 Patients will have a baseline history, clinical examination, hormonal profile FSHLH, fasting Insulinglucose ratio, androgen profile, day 21 serum progesterone, serum leptin and ghrelin levels ultrasound examination ovarian volume and antral follicle count, including Doppler blood flow study ovarian stromal velocity, PI, RI, SD ratio and power Doppler Participants will then be randomised to receive either metformin or orlistat. Patients receiving orlistat will receive the standard dose of the drug as recommended in the BNF. Metformin will be given in an incremental dose starting at 1000mg per day and increased at 4 weekly intervals to 2000mgd, depending on the occurrence of any gastrointestinal intolerance. The endocrinological and ultrasound investigations will be repeated at 4 weekly intervals. Both groups will be given a standard exercise and diet program in conjunction with medical treatment. 