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Obesity and polycystic ovary syndrome

So what are the standards for obesity? 

Asian guidelines: BMI is normal at 18.5-22.9, BMI≧23 is overweight, and BMI≧30 is obese. For specific measurement methods, you can refer to some apps, or prepare a body fat scale at home to record body weight, body fat, and BMI. I won’t go into details here.

What are the causes of obesity? 

  • 1. Genetic factors; 
  • 2. Social environment factors; 
  • 3. Psychological factors; 
  • 4. Sports factors.

The adverse effects caused by obesity itself not only affect the appearance, but the complications caused by long-term obesity are far more serious than we think, such as cardiovascular and cerebrovascular diseases (mainly heart disease and stroke caused by high blood pressure/high blood fat), fat Liver, diabetes, and certain cancers (including endometrial, breast, ovarian, prostate, liver, gallbladder, kidney and colon), for women of childbearing age, the most important hazard is-may affect fertility.

Here we mainly talk about obese polycystic ovary syndrome. Polycystic ovary syndrome (PCOS, hereinafter referred to as polycystic) is one of the common endocrine disorders, which accounts for about 5%-10% of women of childbearing age, and it is more common in women of childbearing age between 17-30 years old. It is the main cause of anovulatory infertility (30-60% of anovulatory infertility). The main clinical symptoms: menstrual changes, infertility, and ovarian insufficiency, acne and hirsutism, alopecia, obesity, acanthosis nigricans, etc.

Clinically, more than 50% of polycystic patients are accompanied by obesity, most of which are abdominal obesity. Excessive androgen, in addition to thickening of abdominal wall fat, can also cause visceral fat accumulation in the abdominal cavity, which is more likely to cause abnormal metabolism And cardiovascular diseases; hyperinsulinemia and insulin resistance can affect fat metabolism and increase blood lipids.

The incidence of complications in patients with polycystic obesity is significantly higher than that of non-obese patients. Obesity increases the risk of metabolic syndrome, insulin resistance, hyperlipidemia, and hypertension in polycystic patients.

Therefore, for obese polycystic patients and those who want to have a healthy baby, we often recommend that patients lose weight appropriately. Studies have shown that moderate weight loss can effectively reduce high androgen and high insulin levels, restore regular menstruation, ovulation, and even pregnancy, and reduce the occurrence of long-term complications. We recommend advanced lifestyle changes to female polycystic patients of childbearing age before proceeding to the next step of treatment, which can achieve a multiplier effect with half the effort. Of course, for different types of polycystic patients (mainly metabolic disorders, mainly high androgen, and mainly fertility disorders), we will conduct more personalized and detailed treatment after a comprehensive evaluation.

In summary, lifestyle adjustment is the first-line treatment, especially for overweight/obese adolescent polycystic patients, including diet control, exercise, behavior training, and weight loss. Improving abdominal obesity and reducing excess body mass may control the vicious cycle of polycystic pathophysiology and improve polycystic metabolic complications. "

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