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The Effect of a Very-Low-Calorie Diet (VLCD) vs. a Moderate Energy Deficit Diet in Obese Women with Polycystic Ovary Syndrome (PCOS)—A Randomised Controlled Trial
Abstract
We performed an open-label, randomised controlled trial to compare the effects of a very-low-calorie diet (VLCD) vs. moderate energy deficit approach on body weight, body composition, free androgen index (FAI), and metabolic markers in obese women with polycystic ovary syndrome (PCOS). Forty eligible patients were randomly assigned to a VLCD (n = 21) or a conventional energy deficit approach (n = 19) over the same period. After eight weeks, both groups experienced significant weight loss; however, this was greater in the VLCD arm (−10.9% vs. −3.9%, p < 0.0001). There was also a trend towards a reduction in FAI in the VLCD group compared to the energy deficit group (−32.3% vs. −7.7%, p = 0.07). In the VLCD arm, two women (18%) had a biochemical remission of PCOS (FAI < 4); this was not the case for any of the participants in the energy deficit arm. There was a significant within-group increase in the sex-hormone-binding globulin (p = 0.002) and reductions in fasting blood glucose (p = 0.010) and waist to hip ratio (p = 0.04) in the VLCD arm, but not in the energy deficit arm. The VLCD resulted in significantly greater weight reduction and was accompanied by more pronounced improvements in hyperandrogenaemia, body composition, and several metabolic parameters in obese women with PCOS as compared to the energy deficit approach.
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“Similar to fasting, CR has been associated with improvements in hyperandrogenemia, particularly through weight reduction; however, further research is needed in this area (Deshmukh et al. 2023).”
From The Effects of Fasting and Caloric Restriction on Reproductive Hormones: A Systematic Review, Meta‐Analysis, and GRADE Assessment (2026) · cites this paper as Deshmukh et al. 2023
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“We reported a slightly lower weight loss with the VLCD in our study as compared to other T2DM cohorts [21]; this could be due to the difference in the mechanism of insulin resistance in women with PCOS as compared to T2DM, and further studies are needed to confirm this effect.”
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Cited by
The Role of Lifestyle Interventions in PCOS Management: A Systematic Review
Gautam, R., Maan, P., Jyoti, A., Kumar, A., Malhotra, N., & Arora, T. (2025) · Nutrients · doi:10.3390/nu17020310 · Cited by 115
Fulgoni, V. L., Agler, A., Ricciuto, L., DiFrancesco, L., Williams, D., & Hertzler, S. R. (2024) · The Journal of Nutrition · doi:10.1016/j.tjnut.2024.07.022 · Cited by 8
Ghoreishy, S. M., Rafiei, S., Atabaki, Y., Jafarbeglou, N., Hamidi, N., Noormohammadi, M., Fatahi, P., Ghaemi, S., Shidfar, F., & Shidfar, F. (2026) · Food Science & Nutrition · doi:10.1002/fsn3.72078
Metadata
- Authors
- Deshmukh, H., Papageorgiou, M., Wells, L., Akbar, S., Strudwick, T., Deshmukh, K., Vitale, S. G., Rigby, A., Vince, R. V., Reid, M., & Sathyapalan, T.
- Affiliations
- Department of Academic Diabetes and Endocrinology, Allam Diabetes Centre, Hull University Teaching Hospitals NHS Trust, Hull HU3 2JZ, UK
- Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland
- School of Sport, Exercise and Rehabilitation Sciences, University of Hull, Hull HU6 7 RX, UK
- School of Psychology and Social Work, University of Hull, Hull HU6 7 RX, UK
- Division of Gynecology and Obstetrics, Department of Surgical Sciences, University of Cagliari, 09121 Cagliari, Italy
- Institute of Clinical and Applied Health Research, Hull York Medical School, Hull HU6 7 RX, UK
- Venue
- Nutrients
- Publisher
- MDPI AG
- Published
- 2023-09-06
- Volume
- 15
- Issue
- 18
- Pages
- 3872
- ISSN
- 2072-6643
- Cited by
- 33
- References
- 16
- Language
- en
- Funders
- an NIHR clinical lectureship
- Hull University Teaching Hospitals NHS
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- CoChat. (2026). Citation check: The Effect of a Very-Low-Calorie Diet (VLCD) vs. a Moderate Energy Deficit Diet in Obese Women with Polycystic Ovary Syndrome (PCOS)—A Randomised Controlled Trial. https://app.cochat.ai/papers/10.3390/nu15183872
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- Deshmukh, H., Papageorgiou, M., Wells, L., Akbar, S., Strudwick, T., Deshmukh, K., Vitale, S. G., Rigby, A., Vince, R. V., Reid, M., & Sathyapalan, T. (2023). The Effect of a Very-Low-Calorie Diet (VLCD) vs. a Moderate Energy Deficit Diet in Obese Women with Polycystic Ovary Syndrome (PCOS)—A Randomised Controlled Trial. Nutrients. https://doi.org/10.3390/nu15183872
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