Weight Loss Medications for PCOS

The field of obesity medicine has been growing rapidly over the last 10 years since its foundation as a board certified specialty in 2011. [1] There is now a wide range of prescription medications available to patients struggling to control hormonal weight fluctuations with PCOS. Here are the top 5 medications with the most evidence.

Phentermine/Topiramate has also been studied for PCOS patients and was shown to improve fasting blood glucose levels, oral glucose tolerance test, insulin sensitivity, and help patient lose between 7-10% of their weight in 24 weeks [6].

Liraglutide is a medication that was originally created for diabetes and insulin resistance problems. It has the added benefit of causing weight loss in many patients. [2] In a study of PCOS patients on Liraglutide, Liraglutide/metformin, metformin alone, and orlistat, Liraglutide was found to most significantly reduce waist circumference. However, liraglutide is not well tolerated for patients with a history of gallbladder or pancreatic problems and can be very expensive, costing patients over $1000 per month due to lack of insurance coverage.

Metformin is another medication primarily for diabetes, however it has been extensively researched in the context of PCOS. PCOS is often associated with insulin resistance, and correcting this sensitivity with metformin has multiple benefits. Insulin resistance is thought to have a pathway relating it to the body’s levels of sex hormone binding globulin (SHBG), thus impacting the total amount of testosterone circulating. [3] By correcting insulin resistance, many patients also find this medication can help with weight loss. It has minimal risk of side effects, and is very inexpensive. [5]

Orlistat has also been studied extensively, as it is an older medication, for women with PCOS. It has been shown to significantly decrease weight, insulin resistance, cholesterol levels, and testosterone in these patients when compared to a calorie-restricted diet alone. [4]

It is important to remember that different medications can work differently in each patient. You may need to try a medication for a few weeks, see how you feel, change dose or change to a different medication. Every body is unique, and so should our selection of weight loss medications for patients with PCOS.

Sources

“ABOM Continues Rapid Growth with 720+ New Diplomates.” American Board of Obesity Medicine, 7 May 2019, [link].

Academic.oup.com. (n.d.). Retrieved April 21, 2022, from [link].

Gynecology, D. of O. and. (n.d.). Polycystic ovary disease and obesity: Leptin, weight-loss... : Clinical obstetrics and gynecology. LWW. Retrieved April 21, 2022, from [link].

Lashen, H. (2010, June). Role of metformin in the management of polycystic ovary syndrome. Therapeutic advances in endocrinology and metabolism. Retrieved April 21, 2022, from [link].

Metformin: An old medication of new fashion: Evolving new ... (n.d.). Retrieved April 21, 2022, from [link].

Pharmacologic therapy to induce weight loss in... Wiley Library. (n.d.). Retrieved April 19, 2022, from [link].

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