Management of obesity in adolescents with polycystic ovary syndrome

ABSTRACT

Introduction: Approximately 1% of adolescents have polycystic ovary syndrome (PCOS) and almost 40–70% of these patients are overweight or obese. Obese adolescents with PCOS have more severe insulin resistance and hyperandrogenemia, a more adverse lipid profile and a worse quality of life than normal-weight adolescents with PCOS. Accordingly, weight loss is an important component of the management of these patients.

Areas covered: The authors discuss the different options for weight loss in obese adolescents with PCOS. Lifestyle changes appear to be effective but adherence to this intervention is suboptimal. There are also limited data regarding the optimal diet in this population. Few small studies have evaluated the effects of pharmacotherapy in these patients. Conflicting data have been reported regarding the effects of metformin on body weight. Notably, agents that have been approved for weight loss in adults have not been evaluated in adolescents with PCOS.

Expert opinion: More studies are needed to identify the most appropriate diet for obese adolescents with PCOS. Well-designed randomized controlled studies are also needed to define the safety and efficacy of pharmacotherapy in this population.

KEYWORDS:

• Adolescents
• diet
• exercise
• metformin
• obesity
• oral contraceptive pill
• polycystic ovary syndrome

Article highlights

• The majority of adolescents with polycystic ovary syndrome (PCOS) are overweight or obese.

• Lifestyle changes are the cornerstone of the management of obesity in this population.

• The optimal diet in these patients is unclear.

• Most studies suggest that metformin does not promote weight loss in obese adolescents with PCOS.

• Orlistat, liraglutide, naltrexone/bupropion, phentermine/topiramate and lorcaserine have not been evaluated, so far, in this population.

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Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This manuscript was not funded.