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Cognitive-behavioral therapy improves weight loss and quality of life in women with polycystic ovary syndrome: a pilot randomized clinical trial
Open accessAbstract
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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“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]
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“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]
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“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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Citations
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Research works printed but not linked: 1
- Evidence-based methodology workshop on polycystic ovary syndrome, 2012
Cited by
Sorted by citations
Update on PCOS: consequences, challenges, and guiding treatment
Hoeger, K. M., Dokras, A., & Piltonen, T. (2021) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgaa839 · Cited by 610
Self-citationStener-Victorin, E., Teede, H., Norman, R. J., Legro, R., Goodarzi, M. O., Dokras, A., Laven, J., Hoeger, K., & Piltonen, T. T. (2024) · Nature Reviews Disease Primers · doi:10.1038/s41572-024-00511-3 · Cited by 495
Self-citationLifestyle management in polycystic ovary syndrome – beyond diet and physical activity
Cowan, S., Lim, S. S., Alycia, C., Pirotta, S., Thomson, R. L., Gibson‐Helm, M. E., Blackmore, R., Naderpoor, N., Bennett, C., Ee, C., et al. (2023) · BMC Endocrine Disorders · doi:10.1186/s12902-022-01208-y · Cited by 322
Alur-Gupta, S., Chemerinski, A., Liu, C., Lipson, J., Allison, K., Sammel, M. D., & Dokras, A. (2019) · Fertility and Sterility · doi:10.1016/j.fertnstert.2019.06.018 · Cited by 161
Self-citationKazemi, M., McBreairty, L. E., Chizen, D. R., Pierson, R. A., Chilibeck, P. D., & Zello, G. A. (2018) · Nutrients · doi:10.3390/nu10101387 · Cited by 118
Metadata
- 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)
- 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
- bronze
- doi.org
- 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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