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Cited by 117Ovarian function and disordersEating Disorders and BehaviorsAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Cognitive-behavioral therapy improves weight loss and quality of life in women with polycystic ovary syndrome: a pilot randomized clinical trial

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Cooney, Laura G., Milman, Lauren W., Hantsoo, Liisa, Kornfield, Sara, Sammel, Mary D., Allison, Kelly C., Epperson, C. Neill, Dokras, Anuja·2018·Fertility and Sterility
DOI 10.1016/j.fertnstert.2018.03.028PMC PMC6443091
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Abstract

Objective To compare the effects of cognitive-behavioral therapy (CBT) and lifestyle modification (LS) versus LS alone on weight, depressive and anxiety symptoms, and stress response in women with polycystic ovary syndrome (PCOS), overweight/obesity, and depressive symptoms. Design A 16-week pilot randomized clinical trial. Setting Tertiary-care PCOS center. Patient(s) Overweight/obese women with PCOS and depressive symptoms. Intervention(s) Weekly CBT (n = 7) or contact only/no therapy (n = 8) for 8 weeks. Both groups received weekly LS for 16 weeks. Main outcome measure(s) Changes in weight, depression (Center for Epidemiologic Studies Depression Scale [CES-D]), anxiety (State-Trait Anxiety Inventory [STAI]), quality of life (Polycystic Ovary Syndrome Health-Related Quality of Life Questionnaire [PCOSQ]), laboratory tests, and response to a Trier Social Stress Test (TSST). Result(s) The CBT+LS group lost more weekly weight (-0.35 kg/wk vs. -0.16 kg/wk) compared with the LS group. Overall, the CBT+LS group lost 3.2 kg versus 1.8 kg for the LS group. The CBT+LS group had greater improvement in PCOSQ at 8 weeks (+3.7 vs. +1.2 points). In the overall cohort, STAI and CES-D decreased by -0.27 points per week and -0.31 points/wk, respectfully, and total and free T decreased at week 8. Heart rate response to TSST was lower at 15 minutes after stressor in the CBT+LS group. Conclusion(s) Weekly CBT+LS for 8 weeks compared with LS alone resulted in significant weight loss and improved quality of life in overweight/obese women with PCOS and depressive symptoms. These interventions were associated with a decreased autonomic response to a laboratory stressor, suggesting a potential link between CBT, weight loss, and modulation of the stress response. Clinical trial registration number NCT01899001.

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  • The CBT study had a high attrition rate for the CBT group, a small sample size, only included participants with an overweight or obese BMI, and was of the shortest duration (8 weeks) of the lifestyle interventions included in this review.

    “this study had a high attrition rate for the CBT group, a small sample size, only included participants with an overweight or obese BMI, and was of the shortest duration (8 weeks) of the lifestyle interventions included in this review”

    From Moving beyond Weight: A Narrative Review of the Dietary and Lifestyle Management for Reducing Cardiometabolic Risk in Polycystic Ovary Syndrome (PCOS) (2023) · cites this paper as [113]

    The Results report 33 women randomized, with only 7 of 20 in the CBT+LS group completing the study; the Participants section limits eligibility to BMI 27–50 kg/m². The CBT Methods section confirms eight weeks of CBT, but the paper describes a 16-week trial with lifestyle intervention throughout. Thus, eight weeks is not the duration of the full lifestyle intervention, and this source cannot establish that it was the shortest intervention in the citing review. Page numbers were not provided in our copy. (LLM, conf=0.89)

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  • CBT as an adjunct to lifestyle counseling improved weight loss compared to standard lifestyle counseling alone, and participants in the CBT group were significantly more likely to meet their exercise goal and keep their weekly food diary.

    “when researchers incorporated CBT as an adjunct to lifestyle counseling, they found significant improvements in weight loss compared to standard lifestyle counseling alone [113]. Additionally, participants in the CBT group were significantly more likely to meet their exercise goal and keep their weekly food diary than those solely in the lifestyle modification group [113].”

    From Moving beyond Weight: A Narrative Review of the Dietary and Lifestyle Management for Reducing Cardiometabolic Risk in Polycystic Ovary Syndrome (PCOS) (2023) · cites this paper as [113]

  • Many lifestyle intervention studies lacked a comparison group, had a small sample size, suffered from high attrition rates, and did not report on the length of duration.

    “Many studies lacked a comparison group [100,105,110,111,112], had a small sample size [105,109,110,112,113], suffered from high attrition rates [100,108,113], and did not report on the length of duration [105]”

    From Moving beyond Weight: A Narrative Review of the Dietary and Lifestyle Management for Reducing Cardiometabolic Risk in Polycystic Ovary Syndrome (PCOS) (2023) · cites this paper as [113]

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1 of the 57 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. [25]Evidence-based methodology workshop on polycystic ovary syndrome, 2012 Executive summary. Available at: https://prevention.nih.gov/docs/programs/pcos/FinalReport.pdf Accessed September 20, 2017.

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Authors
Cooney, L. G., Milman, L. W., Hantsoo, L., Kornfield, S., Sammel, M. D., Allison, K. C., Epperson, C. N., & Dokras, A.
Affiliations
University of Pennsylvania (US)
Corresponding author
Dokras, Anuja
ORCID
Venue
Fertility and Sterility
Publisher
Elsevier BV
Published
2018-07
Volume
110
Issue
1
Pages
161-171.e1
ISSN
0015-0282 (ISSN-L)
DOI
10.1016/j.fertnstert.2018.03.028
PMC
PMC6443091
OpenAlex
W2808702457
Cited by
117
References
57
Citations by year
2026: 13 · 2025: 10 · 2024: 19 · 2023: 23 · 2022: 16 · 2021: 13 · 2020: 12 · 2019: 6 · 2018: 5
FWCI
9.65
Type
journal article
Language
en
Open access
Licence
Locations
  • Fertility and Sterility (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (T32-HD007440)
  • Office of Research on Women's Health
  • University of Pennsylvania
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
cognitive behavioral therapy, polycystic ovary syndrome, lifestyle modification, weight loss, obesity, depressive symptoms, anxiety, quality of life, stress response, heart rate, Trier Social Stress Test
MeSH terms
Adult, Affect, Anxiety, Major Depressive Disorder, Depressive Disorder, Major, Female, Humans, Obesity, Pilot Projects, Polycystic Ovary Syndrome, Quality of Life, Risk Factors, Time Factors, Philadelphia, Weight Loss, Comorbidity, Cognitive Behavioral Therapy, Treatment Outcome, Risk Reduction Behavior

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