Obesity commonly occurs in PCOS and contributes to increased metabolic risk and low self esteem. Advice on weight loss underpins all management strategies in the obese lady with PCOS but weight loss can remain elusive despite best efforts. We wished to determine how diet advice alone compared to metformin and/or liraglutide in our patients.
Methods: We conducted an observational retrospective anonymized review of patients attending an endocrinology clinic actively seeking management of obesity associated with PCOS. All patients received advice on carbohydrate controlled weight reduction diet from a registered dietician and were encouraged to increase exercise levels. One group of patients opted to follow a diet and exercise program only (n=12, mean age 25±7) - 10 declined medication, 2 were intolerant of metformin. A second group of patients also received metformin (n=31,age 30.7±7.3). A third and final group of patients were offered and availed of liraglutide therapy (n=10, age 36.3±7.2, 7 of these patients also received metformin).
Results: Those patients who received liraglutide were significantly heavier than both other groups 116.3±21.1 kg versus 86.3±9.7 kg for diet only and 93.0±16.1 kg for metformin. At six month follow up there was no statistically significant weight loss in the diet group while both other groups achieved statistically significant weight loss and reduction in BMI. See Table. 3 of 12 diet patients achieved weight loss > 5% compared to 9 of 10 liraglutide patients and 22 of 31 metformin treated patients.
|Wt Pre (kg)||Wt Post (kg)||P value paired t test||BMI Pre (kg/m2)||BMI Post (kg/m2)||P value paired t test|
Conclusion: While retrospective studies may contain inherent bias in our group of patients, therapy in the form of metformin and liraglutide with diet and exercise advice was superior to diet & exercise alone. Liraglutide was offered to patients who were older and had significantly higher BMI at first presentation.
18 - 21 May 2019
European Society of Endocrinology