Weight Gain in the Menopause
- Kate Organ
- Jan 4
- 3 min read
If you are experiencing weight gain during perimenopause or after menopause, you are not alone—and you are not doing anything “wrong”. Many women find that weight becomes harder to manage at this stage of life, even when they are eating well and staying active. These changes are driven largely by biology, not willpower.
In recent years, injectable weight-management medicines known as GLP-1 treatments have become available. For some women, they can be a helpful tool during the menopausal transition.
However, they need to be used thoughtfully, with proper medical oversight—particularly if you are taking hormone replacement therapy (HRT).
This article explains why menopause affects weight, how GLP-1 medicines work, their benefits and risks, how patients are monitored in the UK, and why HRT may need reviewing alongside treatment.
Why weight gain is common around menopause
Menopause brings hormonal changes that affect how the body stores fat and regulates appetite.
As oestrogen levels fall, fat distribution often shifts towards the abdomen. This includes an increase in visceral fat, which sits deeper around the organs and is linked to higher risks of type 2 diabetes and heart disease. At the same time, some women experience a reduction in insulin sensitivity, meaning the body becomes more likely to store energy as fat.
Other common menopausal symptoms can also contribute:
Poor sleep from night sweats and hot flushes
Increased stress and low mood
Fatigue, which can reduce activity levels
Loss of muscle mass with age, which lowers resting metabolism unless actively countered with strength training
Together, these changes can make weight gain feel frustratingly out of your control. Importantly, this does not reflect a lack of effort or discipline—it reflects a real physiological shift.
What are GLP-1 medicines?
GLP-1 (glucagon-like peptide-1) is a hormone your gut releases after eating. It helps regulate appetite and blood sugar by signalling fullness to the brain and slowing digestion.
GLP-1 medicines mimic this hormone, helping people feel satisfied with smaller portions and reducing persistent hunger or cravings. They are given as once-weekly injections, with doses increased gradually to improve tolerability.
In the UK, two medicines are currently used:
Wegovy (semaglutide) – a GLP-1 receptor agonist
Mounjaro (tirzepatide) – a dual GIP/GLP-1 receptor agonist, acting on two appetite-regulating pathways
Why GLP-1 medicines can help during menopause
GLP-1 medicines can be particularly useful when menopausal weight gain is driven by increased appetite, central fat gain, or insulin resistance.
They may help by:
Reducing appetite and “food noise”
Helping you feel full sooner and for longer
Improving blood sugar regulation
Supporting steady, sustainable weight loss when combined with lifestyle changes
They are not a replacement for healthy eating or movement, but for some women they make those changes feel achievable again.
Benefits and possible side effects
Potential benefits
Clinically meaningful weight loss for many patients
Improvements in blood sugar, cholesterol and blood pressure
Reduced cravings and improved control around food
Common side effects
Most side effects occur during dose increases and often settle with time:
Nausea
Heartburn or reflux
Constipation or diarrhoea
Reduced appetite or early fullness
GLP-1 medicines and HRT: why review matters
If you take HRT, especially oral progesterone, it is essential that your clinician knows before starting a GLP-1 medicine.
GLP-1 treatments slow stomach emptying and may reduce absorption of oral HRT, particularly the progesterone component that protects the womb lining. The British Menopause Society advises clinicians to be alert to this risk.
In practice, your clinician may:
Review the route or dose of HRT
Monitor bleeding patterns carefully
Adjust treatment to ensure continued endometrial protection
Do not stop or change HRT without medical advice.
Menopausal weight gain is complex, personal, and often deeply frustrating. GLP-1 medicines can be a valuable option for some women—but they work best as part of a compassionate, medically supervised plan that respects both metabolic health and menopausal wellbeing.
If you would like further support with menopause and weight gain we offer a menopause & weight consultation, where HRT, GLP-1 and lifestyle treatment options are all discussed to improve your overall health.
