Women with PCOS more likely to have perception of overweight, attempt weight loss
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Key takeaways:
- Midlife women with PCOS are more likely to have multiple weight loss attempts than those without PCOS.
- About half of women with PCOS and normal weight perceive themselves as having overweight.
Women with polycystic ovary syndrome are more likely to attempt to lose weight multiple times and perceive themselves as having overweight compared with women without PCOS, according to a study published in Obesity.
“Women with PCOS do their best to lose weight, but despite their efforts, they continue to have a clearly higher BMI and waist circumference than other women,” Emilia Pesonen, MSc, doctoral researcher in the department of obstetrics and gynecology, research unit of clinical medicine at the University of Oulu in Finland, told Healio. “Our study indicates for the first time that normal-weight women with PCOS also struggle with their body image. The syndrome itself increased the risk of both several weight-loss attempts and the feeling of being overweight at midlife, and the observed link could not be explained by issues such as BMI or psychological distress.”
Pesonen and colleagues conducted a population-based cohort study of women in the Northern Finland Birth Cohort 1966 who participated in follow-up at age 31 or 46 years. At age 31 years, PCOS was identified if women self-reported symptoms of oligomenorrhea or excess body hair. At age 46 years, women were asked to self-report if they had been diagnosed with PCOS. Women self-reported the number of weight-loss attempts and whether they perceived themselves as significantly overweight, slightly overweight or just the right weight at both follow-ups. Height and weight were measured at clinical examinations.
There were 278 women who reported having PCOS and 1,560 women who did not have PCOS. Women with PCOS had a higher BMI at both age 31 years (24.4 kg/m2 vs. 22.7 kg/m2) and 46 years (27.2 kg/m2 vs. 25.3 kg/m2) than women without PCOS.
The percentage of women who reported multiple weight-loss attempts was higher among women with PCOS than those without PCOS at age 31 years (47% vs. 34%; P < .001) and 46 years (63% vs. 47%; P < .001). Among women with overweight or obesity, the PCOS group still had a higher prevalence of self-reporting multiple weight-loss attempts than those without PCOS (79% vs. 66%; P = .003). In a multivariable-adjusted model, women with PCOS were more likely to attempt weight loss multiple times at age 46 years than those without PCOS (adjusted OR = 1.43; 95% CI, 1-2.04).
Women with PCOS were more likely to believe they were overweight than those without PCOS at age 31 years (73% vs. 53%; P < .001) and 46 years (87% vs. 70%; P < .001). The perception of overweight was similar between the two groups when only women with overweight and obesity were analyzed. However, among women with normal weight, the PCOS group had a higher proportion of women who perceived being overweight compared with the group of women without PCOS at age 31 years (47% vs. 34%; P = .014) and 46 years (60% vs. 39%; P = .001). In a multivariable-adjusted model, PCOS was associated with an increased likelihood for perceiving overweight at age 46 years (aOR = 2.65; 95% CI, 1.35-5.21).
“Women suffering from PCOS need more comprehensive support, such as nutritional therapy and psychotherapy,” Pesonen said. “Doctors often warn women suffering from the syndrome not to gain weight. However, matters related to weight should always be discussed in a positive light, without blaming the women. It is a good idea to focus on health rather than weight during medical appointments. It is also important to keep in mind that not all women with PCOS have overweight. Health care professionals should pay attention to not add to the stress that women with PCOS experience regarding their weight.”
Pesonen said more research is needed to explore whether a weight-neutral approach to care would be more beneficial for women with PCOS.
“We are also hoping that bariatric surgery and medical treatment will be introduced as part of the treatment among women with PCOS who have suffered from obesity for a long time,” Pesonen said.
For more information:
Emilia Pesonen, MSc, can be reached at emilia.pesonen@oulu.fi.
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