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Weight Loss Struggles in Obese PCOS Patients Explained by FL Nurse Practitioner

PCOS Sisters A woman is holding a administering herself an injection in belly

PCOS patients often struggle with obesity.  Dr. Lynsey Johnson, DNP, FNP-C  is a Florida Nurse Practitioner that can explain why weight loss is not easy in PCOS patients. Women with Polycystic Ovarian Syndrome (PCOS) have higher levels of androgens (Hyperandrogenism). Testosterone is a type of androgen that causes symptoms such as acne, unwanted hair growth, irregular periods, obesity, thinning scalp hair, and infertility. Increased testosterone increases insulin levels, which further increases androgen levels, causing increased fat deposition. The body copes with hyperandrogenism by removing excess androgens from the bloodstream and storing them in fat. Weight gain increases both of these hormones synergistically, which further exacerbates this out of control cycle.

Insulin controls the body’s use of sugar or glucose. Over time excessive insulin is released causing insulin resistance of cells. The glucose cannot enter the cell and be used by the body. Instead, it stays in the blood. Insulin resistance can eventually lead to type 2 diabetes. 

Historically, oral insulin sensitizer medications have been used to reduce insulin resistance or increase the body’s sensitivity to insulin allowing glucose to be used by the body, which reduces androgens. This improves fertility and the symptoms of hyperandrogenism and weight loss. 

Semaglutide has been added on to the 2023 PCOS Treatment guidelines (2).

Semaglutide is a GLP-1 agonist that targets receptors in the stomach to slow emptying making you feel full longer, stimulates the pancreas to release more insulin helping you process carbs, and reduces sugar production in the liver. All of these effects help to lower your cholesterol, prevent fatty liver, as well as reduce risk for diabetes and stroke. 

Semaglutide is marketed as Ozempic for Type 2 Diabetics and Wegovy for obesity treatment. It is also FDA approved for treatment of obesity in children ages 12 and older. 

Non diabetic patients using semaglutide saw a 12.4% weight loss on 2.4 mg at 68 weeks (3). In practice, patients generally lose between 5-10 lbs per month consistently.

How do I know if I meet criteria for treatment?

  • If you’re obese with a BMI of 30 or more
  • If you’re overweight with a BMI of 27 and have a weight-related medical condition like cardiovascular disease, hyperlipidemia, diabetes, or hypertension.

Will insurance cover it?

It is often difficult to obtain insurance coverage, which is why many patients prefer to use  FDA registered compounding pharmacies for an average cost of $200-$500 per month.

If I do not meet the criteria for GLP-1 treatment, are there other alternatives? 

Yes, we have many medication options for treating PCOS, however treatment with GLP-1 agonists are the most effective method for PCOS weight gain and obesity.Schedule a PCOS Sisters Telehealth appointment to determine what treatment is right for you here.

We are a PCOS specialized telehealth care clinic providing primary care and PCOS treatment for women throughout Florida, Georgia, Texas, & New York. PCOS Sisters Treatment Program is derived from peer reviewed research and evidence based practice methods delivered by Nurse Practitioners.

Local offices:  

Jacksonville, FL  

Atlanta, GA 

Houston , TX

Orlando, FL 

1. Abdalla MA, Deshmukh H, Atkin S, Sathyapalan T. (2020) A review of therapeutic options for managing the metabolic aspects of polycystic ovary syndrome. Ther Adv Endocrinol Metab. 6;11:2042018820938305. doi: 10.1177/2042018820938305. PMID: 32670541; PMCID: PMC7338645.Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7338645/  

2. https://www.monash.edu/medicine/mchri/pcos/guideline

3. https://www.nature.com/articles/s41591-022-02026-4#:~:text=In%20the%20STEP%201%20and,weeks6%2C7%2C8.

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