Energy balance
Weight loss through lifestyle interventions (hypocaloric diet and physical activity) significantly improves hormonal, metabolic, and reproductive outcomes (including ovulation and fertility) in obese women with PCOS, with benefits correlating to the amount of weight lost.
For obese women with PCOS, losing weight is the most effective way to restore ovulation and fertility. Focus on a hypocaloric diet and regular physical activity. The amount of weight you lose directly correlates with how well your ovulation improves. While medications like Metformin exist, the primary driver of success is the weight loss itself, not just the drug. Your metabolic rate is likely normal for your weight; the difficulty is in maintaining the caloric deficit.
The importance of obesity in the pathogenesis of PCOS is emphasised by the efficacy of lifestyle intervention and weight loss, not only on metabolic alterations but also on hyperandrogenism, ovulation and fertility.
Why this rating
The paper cites multiple studies and a 48-week prospective study showing significant positive effects, though it notes obesity makes weight loss difficult.
Source
Review article: The impact of obesity on reproduction in women with polycystic ovary syndrome
R. Pasquali et al. · BJOG An International Journal of Obstetrics & Gynaecology · 2006
DOI 10.1111/j.1471-0528.2006.00990.x
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