The Impact of a Group Based, Remotely Delivered Weight Loss Intervention in Women with Polycystic Ovary Syndrome on Ovulation, Quality of Life and Body Composition

Overview

Journal Front Reprod Health

Date 2022 Oct 28

PMID 36303658

Authors

Anna M Gorczyca

Felicia L Steger

Lauren T Ptomey

Robert N Montgomery

Riley Mickelsen

Patricia Smith

Joseph E Donnelly

Courtney A Marsh

Affiliations

Soon will be listed here.

Abstract

Background: Obesity and visceral adiposity are associated with anovulation. The most common cause of anovulatory infertility in women of reproductive age is polycystic ovary syndrome (PCOS). We conducted this formative study to examine the effects of a remotely delivered, group-based lifestyle program for women with overweight/obesity and PCOS on ovulation, PCOS related quality of life (PCOSQ) and body composition.

Methods: Women with anovulatory infertility caused by PCOS ( = 12) were enrolled in a 6-month high-intensity weight management intervention. Participants were asked to attend 45 min., group behavioral lifestyle sessions, delivered remotely by a registered dietitian weekly across the 6-mo. study and comply with a reduced energy diet, increased physical activity (225 min/wk.), and self-monitoring of weight, physical activity and diet. Diets consisted of five portion-controlled meals (three shakes + two entrees), at least five servings of fruits/vegetables, and ad libitum non-caloric beverages daily. Wilcoxon signed-rank tests were used to assess changes in outcomes across the intervention.

Results: Twelve women received the weight loss intervention (mean age = 32.7 ± 4.2 yrs., BMI = 36.8 ± 4.5 kg/m, 92% college educated), and 8 completed the intervention. Eight (67%) women reported ovulating during the intervention with an average time to ovulation of 57 ± 45 days. Women lost an average of 3.85 ± 5.94 kg ( = 0.02), decreased their BMI (-1.61 ± 1.09 kg/m; = 0.04), and waist circumference (-4.54 ± 3.03 cm; = 0.04) over the 6-mo. intervention. Additionally, self-reported menstrual problems measured by PCOSQ significantly improved over the study ( = 0.03).

Conclusion: A multicomponent group-based, remotely delivered, lifestyle intervention delivered remotely is a feasible and potentially scalable option to achieve clinically relevant (>3%) weight loss in women with PCOS.

Clinical Trial Registration: www.clinicaltrials.gov, identifier: NCT03677362.

Citing Articles

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.

References

Waitman L, Warren J, Manos E, Connolly D . Expressing observations from electronic medical record flowsheets in an i2b2 based clinical data repository to support research and quality improvement. AMIA Annu Symp Proc. 2011; 2011:1454-63. PMC: 3243191. View

Barnard L, Ferriday D, Guenther N, Strauss B, Balen A, Dye L . Quality of life and psychological well being in polycystic ovary syndrome. Hum Reprod. 2007; 22(8):2279-86. DOI: 10.1093/humrep/dem108. View

Sam S . Obesity and Polycystic Ovary Syndrome. Obes Manag. 2010; 3(2):69-73. PMC: 2861983. DOI: 10.1089/obe.2007.0019. View

Carey D, Norman R . Restoration of reproductive potential by lifestyle modification in obese polycystic ovary syndrome: role of insulin sensitivity and luteinizing hormone. J Clin Endocrinol Metab. 1999; 84(4):1470-4. DOI: 10.1210/jcem.84.4.5596. View

Bonnar J, Flynn A, Freundl G, Kirkman R, Royston R, Snowden R . Personal hormone monitoring for contraception. Br J Fam Plann. 1999; 24(4):128-34. View

Elsenbruch S, Hahn S, Kowalsky D, Offner A, Schedlowski M, Mann K . Quality of life, psychosocial well-being, and sexual satisfaction in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2003; 88(12):5801-7. DOI: 10.1210/jc.2003-030562. View

