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Obesity, PCOS and Liraglutide, a Weight Loss Medication

Updated: Jan 21

H, 24, was diagnosed to have polycystic ovarian syndrome (PCOS) 3 years ago. Her menses were very irregular, occurring once in 2 to 3 months and lasting one to two weeks at times. The amount varied from spotting to heavy flow with clots. She also noticed that her body weight was increasing gradually and she had difficulty losing weight. Her BMI had increased from 26 to 31 over the last 3 years.

Obesity has long been a medical concern globally, as it is associated with the risk of developing medical probles such as diabetes and cardiovascular diseases. In Singapore, it has been increasing at a rapid rate in recent years. It is a problem in about 80% of PCOS patients.

Diet and exercise have been the mainstay in the treatment of obesity. A weight loss of 5% or more in PCOS patients has been shown to have a significant positive effect on the return of menstruation.

Recently, liraglutide, a medication that has been used to treat type 2 diabetes, has been introduced in the management of obese PCOS patients with promising results.

What is Liraglutide?

Liraglutide is a medication used for the treatment of type 2 diabetes and obesity. For obese patients, it is most effective when combined with intensive lifestyle intervention such as calorie reduction diet and appropriate exercise. It also helps keep the weight that has been lost from returning.

How does Liraglutide work?

Liraglutide is a modified form of a gut hormone called GLP1 (glucagon-like peptide-1), and works like the natural hormone.

GLP1 is produced by the cells in the small intestines after food is digested. This hormone acts on the hunger-satiety center in the brain and slows down the passage of food in the stomach leading to an increased feeling of fullness. The appetite is thus suppressed and the patient feels sated.

GLP1 also stimulates the pancreas to increase the secretion of insulin and helps in maintaining the glucose levels in the body

How is Liraglutide given?

For treatment of obesity, it is given by injection under the skin once a day and the dosage is adjusted accordingly for optimal results. What are the side effects of Liraglutide?

Common side effects include:

  • Gastrointestinal: Nausea, vomiting, diarrhea, constipation

  • Urinary: Bladder pain, bloody or cloudy urine, difficult, burning, or painful urination

  • Palpitation

  • Fever and chills

  • Headache, muscle aches and pains

How effective is Liraglutide in treating PCOS with obesity?

Current clinical studies have shown that liraglutide therapy achieved significant reduction in body weight, body mass index (BMI), and abdominal circumference in overweight and obese women with polycystic ovary syndrome. Liraglutide treatment also improved the metabolic and hormonal parameters in the body resulting in the return of regular menstrual periods.

H was counseled on dietary changes and exercise, and was put on metformin. After 6 months of therapy, she did not lose much weight and her periods remained irregular. She is currently contemplating liraglutide therapy.

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