Therefore, mixed ketogenic medical diet therapy for only 45 days, intervening electively and specifically on some of the key pathophysiological moments that determine PCOS, such as insulin resistance, hyperinsulinemia, hyperandrogenism, the increase in LH and the inversion of the LH/FSH ratio, represents an adjuvant metabolic therapy in the management of PCOS, completely free of the adverse effects of the currently used drug therapies, with the added value of reducing the risk of developing obesity, metabolic syndrome and diabetic disease. This evidence concerns the gene PLOD1 and obesity due to melanocortin 4 receptor deficiency.