Cognitive-behavioral therapy improves weight loss and quality of life in women with polycystic ovary syndrome: a pilot randomized clinical trial

This pilot study in overweight/obese women with polycystic ovary syndrome and depressive symptoms shows improved weight loss and quality of life after cognitive-behavioral therapy and lifestyle modification versus lifestyle modification alone.

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Volume 110, Issue 1, Pages 161–171.e1


Laura G. Cooney, M.D., Lauren W. Milman, M.D., Liisa Hantsoo, Ph.D., Sara Kornfield, Ph.D., Mary D. Sammel, Sc.D., Kelly C. Allison, Ph.D., C. Neill Epperson, M.D., Anuja Dokras, M.D, Ph.D.



To compare the effects of cognitive-behavioral therapy (CBT) and lifestyle modification (LS) versus LS alone on weight, depressive and anxiety symptoms, and stress response in women with polycystic ovary syndrome (PCOS), overweight/obesity, and depressive symptoms.


A 16-week pilot randomized clinical trial.


Tertiary-care PCOS center.


Overweight/obese women with PCOS and depressive symptoms.


Weekly CBT (n = 7) or contact only/no therapy (n = 8) for 8 weeks. Both groups received weekly LS for 16 weeks.

Main Outcome Measure(s)

Changes in weight, depression (Center for Epidemiologic Studies Depression Scale [CES-D]), anxiety (State-Trait Anxiety Inventory [STAI]), quality of life (Polycystic Ovary Syndrome Health-Related Quality of Life Questionnaire [PCOSQ]), laboratory tests, and response to a Trier Social Stress Test (TSST).


The CBT+LS group lost more weekly weight (−0.35 kg/wk vs. −0.16 kg/wk) compared with the LS group. Overall, the CBT+LS group lost 3.2 kg versus 1.8 kg for the LS group. The CBT+LS group had greater improvement in PCOSQ at 8 weeks (+3.7 vs. +1.2 points). In the overall cohort, STAI and CES-D decreased by −0.27 points per week and −0.31 points/wk, respectfully, and total and free T decreased at week 8. Heart rate response to TSST was lower at 15 minutes after stressor in the CBT+LS group.


Weekly CBT+LS for 8 weeks compared with LS alone resulted in significant weight loss and improved quality of life in overweight/obese women with PCOS and depressive symptoms. These interventions were associated with a decreased autonomic response to a laboratory stressor, suggesting a potential link between CBT, weight loss, and modulation of the stress response.

Clinical Trial Registration Number


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.