Weight Reduction Through a Cognitive Behavioral Therapy Lifestyle Intervention in PCOS: The Primary Outcome of a Randomized Controlled Trial

Overview

Journal Obesity (Silver Spring)

Specialties Endocrinology
Nutritional Sciences
Physiology

Date 2020 Sep 24

PMID 32969197

Citations 18

Authors

Geranne Jiskoot

Reinier Timman

Annemerle Beerthuizen

Alexandra Dietz de Loos

Jan Busschbach

Joop Laven

Affiliations

Soon will be listed here.

Abstract

Objective: Long-term weight loss is important and difficult to achieve for many women with polycystic ovary syndrome (PCOS). Lifestyle interventions (LS) in PCOS have shown moderate short-term effects. Three-component LS that combine nutrition advice, exercise, and cognitive behavioral therapy have not been tested in long-term interventions.

Methods: Women (N = 183) with PCOS who were trying to conceive and had BMI > 25 kg/m were assigned to 20 group sessions of cognitive behavioral therapy combined with nutrition advice and exercise (LS with or without Short Message Service [SMS] via mobile phone) or care as usual (CAU).

Results: More weight loss was observed in LS than in CAU (P < 0.001). Adding SMS was even more effective (P = 0.017). In CAU, 13 of 60 (21.8%) succeeded in achieving a 5% weight loss, as did 32 of 60 (52.8%) in LS without SMS and 54 of 63 (85.7%) in LS with SMS. The odds of achieving a 5% weight loss were 7.0 (P < 0.001) in LS compared with CAU. More than 18 of 60 (29.0%) of the women in CAU gained weight versus 5 of 60 (8.5%) and 2 of 63 (3.1%) in LS without or with SMS, respectively. The overall dropout rate was 116 of 183 (63.4%).

Conclusions: A three-component LS program resulted in reasonable weight loss in women with PCOS. Adding SMS resulted in more weight loss.

Citing Articles

The Role of Lifestyle Interventions in PCOS Management: A Systematic Review.

Gautam R, Maan P, Jyoti A, Kumar A, Malhotra N, Arora T Nutrients. 2025; 17(2).

PMID: 39861440 PMC: 11767734. DOI: 10.3390/nu17020310.

A qualitative analysis of factors influencing physical activity behaviour in women with PCOS: key learning for physical activity interventions and beyond.

Woodward A, Klonizakis M, Broom D, Cholerton R, Piercy H Health Educ Res. 2024; 40(1).

PMID: 39658268 PMC: 11840715. DOI: 10.1093/her/cyae040.

Comparing the effectiveness of emotion-focused and cognitive-behavioral therapies on body image, anxiety, and depression in women with PCOS.

Amirshahi M, Saremi A, Nouri R, Karbalaee M, Hosseini Sadat R J Educ Health Promot. 2024; 13:230.

PMID: 39297112 PMC: 11410277. DOI: 10.4103/jehp.jehp_687_23.

Polycystic Ovary Syndrome and the Internet of Things: A Scoping Review.

Graca S, Alloh F, Lagojda L, Dallaway A, Kyrou I, Randeva H Healthcare (Basel). 2024; 12(16).

PMID: 39201229 PMC: 11354210. DOI: 10.3390/healthcare12161671.

Effects of mind-body interventions on polycystic ovary syndrome: a comprehensive meta-analysis.

Zhao K, Nie L, Ye X, Hu X J Ovarian Res. 2024; 17(1):154.

PMID: 39054488 PMC: 11271059. DOI: 10.1186/s13048-024-01477-2.

References

Mutsaerts M, Kuchenbecker W, Mol B, Land J, Hoek A . Dropout is a problem in lifestyle intervention programs for overweight and obese infertile women: a systematic review. Hum Reprod. 2013; 28(4):979-86. DOI: 10.1093/humrep/det026. View

Teede H, Deeks A, Moran L . Polycystic ovary syndrome: a complex condition with psychological, reproductive and metabolic manifestations that impacts on health across the lifespan. BMC Med. 2010; 8:41. PMC: 2909929. DOI: 10.1186/1741-7015-8-41. View

Kraemer H, Wilson G, Fairburn C, Agras W . Mediators and moderators of treatment effects in randomized clinical trials. Arch Gen Psychiatry. 2002; 59(10):877-83. DOI: 10.1001/archpsyc.59.10.877. View

Thakkar J, Kurup R, Laba T, Santo K, Thiagalingam A, Rodgers A . Mobile Telephone Text Messaging for Medication Adherence in Chronic Disease: A Meta-analysis. JAMA Intern Med. 2016; 176(3):340-9. DOI: 10.1001/jamainternmed.2015.7667. View

