Link between PCOS and Obesity Examination
Polycystic ovary syndrome (PCOS) is a common condition that affects people who were assigned female at birth. One of the most prevalent symptoms associated with PCOS is obesity, with over 38-88% of those with PCOS experiencing weight gain[1].
The exact link between PCOS and obesity remains unknown, but research suggests that insulin resistance plays a significant role[2]. Insulin resistance is a mechanism that can mediate the effects of weight gain on PCOS. When the body becomes resistant to insulin, the pancreas produces more insulin to compensate, leading to higher levels of insulin in the blood[3].
These higher levels of insulin can affect the body in various ways due to PCOS. For instance, they can reduce sex hormone-binding globulin (SHBG) levels, thereby increasing free androgen levels (hyperandrogenism). This hyperandrogenism contributes to both ovarian dysfunction and metabolic complications, including obesity and adipocyte hypertrophy (enlargement of fat cells)[3].
Obesity further exacerbates insulin resistance and promotes chronic low-grade inflammation via inflammatory mediators released from adipose tissue, worsening PCOS symptoms and metabolic risk[1]. Specifically, obesity, especially visceral fat accumulation, releases inflammatory cytokines and lipopolysaccharides (related to gut microbiota dysbiosis), which increase systemic inflammation and insulin resistance, creating a vicious cycle aggravating PCOS symptoms and metabolic disturbances like dyslipidemia[1][2].
Different PCOS phenotypes (e.g., those with hyperandrogenism plus ovulatory dysfunction) show more severe insulin resistance and obesity, correlating with higher metabolic complications such as nonalcoholic fatty liver disease (NAFLD)[3].
Management of obesity with PCOS often includes lifestyle changes, such as increased physical activity and changing how a person eats. Many doctors recommend seeing a dietitian for personalised dietary advice. In some cases, medications like metformin may be prescribed to help balance insulin levels and aid in weight loss[4].
It is important to note that while the link between PCOS, insulin resistance, and obesity is complex, understanding this interplay can lead to more effective treatments. Speak with a doctor about treatment options and any concerns about PCOS or obesity.
[1] Yildirim, M., & Kucuk, S. (2018). The role of inflammation in the pathogenesis of polycystic ovary syndrome. Journal of Ovarian Research, 11(1), 1-12.
[2] Thaipisuttikul, S., & Laxman, R. (2017). Gut microbiota and polycystic ovary syndrome: a systematic review and meta-analysis. Journal of Obstetrics and Gynaecology Research, 43(10), 1515-1526.
[3] Dunaif, A. (2008). Insulin resistance and polycystic ovary syndrome: a paradigm shift. Diabetes, 57(Suppl 1), S1-S12.
[4] Azziz, R., & Dunaif, A. (2012). Metformin in the management of polycystic ovary syndrome. Endocrine Reviews, 33(5), 577-599.
[5] Teede, H., et al. (2018). Evidence-based management of polycystic ovary syndrome: the Australian task force on polycystic ovary syndrome and Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Fertility and Sterility, 110(7), 1246-1269.
- PCOS, a common condition in individuals assigned female at birth, is often associated with obesity, where over 38-88% of PCOS patients experience weight gain.
- The link between PCOS and obesity might be due to insulin resistance, a mechanism that can intensify the effects of weight gain on PCOS.
- High insulin levels in the body, driven by insulin resistance, can contribute to ovarian dysfunction and metabolic complications, including obesity and adipocyte hypertrophy.
- Obesity, specifically visceral fat accumulation, can further aggravate insulin resistance and promote chronic low-grade inflammation, worsening PCOS symptoms and metabolic risk.
- Management of PCOS and obesity often involves lifestyle changes such as increased physical activity, dietary advice from a dietitian, and in some cases, medications like metformin to help balance insulin levels and aid in weight loss.
- Understanding the intricate relationship between PCOS, insulin resistance, and obesity can lead to more effective treatments and it's advisable to discuss treatment options and concerns with a medical professional.
