Adolescent Girls with PCOS Exhibit Comparable Weight Loss Following Bariatric Surgery
SAN FRANCISCO — Emerging research presented at the ENDO 2025 conference, held from July 12 to 15, 2025, has revealed that adolescent girls diagnosed with polycystic ovary syndrome (PCOS), as well as those considered at risk for the condition, experience weight loss outcomes following metabolic bariatric surgery (MBS) that are comparable to their reproductively normal counterparts. This finding could have significant implications for the clinical management of obesity in this demographic.
The analysis, conducted on a cohort of 155 adolescent girls participating in the Teen-LABS longitudinal study of bariatric surgery, categorized the participants based on their diagnosis: those with established PCOS (characterized by irregular menstrual cycles and hyperandrogenism), those at risk for PCOS (displaying isolated symptoms of irregular menses or hyperandrogenism), and a control group of reproductively normal girls.
Key metrics assessed during the study included changes in body mass index (BMI), the timing of BMI nadir—the lowest recorded BMI following surgery—and fluctuations in PCOS-related symptoms one year after the surgical intervention. Importantly, the researchers excluded time points during which medications that might influence PCOS symptoms were used, ensuring that the findings were solely reflective of the surgical impact.
Weight Loss Results Across Groups
Prior to undergoing MBS, it was noted that 23.8% of participants had PCOS, 53.5% were at risk for developing the condition, and 22.8% were identified as normal. On evaluating the outcomes, BMI reduction at the nadir among all groups showed no significant difference, ranging from -15.2 kg/m² to -16.7 kg/m², with a P-value of .52 indicating statistical equivalence. Similarly, the time to reach BMI nadir varied between 39 to 48 months across the groups, with a P-value of .47, further highlighting comparability.
Among adolescents with PCOS, 41% demonstrated symptom improvement one year post-surgery, with 23% experiencing complete remission. Conversely, 35% continued to face persistent PCOS symptoms. For those categorized as at risk, symptom improvement was observed in only 36%, with 61% of cases showing persistence of symptoms.
Long-term Outcomes and Considerations
The study also monitored post-nadir outcomes, revealing that 58% of patients with PCOS showed symptom improvement at BMI nadir, while 11% achieved remission, and 32% continued to experience symptoms. In contrast, only 29% of the at-risk group reported improvements, with 12% indicating a worsening of their condition, and a substantial 59% remaining unchanged.
Significantly, after periods of weight regain, 33% of adolescents with prior PCOS cases demonstrated symptom improvement, while 67% stabilized without further symptom influence. Among those considered at risk, a mere 15% improved, whereas 20% worsened and 65% persisted with symptoms.
The researchers concluded that metabolic bariatric surgery presents a viable option for managing obesity in adolescent girls with PCOS and those at risk, offering similar benefits to those observed in reproductively normal individuals. As obesity and its associated health problems continue to pose significant public health challenges, this research underscores the potential of bariatric surgery as a critical intervention in young populations struggling with weight and PCOS.
For further information, reference the study presented by Gaddam et al. at the ENDO 2025 conference titled “Impact of metabolic surgery on PCOS, irregular menses, and hyperandrogenism during adolescence”.
