The Role of Anti-Obesity Medications in Polycystic Ovary Syndrome

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.