Research questionWhat is the effect of weight loss through different interventions (three-component lifestyle intervention with short message service (SMS+) vs three-component lifestyle intervention without SMS (SMS-) vs care as usual (CAU)) on PCOS characteristics (ovulatory dysfunction (OD), hyperandrogenism (HA), polycystic ovarian morphology (PCOM)) and phenotype distribution? DesignAnalysis of secondary outcome measures of a randomized controlled trial. Women (n=183) diagnosed with PCOS, a wish to become pregnant and a BMI >25 kg/m² were either assigned to a one-year three-component (cognitive behavioural therapy, diet, exercise) lifestyle intervention group, with or without SMS, or to CAU (advice to lose weight). ResultsThe prevalence of biochemical HA was 30.9% less in the SMS-group when compared to CAU after one year (p=0.027). Within-group analyses revealed significant improvements in OD (SMS+: -39.8% p=0.001, SMS-: -30.5% p=0.001, CAU: -32.1% p<0.001), biochemical HA (SMS-: -27.8% p=0.007) and PCOM (SMS-: -14.0% p=0.034). Finally, weight loss per se had a significant favourable effect on OD and HA. ConclusionsAll groups demonstrated improvements regarding PCOS characteristics, although these were more profound within the lifestyle intervention groups. Weight loss per se led to an amelioration of both the diagnostic characteristics as well as in the phenotype of PCOS.Hence, a three-component lifestyle intervention aiming at a 5-10% weight loss should be recommended for all women with PCOS before they get pregnant.

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