Weight reduction, of as little as 3-5%, has been associated with improvements in ovulation rates in PCOS women who are overweight or obese. Although studies are consistent in this regard, no large scale controlled trials are available to assess improvements in pregnancy rates. There are no specific dietary regimens that target PCOS and effective weight reduction has been demonstrated with a wide variety of approaches.
Achieving and maintaining permanent weight reduction is a challenge that is often met with repeated failures and relapse. Severely restrictive diets have not been shown to improve outcomes over modest changes in diet that result in slow weight reduction. Metabolic parameters are also consistently improved with lifestyle modification that includes weight reduction. Exercise, although not a significant tool in initial weight reduction, is associated with better maintenance of weight reduction
over time and should be encouraged. Significant support is needed to encourage women with PCOS who are overweight or obese to consider lifestyle modification as the first line of therapy.
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