body weight over a mean of 6.25 mo. Body fat distribution was quantitated by magnetic resonance imaging. Hormones were measured in the morning at baseline, after 1 wk of VLCD, and after 10% weight loss. To monitor LH release, blood was sampled for 24 h at 10-min intervals before intervention and after 7 days of VLCD. Responders were defined a priori as individuals exhibiting two or more ovulatory cycles in the course of intervention, as corroborated by serum progesterone concentrations ≥18 nmol/l followed by vaginal bleeding. At baseline, responders had a higher sex hormone-binding globulin (SHBG) concentration but were otherwise indistinguishable from nonresponders. Body weight, the size of body fat depots, and plasma insulin levels declined to a similar extent in responders and nonresponders. Also, SHBG increased, and the free testosterone index decreased comparably. However, responders exhibited a significant decline of circulating estradiol concentrations (from 191 ± 82 to 158 ± 77 pmol/l, means ± SD, P = 0.037) and a concurrent increase in LH secretion (from 104 ± 42 to 140 ± 5 U·l-1·day-1, P = 0.006) in response to 7 days of VLCD, whereas neither parameter changed significantly in nonresponders. We infer that evidence of retention of estradiol-dependent negative feedback on LH secretion may forecast follicle maturation and ovulation in obese patients with PCOS under dietary restriction.

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