A married woman in her 30s presented with difficulty conceiving and underwent a gynecological evaluation. An ultrasound revealed multiple ovarian cysts, suggesting polycystic ovary syndrome (PCOS). Additional investigations found high cholesterol, fatty liver, and impaired glucose tolerance. However, this was only the apparent manifestation of a condition that had likely begun much earlier. During adolescence, she had been overweight, consumed a diet high in refined carbohydrates, ultraprocessed food, junk food and fast food, engaged in little physical activity, and spent prolonged periods sitting. 

This case illustrates that PCOS does not arise suddenly. Its origins often begin in childhood and adolescence, when unhealthy dietary patterns, sedentary lifestyle, and excess weight gradually contribute to insulin resistance and metabolic dysfunction.  

PCOS has long been perceived as a gynaecological disorder, mainly focused on ovarian cysts. The diagnosis of PCOS is based on at least two of the following three features (1) ovulatory dysfunction (irregular or absent menstrual cycles), (2) clinical or........

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