The role of orlistat combined with lifestyle changes in the management of overweight and obese patients with polycystic ovary syndrome

Panidis, Dimitrios; Τζιόμαλος, Κωνσταντίνος; Papadakis, Efstathios; Chatzis, Panagiotis; Kandaraki, Eleni; Tsourdi, Elena; Katsikis, Ilias

doi:10.1111/cen.12305

Cited by 35 publications

(43 citation statements)

References 37 publications

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“…56,57 A reduced carbohydrate diet also appears to result in preferential loss of abdominal fat mass. 58 It is well established that diet improves IR in patients with PCOS, [59][60][61] while exercise also appears to improve IR and to reduce visceral fat in this population. 62,63 Lifestyle changes reduced the risk of progression from IGT to T2DM in the general population 64,65 and in patients with PCOS.…”

Section: Management Of Prediabetes and T2dm In Patients With Pcosmentioning

confidence: 99%

“…62 Importantly, the use of antiobesity agents is not recommended because of limited data on their safety and efficacy in patients with PCOS. 57,61,71 In patients with PCOS who are diagnosed with T2DM there are no specific recommendations for the choice of antidiabetic treatment. 72 Accordingly, metformin and lifestyle changes are the treatment of choice, while any antidiabetic agent can be added in patients who do not achieve glycemic targets despite treatment with metformin (i.e.…”

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confidence: 99%

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Prevalence, pathogenesis and management of prediabetes and type 2 diabetes mellitus in patients with polycystic ovary syndrome

Lazaridou

Dinas

Τζιόμαλος

2018

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Polycystic ovary syndrome (PCos) is the most common endocrinopathy in women of reproductive age. PCos is not only the leading cause of anovulatory infertility but is also associated with an array of metabolic disorders, among which impaired glucose metabolism has been a topic of intense research. The aim of the present narrative review is to summarize the findings of the studies that have evaluated the prevalence and incidence of prediabetes and type 2 diabetes mellitus (T2Dm) in patients with PCos, to analyze the factors underpinning the association between T2Dm and PCos and to discuss the current strategies for screening and management of impaired glucose metabolism in this population. Both prediabetes and T2Dm are highly prevalent in patients with PCos. Accordingly, regular screening is recommended in this population for the early identification of impaired glucose metabolism, particularly in overweight or obese patients and in those with a family history of T2Dm. Prevention of T2Dm in patients with prediabetes is primarily based on lifestyle changes, while metformin might be considered in selected cases. The treatment of T2Dm is similar in patients with and without PCos but appropriate contraceptive measures should be implemented in patients receiving treatments other than insulin, metformin or glyburide.

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Section: Management Of Prediabetes and T2dm In Patients With Pcosmentioning

confidence: 99%

mentioning

confidence: 99%

Prevalence, pathogenesis and management of prediabetes and type 2 diabetes mellitus in patients with polycystic ovary syndrome

Lazaridou

Dinas

Τζιόμαλος

2018

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“…This drug inhibits intestinal lipase activity, thus reducing fat absorption, but may result in steatorrhoea. Experience of the use of this drug in patients with PCOS is limited, but if combined with diet it reduces the body weight and improves insulin resistance, hyperandrogenaemia and cardiovascular risk factor [89,90].…”

Section: Treatment With Anti-obesity Drugsmentioning

confidence: 99%

Polycystic ovaries and obesity

Messinis

Messini

Anifandis

et al. 2015

Best Practice & Research Clinical Obstetrics & Gynaecol

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“…The British Fertility Society advises that fertility treatment should be deferred until women have a body mass index (BMI) of less than 35 or BMI under 30 if they are below 37 years of age [7]. Metformin and nonsurgical weight loss measures have been advocated as first-line management for PCOS [8, 9]. It has been suggested that even a modest loss of up to 5% of the initial body weight can result in spontaneous ovulation, restoration of menstrual cycle regularity, and pregnancy in obese women with PCOS [10–12].…”

Section: Introductionmentioning

confidence: 99%

Bariatric Surgery, Polycystic Ovary Syndrome, and Infertility

2016

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Background. Polycystic ovary syndrome (PCOS) is the commonest cause of female infertility. Visceral obesity and insulin resistance are key pathophysiological mechanisms behind PCOS. Women suffering from this syndrome and infertility often seek bariatric surgery hoping that they would be able to conceive postoperatively. Objective. At present, there is no consensus on the role of bariatric surgery in the management of PCOS-associated infertility within the medical community, making it difficult to give specific advice to these women, so a review of the literature was necessary. Results. A detailed review of the literature was performed. Only 6 manuscripts were relevant and contained quantitative data. They demonstrated that bariatric surgery results in postoperative conception rates varying from 33% to 100%. Surgery is also associated with amelioration of menstrual irregularities, hormonal abnormalities, and hirsutism that are associated with PCOS. These studies were retrospective and only had a small number of participants with infertility. Conclusions. Bariatric surgery has been shown to conclusively improve life expectancy, quality of life, and comorbidities like type 2 diabetes and obstructive sleep apnea. However, further research is required to identify whether weight loss surgery results in significant improvement in fertility of women with PCOS and to investigate which operation has the best results.

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The role of orlistat combined with lifestyle changes in the management of overweight and obese patients with polycystic ovary syndrome

Abstract: Orlistat combined with lifestyle changes induces substantial weight loss in women with PCOS, resulting in improvements in IR, hyperandrogenemia and cardiovascular risk factors.

Cited by 35 publications

References 37 publications

Prevalence, pathogenesis and management of prediabetes and type 2 diabetes mellitus in patients with polycystic ovary syndrome

Prevalence, pathogenesis and management of prediabetes and type 2 diabetes mellitus in patients with polycystic ovary syndrome

Polycystic ovaries and obesity

Bariatric Surgery, Polycystic Ovary Syndrome, and Infertility

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