Table 2.

Gaps/future directions for weight management in adolescents with PCOS

Category	Adolescent/Family	Provider	Research
Physiology	Personalized treatment (i.e. for different PCOS phenotypes, genotypes, family history)	Improved provider knowledge of PCOS pathophysiology, comorbidities, treatment strategies, holistic interdisciplinary approach	Identification of molecular mechanisms (e.g. role of hypothalamic signaling) to guide personalized treatment
Feasibility and Acceptability of Interventions	Identify and address adolescent-specific barriers (e.g. time, cost, access, psychological concerns)	Support provider engagement and training	Conduct cost benefit analyses; Use CBPR, SMART, and/or Dissemination & Implementation methodologies
Sustainability of Effects	Develop individualized treatments for weight loss maintenance and prevention of regain through combination therapies	Create and test new models of care delivery with increased dose/intensity	Conduct research with stakeholders at multiple levels (individual, medical home, community, policy) to reduce barriers and maximize success
Equity	Elicit and incorporate adolescent/family input about facilitators and barriers	Improve provider/program knowledge of community resources	Test novel intervention strategies (e.g. online exercise sessions, social media) that directly address social determinants of health
Lifespan approach	Understand and address cultural beliefs/attitudes about food/growth, activity, sleep, across the lifespan (e.g. infancy, adolescence, pregnancy)	Build adult/pediatric care collaborations	Establish stitched or continuous cohorts from adolescence through adulthood; Transition work from pediatric to adult weight management/PCOS homes

CBPR – Community Based Participatory Research | SMART – Sequential Multiple Assignment Randomized Trial

Significant gaps in the literature with suggested future directions to advance the field of weight management among adolescents with PCOS