Oral Presentation Australian and New Zealand Obesity Society Annual Scientific Conference 2023

Women with class 3 obesity with and without polycystic ovarian syndrome: Outcomes from a multidisciplinary weight management program (97818)

Joshua V Gialouris 1 , Flavia Bueno 2 , Ritesh Chimoriya 3 , Pamela A Reyes 3 , Kathy Grudzinskas 1 , Kormas Nic 1 , Milan K Piya 1 3
  1. South Western Sydney Metabolic Rehabilitation and Bariatric Program, Camden and Campbelltown Hospitals, NSW, Australia
  2. Mater Hospital, St Vincent's Health Australia, NSW , Australia
  3. School of Medicine, Western Sydney University, NSW, Australia

Background/Aims: Polycystic ovarian syndrome (PCOS) may affect outcomes following a weight management program (WMP). This study aimed to assess the prevalence of PCOS in women with class 3 obesity joining a multidisciplinary WMP, and compare 12-month outcomes between those with and without PCOS.

Methods: A retrospective cohort study of all female patients joining a publicly funded multidisciplinary WMP in Sydney, March 2018 to June 2022. Pre-existing diagnosis of PCOS, clinical, pathology and questionnaire data were collected at baseline and 12-months. 

Results: Of 296 women who joined the program, 179 (60.5%) had 12-month data available. At baseline, 24.3% (n=72) had a previous diagnosis of PCOS, and they were younger (39.3±12.6 vs 50.2±13.0 years, p<0.01), with higher baseline weight (145.4±29.2 vs 139.1±27.6 kg, p<0.05) but similar BMI (53.2±9.0 vs 52.7±9.5 kg/m2, p=0.3), compared to women without PCOS. Women with PCOS had lower Edmonton Obesity Staging System scores (2.2±0.6 vs 2.4±0.6, p<0.01), and lower prevalence of Type 2 diabetes (T2DM) (40.3 vs 48.7%). The Kessler Psychological Distress Scale (K10) (28.4±9.7 vs 25.6±9.3, p<0.05) and Depression and Anxiety Stress Scale 21-stress (DASS21s) scores (9.8±5.7 vs 7.6±5.0, p<0.05) were higher in women with PCOS. At 12-months, patients with PCOS lost significantly less weight than those without PCOS (3.1±6.5% vs 6.7±10.7%, p<0.05). Significant improvements in K10 (29.2±10.1 vs 24.4±10.1, p<0.05) and Eating Disorder Examination Questionnaire (EDE-Q) (17.4±6.4 vs 14.5±5.7, p<0.05) scores were seen in the PCOS group after 12 months. Significant improvements in K10 (25.8±9.5 vs 21.1±9.1, p<0.01) but not EDE-Q scores (15.5± 6.4 vs 13.6± 6.0, p=0.05) were observed in the group without PCOS. 

Conclusion:

Despite younger age, fewer co-morbidities and lower T2DM prevalence, patients with PCOS and class 3 obesity achieved significantly less weight loss after 12 months in a multidisciplinary WMP. However, significant improvement in psychological stress and eating disorder scores were observed.