Can Ozempic® Help with Menopause Weight Gain?

With all the changes you might experience during menopause, one of the more frustrating can be weight gain. If this is you, know that you're not alone, as research shows that menopausal women tend to gain an average of one pound per year during this transitional period.¹ So, it's certainly understandable if you're more eager to find a solution to lose weight and feel more like yourself again.

Chances are you've heard about the recent trend of using prescription drugs, like Ozempic, to shed unwanted pounds. You may have even noticed that major news outlets, including The New York Times and Women's Health, have recently shared stories about menopausal women turning to Ozempic to better manage their weight.^2,3 

The question is, should you join them?

Why Some Women May Gain Weight During Menopause

Before we delve into whether you should consider taking Ozempic or not, it's first important to understand why weight gain happens during menopause in the first place.

First, there are a lot of reasons you can gain weight during menopause, including hormonal changes, metabolic shifts, and variations in your lifestyle. As estrogen levels decline, your body may start storing fat around your belly, rather than your thighs and hips. This is reflected in the fact that belly fat only accounts for 5% to 8% of total fat in women before menopause and around 15% to 20% after.⁴ As if that isn't challenging enough, shifting estrogen levels can also lead to insulin resistance, which can elevate your blood sugar levels and trigger weight gain.^5,6

Loss of muscle mass can also contribute to weight gain during menopause. The loss of muscle is common with age progression, and if you’re sustaining less muscle mass, your body isn’t burning as many calories.^7,8 This means that even if you eat and exercise the same way you did before menopause, it’s possible that you will be burning fewer calories and may be prone to gaining weight more easily.⁹

Lifestyle factors can also play a part in weight changes in menopause. Many people are less active as they get older, especially if they spend long hours immobile at a desk, and exercise less; this can all can contribute to weight gain.¹⁰ You might also gain weight if you're not getting enough sleep or are on certain medications – for example, some prescriptions used to combat hormone-related menopause symptoms can contribute to weight gain.^{11, 12}

The Rise of Ozempic Use for Menopausal Weight Management

Considering the vast number of women who experience weight gain during menopause, it's no wonder why they're considering alternative solutions to help them manage their weight. The New York Times reported that women are increasingly turning to glucagon-like peptide-1 (GLP-1) agonists to lose weight during menopause. These GLP-1s include prescription drugs like Ozempic and Wegovy®, which have the active ingredient semaglutide, Trulicity®, which contains dulaglutide, and Zepbound and Mounjaro which are newer tirzepatides.^{13, 14, 15, 16} Stephanie Faubion, M.D., the medical director for the Menopause Society and director of the Mayo Clinic's Center for Women's Health, told the New York Times her organizations receive daily requests for these types of medications.¹⁷

It’s important to note, though, that the U.S. Food and Drug Administration has approved Ozempic and Trulicity for managing type-2 diabetes, not for weight loss. That said, Wegovy is an approved weight loss drug.^{18, 19} Research does suggest that these medications may help menopausal women lose weight by suppressing appetite and reversing insulin resistance.^{20, 21}

Does Ozempic Work for Menopause Weight Gain?

There's limited research specifically about semaglutides and menopausal weight changes, but general studies suggest they may also help to combat menopausal weight gain. In 2021, The New England Journal of Medicine reported on a clinical trial of nearly 2,000 non-diabetic adults with obesity who took semaglutide, Ozempic's active ingredient, every week, for 68 weeks, while exercising regularly and eating healthy. Participants in the study lost an average of 15% of their body weight, which equated to five times as much as the placebo group. While this study didn't specifically focus on menopausal women, three-quarters of participants were female with an average age of 46²²(as a reminder, menopause typically begins between 45 and 55 years of age).²³

A smaller clinical trial with more than 300 participants was conducted in 2022. This study also found people who took semaglutide weekly lost an average of 15% of their body weight. These participants had an average age of 47 and an average BMI of 38.5 – nearly 80% were female.²⁴

Safety Concerns About Using Ozempic to Manage Menopausal Weight Gain

Whether or not Ozempic or similar drugs, work, likely isn't your only concern. It’s only natural to consider any safety issues or risks associated with use, as well. That being said, there are side effects that you should know about if you're thinking about trying Ozempic or another weight loss drug.

