title: Overweight in polycystic ovary syndrome. An update on evidence based advice on diet, exercise and metformin use for weight loss.
abstract: OBJECTIVE
  Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in premenopausal women affecting 5-10%. Nearly 50% are overweight or obese, which result in a more severe phenotype of PCOS. Weight loss is therefore considered the first line treatment in overweight women with PCOS. The aim of this study was to appoint evidence based and clinically applicable advises on weight loss in overweight women with PCOS.
  
  
  METHODS
  A review of the existing literature on weight loss through lifestyle modification and/or metformin treatment in overweight women with PCOS. The primary outcome was weight loss. The clinical manifestations of hyperandrogenism and menstrual cyclicity were secondary outcomes. Metabolic parameters were not included in the present review.
  
  
  RESULTS
  Weight loss is most effectively achieved through a 12-1500 kcal/day diet, which results in a clinically relevant weight loss. The type of diet has no implications for degree of weight loss. Physical activity has no significant additive effect on weight loss. Metformin combined with a low calorie diet has subtle additive effect on weight loss and level of androgens when compared to diet alone.
  
  
  CONCLUSIONS
  Weight loss through life style changes, preferably a low calorie diet, should be the first line treatment in overweight/obese women with PCOS. Metformin can be considered as an additional treatment but has subtle additive effect.
authors: Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark. pernille.ravn@ouh.regionsyddanmark.dk
authors: P
authors: P
authors: Ravn
authors: A G
authors: AG
authors: Haugen
authors: D
authors: D
authors: Glintborg
mesh_terms: D015992:Body Mass Index; D031204:Caloric Restriction; D019317:Evidence-Based Medicine; D015444:Exercise; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008687:Metformin / Q000627:therapeutic use*; D050177:Overweight / Q000150:complications / Q000178:diet therapy* / Q000188:drug therapy* / Q000628:therapy; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000178:diet therapy* / Q000188:drug therapy* / Q000628:therapy; D015431:Weight Loss
chemical_list: D007004:Hypoglycemic Agents; D008687:Metformin