The stigma around menopause has lessened as more people share their experiences, helping others feel validated and prepared for this life transition. Perimenopause begins the winding down of the reproductive cycle and leads into menopause. Hormonal shifts during this time cause a range of symptoms—from hot flashes and mood changes to weight gain—and many seek effective treatments.
Interest in therapies has surged alongside research. A recent clinical trial found that participants on a plant-focused diet saw a 92% drop in severe hot flashes and reported weight loss and improved well-being. Still, for many, diet alone may not offset menopause-related body changes. The so-called “meno belly” refers to stubborn abdominal fat that is often resistant to prior strategies.
GLP-1 medications—such as Ozempic, Wegovy, and Zepbound—are glucagon-like peptide-1 receptor agonists that mimic gut hormones to reduce hunger and are widely used for obesity and weight management. Recent studies suggest GLP-1s may also help address menopause weight gain. Michael Snyder, MD, Medical Director of the Bariatric Surgery Center at Rose Medical Center and an obesity specialist, says, “This is a real and expected physiologic change as it relates to aging. During menopause, GLP-1 receptor agonist treatment is rapidly becoming a first-line treatment option for weight gain.”
This interview has been lightly edited for clarity.
Why weight changes occur
Snyder explains that falling estrogen and progesterone levels alter metabolism, fat distribution, and appetite regulation. Lower sex hormones make it easier to store fat—especially around the abdomen—and harder to lose it. Menopause-related sleep disruption and increased stress raise cortisol, which promotes midsection fat storage. Because excess fat must be stored somewhere, many people accumulate it in the belly.
When weight gain begins
Weight changes often start in perimenopause, typically in the mid-to-late 40s. Although the average age of menopause in the U.S. is 52, declines in hormone levels can start years earlier and continue into postmenopause if lifestyle adaptations aren’t made. It’s usually a gradual decline, not an abrupt shift.
Managing new weight gain
Snyder notes that any unexplained weight gain can be frightening when past strategies stop working. Key lifestyle approaches include:
– Increasing protein and fiber to enhance fullness.
– Strength training 2–3 times per week to preserve muscle and support metabolism.
– Limiting calorie-dense, highly processed foods and refined carbohydrates.
– Consulting an OB-GYN for complex cases to assess hormonal health and discuss medical options.
How GLP-1s help
GLP-1 receptor agonists reduce appetite and cravings, slow gastric emptying to extend satiety, and improve insulin sensitivity. Because they address several drivers of weight gain, they are a powerful tool for menopause-related weight management.
A 360-degree approach for sustainable results
Snyder emphasizes that lasting management usually requires multiple coordinated strategies:
– Regular strength training and physical activity to maintain muscle and metabolic rate.
– Prioritizing protein and fiber while reducing added sugars and refined carbs.
– Improving sleep and managing stress to stabilize hormones and appetite.
– Seeking rational, expert guidance rather than fads, gimmicks, or unproven supplements. (Some research suggests certain vitamins may ease low-estrogen symptoms, but stronger studies are needed.)
– Regular medical follow-ups for tailored advice on nutrition, exercise, and possible hormonal or medication support, including hormone replacement therapy (HRT) or GLP-1 drugs.
Menopause weight gain is not a moral failing. When prior approaches stop working, medical professionals can offer evidence-based dietary, behavioral, and pharmacologic options to help individuals reach a new, sustainable baseline. If you’re experiencing perimenopause or menopause-related weight changes, discuss symptoms and treatment choices with your doctor or OB-GYN.