First, keep in mind that the rapid weight loss Ozempic can trigger has been linked to a loss of muscle mass.^{25, 26} For women who are already noticing a loss of muscle during menopause, this can be especially concerning. 

Perhaps even more worrisome though, is that taking Ozempic for menopause weight gain could lower bone density.²⁷ Since bone density also begins declining as estrogen levels fall during menopause, taking a medication that also reduces bone density may leave you more vulnerable to osteoporosis. This condition, which makes bones weaker and more at risk of breaking, impacts one in three women over the age of 50.^{28, 29}

The decision to take Ozempic or any other medication to combat menopause-related weight gain is a personal and complex one. It's important to consider recent research on the drug's effectiveness, the benefits and risks, as well as your individual health circumstances in order to make a decision that’s best for you. It's also highly recommended that you speak with your healthcare provider about the challenges you're experiencing related to weight, and get personalized advice about whether Ozempic, similar drugs, or other strategies could help you better manage weight changes experienced during menopause.

Resources:

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8373626/
2. https://www.nytimes.com/2023/11/27/well/live/menopause-ozempic-weight-gain.html
3. https://www.womenshealthmag.com/weight-loss/a46094756/ozempic-early-menopause-weight-loss/
4. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/menopause-and-weight-gain
5. https://www.sciencedirect.com/science/article/pii/S0002944021002455
6. https://my.clevelandclinic.org/health/diseases/22206-insulin-resistance
7. https://my.clevelandclinic.org/health/diseases/23167-sarcopenia
8. https://www.everydayhealth.com/fitness/factors-that-can-affect-how-many-calories-you-burn/
9. https://www.health.harvard.edu/staying-healthy/the-truth-about-metabolism
10. https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/menopause-weight-gain/art-20046058
11. https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/menopause-weight-gain/art-20046058
12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8373626/
13. https://www.beckershospitalreview.com/pharmacy/menopausal-women-turn-to-wegovy-ozempic-for-weight-loss.html
14. https://www.medicalnewstoday.com/articles/drugs-ozempic-vs-wegovy
15. https://www.healthline.com/health/weight-loss/glp1-for-weight-loss#comparison-chart
16. https://www.fda.gov/news-events/press-announcements/fda-approves-new-medication-chronic-weight-management
17. https://www.beckershospitalreview.com/pharmacy/menopausal-women-turn-to-wegovy-ozempic-for-weight-loss.html
18. https://www.forbes.com/health/weight-loss/ozempic-vs-wegovy-vs-mounjaro/
19. https://www.prnewswire.com/news-releases/fda-approves-additional-doses-of-trulicity-dulaglutide-for-the-treatment-of-type-2-diabetes-301124206.html
20. https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/expert-answers/byetta/faq-20057955
21. https://www.health.com/menopause-weight-loss-ozempic-wegovy-8410817
22. https://www.nejm.org/doi/full/10.1056/NEJMoa2032183
23. https://www.nia.nih.gov/health/menopause/what-menopause
24. https://www.nature.com/articles/s41591-022-02026-4
25. https://www.healthline.com/health-news/ozempic-muscle-mass-loss
26. https://www.healthline.com/health-news/ozempic-muscle-mass-loss
27. https://www.verywellhealth.com/ozempic-muscle-loss-older-adults-7565314#:~:text=While%20muscle%20mass%20declines%20naturally,mass%20while%20taking%20these%20medications.
28. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/menopause-and-osteoporosis
29. https://www.ncbi.nlm.nih.gov/books/NBK559156/