Barriers and facilitators to weight management in overweight and obese women living in Australia with PCOS: a qualitative study

Abstract

BackgroundLifestyle modification targeting weight management is the first-line treatment for women with Polycystic Ovary Syndrome (PCOS) regardless of presenting symptoms. Women with PCOS are more likely to gain more weight compared with women without PCOS, which may be related to barriers in engaging in lifestyle modification. The aim of this study is to explore the experience of women with PCOS in weight management and to determine the facilitators and barriers to lifestyle modifications in women with PCOS.MethodsTen women with PCOS participated in focus groups and semi-structured telephone interviews on lifestyle and weight management in PCOS. Discussions were audio-recorded and transcribed verbatim. Thematic analysis of the transcripts was conducted. Thematic analysis of the transcripts were conducted using the method of constant comparison.ResultsWomen in the current study attempted a wide range of weight loss interventions, but had difficulties losing weight and preventing weight regain. Women felt that having PCOS affected their ability to lose weight and to keep it off. Facilitators to lifestyle modification for weight management were reported as structured approaches such as having balanced meals and support by health professionals, peers, friends or family. Barriers to lifestyle changes in women with PCOS included logistical barriers such as time and cost, motivational barriers including tiredness or feeling unrewarded, environmental barriers such as not having access to safe places to exercise, emotional barriers such as having depressive and defeating thoughts, and relational barriers such as having unsupportive partner or prioritising children’s meal preferences.ConclusionsWomen with PCOS face a number of personal, environmental and social facilitators and barriers to lifestyle modification for weight loss. While many of these are also experienced by women without PCOS, women with PCOS face additional barriers in having low sense of self-confidence and high prevalence of negative thoughts which may impair their ability to maintain efforts in lifestyle modification over the long term. Future research should further explore the impact of the emotional and mental burden of PCOS on the management of weight and other aspects of PCOS. Future lifestyle intervention should also address the psychosocial aspect of PCOS.

A Qualitative Analysis of an Aerobic Interval Training Programme for Obese Outpatients Carried Out in a Hospital Context

“…However, there are few qualitative studies that explored the motivations and experiences of obese individuals regarding PA. Thus, this study may be useful for the future direction of programme with this client group and complements previous research in the area using qualitative methods [30,31]. The results showed that despite the patients beginning the exercise programme to lose weight, improve their health and join the programme through their doctor's recommendation, they experienced doubts and feelings of apprehension about starting the programme.…”

“…Finally, different descriptive categories were created, representing the main themes of interest identified by the research team. The research team was involved throughout the process, and frequent meetings were held [30]. Table 2 presents the themes and their subthemes.…”

Exploring the Perceptions of Women from Under-Resourced South African Communities about Participating in a Low-Carbohydrate High-Fat Nutrition and Health Education Program: A Qualitative Focus Group Study

“…Family support is believed to be of aid in adherence to a range of dietary and health interventions [55][56][57][58]. In contrast, participants in this study identified the lack of support from family and peers as a major challenge during the EBSA program and it made eating in social situations difficult.…”

Weight Reduction Through a Cognitive Behavioral Therapy Lifestyle Intervention in PCOS: The Primary Outcome of a Randomized Controlled Trial

“…Others have shown that lifestyle treatment in combination with weight‐loss medication, meal replacement products, and/or (very) low‐calorie diets are successful only for a short period of time in women with PCOS (14,15,33,34). Many participants regain the lost weight because they find it difficult to adhere to medication, meal replacement products, and/or (very) low‐calorie diets for long periods of time (35). This might explain why long‐term results of such therapies are absent or disappointing.…”