Lifestyle change is the first-line of treatment for the management of women with PCOS, however obtaining long-term adherence is challenging. In order to improve adherence to advice on lifestyle, we propose a strategic systematic approach that could be easily remembered with the acronym I.M.P.R.O.V.E.: Inform, Motivate, Prescribe, Reward, Oversee, Visualize, Empower. Besides giving information and recommendations, it emphasizes the need to listen to PCOS patients in order to better motivate and to encourage to increase those physical activities they like the most. The reduction of calorie intake more than macronutrient changes may also be proposed. In the second phase the strategy aims to assess lifestyle changes, trying to visualize and quantify them so as to reinforce adherence and motivation or to find new motivations and rewards. The final goal is to empower the patient in order to maintain long term self-adherence. Lifestyle approach is not an alternative to pharmacological treatment of PCOS, but it is synergic with it as it can counterbalance some side effects or risks.
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