Su H, Yi Y, Wei T, Chang T, Cheng C . Detection of ovulation, a review of currently available methods. Bioeng Transl Med. 2018; 2(3):238-246. PMC: 5689497. DOI: 10.1002/btm2.10058. View

Harris P, Taylor R, Minor B, Elliott V, Fernandez M, ONeal L . The REDCap consortium: Building an international community of software platform partners. J Biomed Inform. 2019; 95:103208. PMC: 7254481. DOI: 10.1016/j.jbi.2019.103208. View

Galletly C, Clark A, Tomlinson L, Blaney F . Improved pregnancy rates for obese, infertile women following a group treatment program. An open pilot study. Gen Hosp Psychiatry. 1996; 18(3):192-5. DOI: 10.1016/0163-8343(96)00006-0. View

10.

Blackshaw L, Chhour I, Stepto N, Lim S . Barriers and Facilitators to the Implementation of Evidence-Based Lifestyle Management in Polycystic Ovary Syndrome: A Narrative Review. Med Sci (Basel). 2019; 7(7). PMC: 6681274. DOI: 10.3390/medsci7070076. View

11.

Azziz R, Marin C, Hoq L, Badamgarav E, Song P . Health care-related economic burden of the polycystic ovary syndrome during the reproductive life span. J Clin Endocrinol Metab. 2005; 90(8):4650-8. DOI: 10.1210/jc.2005-0628. View

12.

Stunkard A, Messick S . The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger. J Psychosom Res. 1985; 29(1):71-83. DOI: 10.1016/0022-3999(85)90010-8. View

13.

Harris P, Taylor R, Thielke R, Payne J, Gonzalez N, Conde J . Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2008; 42(2):377-81. PMC: 2700030. DOI: 10.1016/j.jbi.2008.08.010. View

14.

Kristal A, Kolar A, Fisher J, Plascak J, Stumbo P, Weiss R . Evaluation of web-based, self-administered, graphical food frequency questionnaire. J Acad Nutr Diet. 2014; 114(4):613-21. PMC: 3966309. DOI: 10.1016/j.jand.2013.11.017. View

15.

Clark A, Thornley B, Tomlinson L, Galletley C, Norman R . Weight loss in obese infertile women results in improvement in reproductive outcome for all forms of fertility treatment. Hum Reprod. 1998; 13(6):1502-5. DOI: 10.1093/humrep/13.6.1502. View

16.

Lim S, Norman R, Davies M, Moran L . The effect of obesity on polycystic ovary syndrome: a systematic review and meta-analysis. Obes Rev. 2012; 14(2):95-109. DOI: 10.1111/j.1467-789X.2012.01053.x. View

17.

Jiskoot G, Timman R, Beerthuizen A, Dietz de Loos A, Busschbach J, Laven J . Weight Reduction Through a Cognitive Behavioral Therapy Lifestyle Intervention in PCOS: The Primary Outcome of a Randomized Controlled Trial. Obesity (Silver Spring). 2020; 28(11):2134-2141. PMC: 7702123. DOI: 10.1002/oby.22980. View

18.

Karimzadeh M, Javedani M . An assessment of lifestyle modification versus medical treatment with clomiphene citrate, metformin, and clomiphene citrate-metformin in patients with polycystic ovary syndrome. Fertil Steril. 2009; 94(1):216-20. DOI: 10.1016/j.fertnstert.2009.02.078. View

19.

Pirotta S, Joham A, Moran L, Skouteris H, Lim S . Implementation of evidence-based PCOS lifestyle management guidelines: Perceived barriers and facilitators by consumers using the Theoretical Domains Framework and COM-B Model. Patient Educ Couns. 2021; 104(8):2080-2088. DOI: 10.1016/j.pec.2021.01.036. View

20.

Kocelak P, Chudek J, Naworska B, Bak-Sosnowska M, Kotlarz B, Mazurek M . Psychological disturbances and quality of life in obese and infertile women and men. Int J Endocrinol. 2012; 2012:236217. PMC: 3403244. DOI: 10.1155/2012/236217. View