Effectiveness of a 6-Month Lifestyle Intervention on Diet, Physical Activity, Quality of Life, and Markers of Cardiometabolic Health in Women with PCOS and Obesity and Non-PCOS Obese Controls: One Size Fits All?

Abstract

Little is known about the difference in effectiveness of lifestyle intervention between women with PCOS and non-PCOS women. In a post hoc longitudinal analysis of a randomized, controlled trial, we aimed to investigate whether infertile women with PCOS and obesity (N = 87) responded differently to a 6-month lifestyle intervention program than infertile non-PCOS obese controls (N = 172). We evaluated several aspects of the intervention such as changes in diet, physical activity, and dropout rate, as well as the effect on weight, quality of life (QoL), and cardiometabolic outcomes. Multilevel analyses were used, and analyses were adjusted for baseline characteristics such as age, education, and smoking. Although BMI in both groups significantly decreased at 3 months and 6 months, there were no significant differences between the groups at 3 months (adjusted B: −0.3, 95% CI: −0.9 to 0.3, p = 0.35) and 6 months (adjusted B: 0.5, 95% CI: −0.4 to 1.4, p = 0.29). Women with PCOS and non-PCOS women had similar compliance with the lifestyle intervention in terms of actual change in diet and physical activity. Mental QoL scores were not different at either 3 or 6 months. Physical QoL scores were lower in women with PCOS compared with non-PCOS women at 3 months (adjusted B: −2.4, 95% CI: −4.8 to −0.06, p = 0.045) but not at 6 months. Cardiometabolic parameters did not differ between the groups. Our results showed that infertile women with PCOS and obesity and non-PCOS obese controls responded largely similarly to our lifestyle intervention and achieved the same level of improvement in markers of cardiometabolic health.

Effects of weight loss intervention on anxiety, depression and quality of life in women with severe obesity and polycystic ovary syndrome

“…These findings are in contrast to previous studies on women with obesity and PCOS, in which weight loss led to improvement in several domains of the SF-36 15 , 49 . However, a more recent study of HRQoL in women with severe obesity showed no difference in improvement between women with and without PCOS after weight loss 50 .…”

Fitness Assessments of Women with Polycystic Ovary Syndrome: A Prospective Process Feasibility Study

“…The participants in this study presented with low levels of SHBG, which is often related to hyperandrogenism (also present in the participants in this study). The association between physical activity or cardiovascular fitness might be mediated, in part, through androgens; however, this has only been studied in men [27]. Findings from a systematic review about exercise effects on hormones suggest that SHBG was largely unaffected by aerobic exercise but increased with either the isolated use of resistance training or the combination of cardiovascular and resistance exercise [28].…”

Moving beyond Weight: A Narrative Review of the Dietary and Lifestyle Management for Reducing Cardiometabolic Risk in Polycystic Ovary Syndrome (PCOS)

“…Researchers have explored lifestyle interventions that included energy-restricted diets and exercise in individuals with PCOS with overweight and obesity (Table 2). The interventions included in this review differ in the amount of energy restricted, with energy deficits ranging from 500-800 kcal/day deficit [100][101][102][103][104] or total energy intakes ranging between 1000-1400 kcal/day [105][106][107]. The exercise components also varied and consisted of individualized exercise programs [100][101][102], structured exercise training programs [103,106], and general exercise recommendations [104,105,107].…”