The role of orlistat combined with lifestyle changes in the management of overweight and obese patients with polycystic ovary syndrome
Open accessAbstract
OBJECTIVE: Obesity is frequently present in women with the polycystic ovary syndrome (PCOS) and aggravates insulin resistance (IR) and hyperandrogenemia. We aimed to assess the effects of orlistat combined with lifestyle changes in overweight and obese women with PCOS and body mass index (BMI)-matched controls. DESIGN: Prospective study. PATIENTS: We studied 101 women with PCOS (age 26·1 ± 6·4 years, BMI 34·5 ± 5·9 kg/m(2) ) and 29 BMI-matched women with normal ovulating cycles. All women were instructed to follow a low-calorie diet to exercise and were treated with orlistat 120 mg tid for 6 months. MEASUREMENTS: Metabolic and endocrine characteristics of PCOS, blood pressure (BP) and lipid profile. RESULTS: A significant and comparable reduction in BMI was observed in women with PCOS and controls. Systolic and diastolic BP decreased only in women with PCOS. Serum low-density lipoprotein cholesterol levels decreased in both women with PCOS and controls; however, this reduction was greater in controls. In contrast, serum high-density lipoprotein cholesterol levels did not change in women with PCOS and decreased in controls. Serum triglyceride levels decreased significantly and to a comparable degree in the two groups. Similarly, markers of IR improved significantly and to a comparable degree in women with PCOS and controls. Serum testosterone levels and the free androgen index decreased significantly in women with PCOS and did not change in controls. CONCLUSIONS: Orlistat combined with lifestyle changes induces substantial weight loss in women with PCOS, resulting in improvements in IR, hyperandrogenemia and cardiovascular risk factors.
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One study with a hypocaloric diet + an anti-obesity drug intervention (Orlistat), and another study with an anti-obesity drug intervention (Orlistat) + a hypocaloric diet + exercise intervention, reported a statistically significant difference in total testosterone following intervention between the two study groups, with the non-PCOS group having lower values in both studies.
“One study with a hypocaloric diet + an anti-obesity drug intervention (Orlistat) [30], and another study with an anti-obesity drug intervention (Orlistat) + a hypocaloric diet + exercise intervention [35] reported a statistically significant difference in total testosterone following intervention between the two study groups, with the non-PCOS group having lower values in both studies (Table 3).”
From Weight management interventions in women with and without PCOS: a systematic review (2017) · cites this paper as [35]
One study with an anti-obesity drug intervention (Orlistat) + a hypocaloric diet + exercise intervention reported a statistically significant difference in FAI values post intervention between groups (p = 0.021), with women in the non-PCOS group having a lower mean value.
“Five studies reported FAI [31,33,35,40,44], with one study with an anti-obesity drug intervention (Orlistat) + a hypocaloric diet + exercise intervention [35] reporting a statistically significant difference in values post intervention between groups (p = 0.021), with women in the non-PCOS group having a lower mean value (Table 3).”
From Weight management interventions in women with and without PCOS: a systematic review (2017) · cites this paper as [35]
Three studies reported that there was no statistically significant difference in fasting glucose post-intervention between the two groups.
“The majority of studies did not report whether there were between-group statistical significance, and three studies [35,43,44] reported that there was no statistically significant difference in fasting glucose post-intervention between the two groups (Table 4).”
From Weight management interventions in women with and without PCOS: a systematic review (2017) · cites this paper as [35]
One study with an anti-obesity drug intervention (Orlistat) + a hypocaloric diet + exercise intervention reported a statistically significant difference in total, LDL and HDL cholesterol post-intervention between groups, with women in the PCOS group having lower mean values.
“One study with an anti-obesity drug intervention (Orlistat) + a hypocaloric diet + exercise intervention [35] reported a statistically significant difference in total, LDL and HDL cholesterol post-intervention between groups, with women in the PCOS group having lower mean values (Table 5).”
From Weight management interventions in women with and without PCOS: a systematic review (2017) · cites this paper as [35]
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- Authors
- Panidis, D., Tziomalos, K., Papadakis, E., Chatzis, P., Kandaraki, E. A., Tsourdi, E. A., & Katsikis, I.
- Affiliations
- Aristotle University of Thessaloniki (GR)
- First Propedeutic Department of Internal Medicine Aristotle University of Thessaloniki AHEPA Hospital Thessaloniki Greece
- Venue
- Clinical Endocrinology
- Publisher
- Wiley
- Published
- 2013-08-28
- Volume
- 80
- Issue
- 3
- Pages
- 432-438
- ISSN
- 0300-0664 (ISSN-L)
- 1365-2265
- OpenAlex
- W2162587787
- Cited by
- 43
- References
- 39
- Citations by year
- 2026: 2 · 2024: 4 · 2023: 5 · 2021: 3 · 2020: 1 · 2019: 3 · 2018: 5 · 2017: 5 · 2016: 3 · 2015: 6 · 2014: 5 · 2013: 1
- FWCI
- 6.04
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- orlistat, polycystic ovary syndrome, obesity, overweight, lifestyle modification, weight loss, insulin resistance, hyperandrogenemia, hypocaloric diet, physical activity, blood pressure, lipid profile, triglycerides, free androgen index, testosterone, cardiovascular risk factors
- MeSH terms
- Orlistat, Adult, Combined Modality Therapy, Female, Humans, Lactones, Life Style, Obesity, Polycystic Ovary Syndrome, Weight Loss, Exercise, Body Mass Index, Anti-Obesity Agents, Caloric Restriction, Overweight, Young Adult, Weight Reduction Programs
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