These drugs are very effective at treating PCOs and it’s likely that of all the non diabetes causes of obesity this one will be treated under the NHS. It is common to be prescribed Metformin for PCOs and weight loss is a side effect.
In PCOs weight gain is not down to excess eating but due to insulin resistance. It is one of the complex endocrine disorders. Combined with poor eating habits it is easy to pile on weight, but extremely difficult to lose weight even with extreme calorie deficit. Essentially the way your body uses, stores and processes glucose is dysfunctional.
Fertility is affected so Metformin is often prescribed because it can kick start your reproductive function. Tirzepatide is just a newer generation of Metformin that is more effective.
Taking Mounjaro with PCOs will give quick effective results because most of the time women with PCOs will be on a calorie deficit diet.
I have secondary PCOs as a result of a pituitary problem. Now that I’m post menopausal my pituitary problem has gone into full remission, also my ovaries have shut down. I no longer suffer with the resulting insulin resistance so I don’t constantly crave carbs. Insulin resistance produces a rapid low sugar glucose after you eat which triggers the hunger centre in the brain. In addition glucose is cleared from your blood rapidly and stored as fat before you can use it, it is also difficult for your body to break down the fat stores.
Insulin resistance does have evolutionary advantages, fat storage was a survival mechanism when the early humans moved from sub Sahara into Northern Europe but it came with a price, increased heart disease. Unfortunately modern lifestyle with heated houses and a carb rich diet means insulin resistance lends itself to weight gain.
Most women with PCOs will fall into the overweight/obese category. It’s doesn’t cause over eating it just means that you store fat more easily from a normal diet.
Overeating to the point of morbid obesity is the result of behaviour and poor diet.
I can lose weight rapidly with a low carb diet and have no problem maintaining weight, however the spanner in the works is Anastrazole, I had breast cancer three years ago, which blocks oestrogen and I have found that weight loss is almost impossible. Most women taking it have reported rapid weight loss when they finish taking it. The other side effect is crippling joint and muscle pain alongside chronic fatigue. You may have survived the cancer but often the side effects of adjunctive treatment can be a problem.
In the future I can see the advantage of these drugs for people with underlying endocrine problems particularly those that predispose them to diabetes and heart disease but they are not the answer for hard core behavioural overeaters. They will always need a massive amount of support to retrain eating habits which are often set in stone from infancy. The food industry has a lot to answer for with these individuals and I strongly support a sugar tax from both a moral and professional point of view. The biggest changes we have seen in the last 30 years are the mammoth growth in the soft drinks/ energy drinks industry, the ready meals sector and of course fast food made worse by the ever growing Uber eats culture.