Polycystic Ovarian Syndrome (PCOS) and Weight Gain

– written by: Rebecca Levine MS, RD, LDN

PCOS stands for Polycystic Ovarian Syndrome. Many overweight women may be diagnosed with PCOS and feel that they have not been given enough information on what the condition is or why it occurs. It is estimated that 1 in 10 women have PCOS, but may be uninformed about the condition. PCOS is considered a syndrome or a set of symptoms. Inconsistencies with symptoms can sometimes make PCOS difficult to diagnose. In addition, not every woman experiences the same symptoms. PCOS diagnosis involves 2 or 3 of the following symptoms: irregular ovulation, excess androgens (male hormones, and polycystic ovaries. PCOS is the leading cause of female infertility. Almost 10% of all reproductive age women worldwide show symptoms of PCOS. In addition, many patients with PCOS exhibit excess male hormones, which display as male-like hair growth, acne or thinning of the hair at the scalp.

This combination of PCOS symptoms can lead to an increased risk of obesity, heart disease, high blood pressure, diabetes, and infertility. Many women who are diagnosed with PCOS also have a family history of obesity, diabetes or insulin resistance. Treatment of PCOS requires a combination of medical therapy, diet and exercise modifications and psychological support. It has also been shown that weight loss surgery can help overweight women to manage their PCOS more effectively.

PCOS and Metabolic Abnormalities:

Women with PCOS have high prevalence of insulin resistance and impaired tolerance to glucose, both possible precursors to diabetes. Insulin resistance can be difficult to measure, but more than 50% of women with PCOS have insulin resistance and many progress to having the Metabolic Syndrome. Metabolic Syndrome requires 3 of the following for diagnosis: central obesity, elevated triglycerides, elevated LDL (bad) cholesterol and low HDL (good) cholesterol, high blood pressure and elevated fasting blood sugar. About 40-50% of women with PCOS are diagnosed with Metabolic Syndrome.

It has been shown that being overweight can worsen the symptoms of Metabolic Syndrome. Despite widespread agreement that weight control is critical for treating symptoms of PCOS and Metabolic Syndrome, weight loss can be difficult for many patients to achieve on their own. Other health conditions combined with an increase in excess body weight can cause people to feel discouraged when it comes to weight loss. Although diet and exercise modifications are usually the first line of treatment for overweight women, most studies show limited ability to lose large amounts of excess body weight and keep weight off with traditional methods. Weight loss surgery treatment for women with a larger amount of excess body weight has been shown to be an effective treatment for PCOS.

Metabolic Improvements after Bariatric Surgery:

As previously discussed, several metabolic abnormalities can come along with having PCOS. Weight loss surgery has been shown to help with metabolic abnormalities by improving insulin sensitivity and glucose usage, and lowering cholesterol and blood pressure. In addition, a study that followed women with PCOS noted that most women regained normal menstrual function and many had spontaneous ovulation after weight loss surgery. These patients also showed a significant decrease in male-like hair growth and androgen production. Many women also showed signs of hypothyroidism before surgery, which was significantly reduced after weight loss surgery. Another study of women undergoing Lap Band surgery with PCOS, with a follow-up period of more than 2 years, showed that all women resumed normal menstrual cycles and showed improved blood glucose control after weight loss surgery.

It has been shown that women with large amounts of excess body weight who also have PCOS are at an increased risk for life-long health issues far beyond menopause. Even starting with a weight loss of 5% of total body weight has been shown to be effective in starting to improve both reproductive and metabolic abnormalities in women with PCOS. Here at DayOne Health we are committed to helping women lose weight and improve symptoms of PCOS. Treatment of PCOS requires a multifactorial approach which can include nutrition and physical activity counseling and stress management. DayOne Health offers a comprehensive support program that is tailored to patients’ individual needs.

Please call our clinic at (312) 255-1900 to learn more about our weight loss surgery program.

Resources

Grassi, MS, RD, LDN, Angela . (January 22, 2013). McDonald Center for Obesity Prevention and Education (COPE). PCOS and Weight Management: Best Strategies for Healthcare Providers. http://www1.villanova.edu/content/villanova/nursing/centers/obesity/webinar_archives/_jcr_content/pagecontent/download_4/file.res/COPE%20Webinar%20PCOS%20and%20Weight%20Management.pdf.

Grassi, MS, RD, LDN, Angela. Nutrition Information for PCOS. Retreived from www.pcosnutrition.com.

Malik, Shaveta M., Traub, Michael L. (April 15, 2012). Defining the Role of Bariatric Surgery in Polycystic Ovarian Syndrome Patients. World Journal of Diabetes, 3(4): 71-79. http://www.wjgnet.com/1948-9358/pdf/v3/i4/71.pdf.