Dalle Grave R, Centis E, Marzocchi R, El Ghoch M, Marchesini G . Major factors for facilitating change in behavioral strategies to reduce obesity. Psychol Res Behav Manag. 2013; 6:101-10. PMC: 3794892. DOI: 10.2147/PRBM.S40460. View

Rossner S . Defining success in obesity management. Int J Obes Relat Metab Disord. 1997; 21 Suppl 1:S2-4. View

Thomson R, Buckley J, Lim S, Noakes M, Clifton P, Norman R . Lifestyle management improves quality of life and depression in overweight and obese women with polycystic ovary syndrome. Fertil Steril. 2009; 94(5):1812-6. DOI: 10.1016/j.fertnstert.2009.11.001. View

Goss A, Chandler-Laney P, Ovalle F, Goree L, Azziz R, Desmond R . Effects of a eucaloric reduced-carbohydrate diet on body composition and fat distribution in women with PCOS. Metabolism. 2014; 63(10):1257-64. PMC: 4191914. DOI: 10.1016/j.metabol.2014.07.007. View

De Frene V, Verhofstadt L, Lammertyn J, Stuyver I, Buysse A, De Sutter P . Quality of Life and Body Mass Index in Overweight Adult Women with Polycystic Ovary Syndrome During a Lifestyle Modification Program. J Obstet Gynecol Neonatal Nurs. 2015; 44(5):587-99. DOI: 10.1111/1552-6909.12739. View

10.

Castelnuovo G, Pietrabissa G, Manzoni G, Cattivelli R, Rossi A, Novelli M . Cognitive behavioral therapy to aid weight loss in obese patients: current perspectives. Psychol Res Behav Manag. 2017; 10:165-173. PMC: 5476722. DOI: 10.2147/PRBM.S113278. View

11.

Moran L, Hutchison S, Norman R, Teede H . Lifestyle changes in women with polycystic ovary syndrome. Cochrane Database Syst Rev. 2011; (2):CD007506. DOI: 10.1002/14651858.CD007506.pub2. View

12.

Werrij M, Jansen A, Mulkens S, Elgersma H, Ament A, Hospers H . Adding cognitive therapy to dietetic treatment is associated with less relapse in obesity. J Psychosom Res. 2009; 67(4):315-24. DOI: 10.1016/j.jpsychores.2008.12.011. View

13.

Lim S, Davies M, Norman R, Moran L . Overweight, obesity and central obesity in women with polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2012; 18(6):618-37. DOI: 10.1093/humupd/dms030. View

14.

Legro R, Dodson W, Kris-Etherton P, Kunselman A, Stetter C, Williams N . Randomized Controlled Trial of Preconception Interventions in Infertile Women With Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2015; 100(11):4048-58. PMC: 4702450. DOI: 10.1210/jc.2015-2778. View

15.

Okorodudu D, Bosworth H, Corsino L . Innovative interventions to promote behavioral change in overweight or obese individuals: A review of the literature. Ann Med. 2014; 47(3):179-85. PMC: 4398644. DOI: 10.3109/07853890.2014.931102. View

16.

Christian J, Tsai A, Bessesen D . Interpreting weight losses from lifestyle modification trials: using categorical data. Int J Obes (Lond). 2009; 34(1):207-9. PMC: 2897147. DOI: 10.1038/ijo.2009.213. View

17.

Egan N, Read A, Riley P, Atiomo W . Evaluating compliance to a low glycaemic index (GI) diet in women with polycystic ovary syndrome (PCOS). BMC Res Notes. 2011; 4:53. PMC: 3060831. DOI: 10.1186/1756-0500-4-53. View

18.

Brink E, van Rossum C, Postma-Smeets A, Stafleu A, Wolvers D, Dooren C . Development of healthy and sustainable food-based dietary guidelines for the Netherlands. Public Health Nutr. 2019; 22(13):2419-2435. PMC: 7083597. DOI: 10.1017/S1368980019001435. View

19.

Telch C, Agras W, Rossiter E, Wilfley D, Kenardy J . Group cognitive-behavioral treatment for the nonpurging bulimic: an initial evaluation. J Consult Clin Psychol. 1990; 58(5):629-35. DOI: 10.1037//0022-006x.58.5.629. View

20.

Lim S, Hutchison S, Van Ryswyk E, Norman R, Teede H, Moran L . Lifestyle changes in women with polycystic ovary syndrome. Cochrane Database Syst Rev. 2019; 3:CD007506. PMC: 6438659. DOI: 10.1002/14651858.CD007506.pub4. View