Menopause and excess weight: can GLP-1 treatment help?

“I eat about the same as before, but I’m gaining weight. My waistline, in particular, is changing.”

Many women recognise this during the menopause transition. Clothes fit differently, losing weight seems harder, and waist circumference increases. Why does this happen? And can medicines such as semaglutide or tirzepatide help?

Why does the body change during the menopause transition?

Weight gain in midlife results from a combination of ageing, hormonal changes, and lifestyle factors.

Muscle mass often decreases with age. This can reduce the amount of energy the body uses. Less physical activity, stress, and poorer sleep can also contribute.

Declining oestrogen levels mainly influence where the body stores fat: fat accumulates more readily around the abdomen, including around the internal organs. Waist circumference can therefore increase without a major change on the scales. Menopause does not automatically cause excess weight, but it can change body composition.

Does menopause hormone therapy help with weight loss?

Menopause hormone therapy may be appropriate for troublesome hot flushes, night sweats, and other menopause symptoms. It is not prescribed as a weight-loss treatment.

When symptoms and sleep improve, staying active and maintaining healthy habits may become easier. Its effects on abdominal fat and body composition are generally modest.

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