Weight control in polycystic ovary syndrome

Many individuals with polycystic ovary syndrome (PCOS) are overweight (have a body mass index [BMI] between 25 to 29 kg/m²), obese (BMI of 30 kg/m² or more) or centrally obese. Obesity in individuals with PCOS increases the risk and severity of:

• menstrual disturbance
• infertility
• obstructive sleep apnoea
• insulin resistance and type 2 diabetes
• cardiovascular disease 
• poor mental health
• nonalcoholic fatty liver disease.

In overweight individuals with PCOS, losing 5% of total body weight results in:

• reduced insulin resistance and hyperandrogenism
• improved ovulatory function, fertility and psychological wellbeing.

For information on weight management, see General principles of management of excess body weight.

If lifestyle measures are not effective in managing weight after 6 months, consider adding metformin. Metformin does not cause significant weight loss but may prevent weight gain.