The polycystic ovary syndrome (PCOS) is the most common
endocrinopathy and the most frequent cause of anovulatory infertility in women of
reproductive age. PCOS can lead to various clinical consequences including
reproductive, metabolic and psychological problems. Obesity has been defined as
having excess body fat that is closely related to insulin resistance, and the estimated
incidence of obesity in PCOS has been reported to be 40% to 60%. The initial
management option includes lifestyle interventions in patients with PCOS complicated
by obesity and insulin resistance. For the dietary management, it is important to have
reduced body weight and maintain a lower long-term body weight by preventing
further weight gain. Although these lifestyle interventions can provide modest weight
loss, in some cases it is necessary to use pharmacologic agents to gain optimal weight
loss and maintain optimal weight in the long term. Studies including the use of
pharmacologic agents for the treatment of obesity and insulin resistance have increased
over the last decade. Pharmacologic agents including orlistat, metformin, glucagon-like
peptide-1 receptors (exenatide and liraglutide), phentermine, topiramate, lorcaserin are
available for the treatment of obesity and studies have also focused on the effectiveness
of these anti-obesity medications in patients with PCOS in the recent years. It has been
demonstrated that anti-obesity drugs have beneficial effects on metabolic parameters
and weight loss in the obese patients with PCOS used in conjunction with diet and
lifestyle modification. However, the administration of these drugs for the PCOS
treatment should be under constant medical supervision due to the requirement of
monitorization of possible side effects and dose adjustment.
Keywords: Adipokines, Diet, Infertility, Insulin resistance, Metformin, Obesity,
Orlistat, Overweight, Polycystic ovary syndrome, Topiramate.
