Treatment of obesity in polycystic ovary syndrome: A position statement of the Androgen Excess and Polycystic Ovary Syndrome Society
Open accessAbstract
Objective To summarize current evidence on lifestyle management (dietary, exercise, or behavioral interventions) of obesity in women with polycystic ovary syndrome (PCOS), to indicate gaps in knowledge, and to review the medical and surgical alternatives for weight management.Design Expert panel appointed by the Androgen Excess and PCOS Society (AEPCOS Society) to review the literature and draft the initial report after a consensus process via electronic communication. The initial report was reviewed and critiqued by all expert panel members and the AEPCOS Society Board of Directors and modified based on their comments.Conclusion(s) Lifestyle management should be used as the primary therapy in overweight and obese women with PCOS for the treatment of metabolic complications. For reproductive abnormalities, lifestyle modification may improve ovulatory function and pregnancy. Data are preliminary for improvement in pregnancy and live-birth rates, and further research is needed. There is currently no evidence that modifying dietary macronutrient composition offers additional benefits over conventional dietary approaches for weight loss, and further research is needed. Emerging evidence suggests that exercise offers additional benefits to dietary energy restriction for reproductive features of PCOS.
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The original questionnaire was developed by the study authors based on established guidelines regarding PCOS management.
“The original questionnaire was developed by the study authors based on established guidelines regarding PCOS management [18,19].”
From Dietary Patterns and Metabolic and Hormonal Parameters in Women with Suspected PCOS (2025) · cites this paper as [18]
Prevention of weight gain is recommended in PCOS position statements and guidelines.
“Prevention of weight gain is recommended in PCOS position statements and guidelines (12, 29) and is more feasible at the individual level than weight loss (30).”
From Delayed Diagnosis and a Lack of Information Associated With Dissatisfaction in Women With Polycystic Ovary Syndrome (2016) · cites this paper as [29]
Weight loss improves all the features of PCOS.
“Weight loss, in turn, improves all the features of PCOS, and lifestyle (diet, physical activity and behavior) changes and weight management are recommended as first line treatment for PCOS [21,22]”
From Weight management interventions in women with and without PCOS: a systematic review (2017) · cites this paper as [21]
Weight loss improves reproductive, metabolic and psychological features in PCOS.
“weight loss improves reproductive, metabolic and psychological features”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [6]
Increased obesity exacerbates incidence, prevalence and severity of PCOS.
“increased obesity exacerbates incidence, prevalence and severity of PCOS”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [6]
Among women who are already overweight, multidisciplinary lifestyle intervention aimed at improving IR and aiding weight management is recognised as first-line therapy for most women who are overweight.
“among those who are already overweight, multidisciplinary lifestyle intervention aimed at improving IR and aiding weight management is recognised as firstline therapy for most women who are overweight. 6”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [6]
Lifestyle therapy has significant health benefits in women with PCOS.
“Lifestyle therapy is deemed first line for women with PCOS, targeting prevention of weight gain and promoting weight loss where required, with significant health benefits. 6,163,207”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [6]
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Self-citationLifestyle Modification Programs in Polycystic Ovary Syndrome: Systematic Review and Meta-Analysis
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Moran, L. J., Ranasinha, S., Zoungas, S., McNaughton, S. A., Brown, W. J., & Teede, H. J. (2013) · Human Reproduction · doi:10.1093/humrep/det256 · Cited by 144 · see citing works
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Self-citationWomen's experiences of polycystic ovary syndrome diagnosis
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Effects of Mixed of a Ketogenic Diet in Overweight and Obese Women with Polycystic Ovary Syndrome
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Weight management interventions in women with and without PCOS: a systematic review
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A randomized pilot study of dietary treatments for polycystic ovary syndrome in adolescents
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“Treatment guidelines specify lifestyle modification, including weight-loss diets, as the first line of therapy for PCOS among overweight and obese girls (11,12).”
Health-related knowledge, beliefs and self-efficacy in women with polycystic ovary syndrome
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THERAPY OF ENDOCRINE DISEASE: Treatment of hirsutism in the polycystic ovary syndrome
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Self-citationOptimizing reproductive health in women with obesity and infertility
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Aerobic exercise improves cardiac autonomic modulation in women with polycystic ovary syndrome
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“While weight loss improves many of the clinical features of PCOS (25) , it is important to appreciate that IR also affects women with PCOS who present within a healthy-weight range (in accordance with normal BMI classifications) (26) .”
Self-citationDietary Patterns and Metabolic and Hormonal Parameters in Women with Suspected PCOS
Kowalczyk, K., Kadłubek, S., Krużel, A., Sikora, D., Daniluk, J., & Madej, P. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14082708 · Cited by 4 · see citing works
“The original questionnaire was developed by the study authors based on established guidelines regarding PCOS management [18,19].”
- Authors
- Moran, L. J., Pasquali, R., Teede, H. J., Hoeger, K. M., & Norman, R. J.
- Affiliations
- Jean Hailes (AU)
- IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola (IT)
- University of Rochester Medicine (US)
- The University of Adelaide (AU)
- Corresponding author
- Moran, Lisa J.
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2009-12
- Volume
- 92
- Issue
- 6
- Pages
- 1966-1982
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W2016548273
- Cited by
- 444
- References
- 103
- Citations by year
- 2026: 23 · 2025: 28 · 2024: 17 · 2023: 21 · 2022: 29 · 2021: 29 · 2020: 28 · 2019: 20 · 2018: 31 · 2017: 16 · 2016: 20 · 2015: 32 · 2014: 32 · 2013: 22 · 2012: 33
- FWCI
- 24.33
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- polycystic ovary syndrome, obesity, weight management, lifestyle modification, dietary intervention, physical activity, behavioral interventions, ovulatory function, pregnancy outcomes, live birth, metabolic complications, macronutrient composition, caloric restriction, bariatric surgery, hyperandrogenism
- MeSH terms
- Female, Humans, Obesity, Polycystic Ovary Syndrome, Pregnancy, Risk Factors, Societies, Medical, Risk Reduction Behavior, Overweight
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