PhD defence L.G. (Geranne) Jiskoot

Dissertation in short:

Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder that affects 8–15% of the women in their reproductive years. Most women with PCOS suffer from overweight and obesity throughout their entire life. Obesity negatively affects all clinical features, and a 5 to 10% weight loss has shown promising results on reproductive, metabolic and psychological level. Previous studies were not developed for long-term weight loss and it is unclear whether these results can be translated to daily life. Therefore, we designed a randomized controlled trial to examine if a three-component lifestyle intervention (with or without short message service (SMS)) was effective to develop long-term healthy lifestyle habits. We found that the odds to achieve a 5% weight loss were 7 times larger in the lifestyle intervention with cognitive behavioral therapy (CBT) compared to the care as usual (CAU). In CAU, 21.8% of the women had a 5% weight loss compared to 52.8% of the women in the lifestyle intervention without SMS and 85.7% in the lifestyle intervention with SMS. Beside weight loss, the intervention was also effective to improve depression, self-esteem and disordered eating behavior while women in CAU had no improvements. Based on a prediction model, we examined that higher depression scores were associated with a lower chance to achieve ≥5% weight loss. Therefore, the treatment of depression seems very important in women with PCOS. Based on a review and meta-analysis we examined that that CBT is an effective form of therapy to treat depression in women with PCOS.