Jump to: Why does menopause cause weight gain? | How can Ozempic or Wegovy help with menopause weight gain? | Practical tips for avoiding menopausal weight gain | Take home message
A recent study published in the journal Menopause suggests that combining semaglutide (Ozempic and Wegovy) with hormone-replacement therapy (HRT) may help support more weight loss compared to women not on HRT.
The study retrospectively analysed data from patients in the Mayo Clinic Health System in the U.S. who were treated with semaglutide for obesity.
They then identified patients who were also on HRT or not to determine the impact of semaglutide in combination with HRT on weight loss and other health outcomes, like blood pressure.
The results showed that women using semaglutide in combination with HRT lost 16% of their body weight after 12 months, compared with 12% in women using semaglutide but not on HRT, a 30% relative difference between the two groups.
For women who choose not to undergo HRT, the results still suggest that semaglutide can support clinically meaningful weight loss of over 10% during menopause.
However, it’s important to acknowledge that this wasn’t a controlled study where participants were randomised to one of two interventions to determine the difference over time.
Controlled experiments give us more confidence that group differences can be attributed to the intervention rather than other potential influences.
Still, this is the first study published to suggest a potential benefit of combining weight-loss injections like Ozempic and Wegovy with HRT to support weight loss.
Read on as we discuss why combining weight-loss injections with HRT could support weight loss during menopause.
1) Why does menopause cause weight gain?
Research suggests that around 70% of women will experience some weight gain during menopause.
The average weight gain during menopause is estimated to be around 2.1kg. However, as menopause affects every woman differently, this average may not apply to everyone.
Research has suggested that the change in the hormonal balance that occurs during menopause can impact appetite regulation and hunger.
One study tracked 94 women over 5 years of their menopausal transition to investigate the impact of menopause on their appetite and energy intake.
The study showed that appetite and hunger significantly increased during the menopausal transition and were maintained in the first couple of years post-menopause. The women in this study also reported experiencing a higher preoccupation with food.
The increased hunger observed in this study is likely related to the rise in the hunger hormone ghrelin.
One study showed that ghrelin levels increased by 9-fold from premenopause to perimenopause. Researchers aren’t exactly sure why this happens.
During the menopausal transition, ghrelin rises alongside other changes, such as oestrogen, FSH, and leptin.
It’s possible that the rise in ghrelin serves a purpose elsewhere in the body and has the unfortunate knock-on effect of increasing hunger.
So, menopause could potentially lead to weight gain through increased hunger and a change in eating behaviour linked to the changes in hormonal balance in the body.
Menopause and activity levels
Research has suggested that activity levels fall during the menopausal transition, contributing to decreased energy expenditure.
This is likely due to the impact of the changing hormone levels on our mood, sleep, and stress levels. It might be that our desire to participate in physical activity decreases during this time.
Fat redistribution
As discussed, oestrogen levels decrease significantly during menopause. Oestrogen plays a role in where the body stores fat.
Research has shown that when oestrogen levels fall, our bodies store more fat in and around our internal organs, known as visceral fat.
Additionally, menopause can increase cortisol levels, one of our stress hormones, which can also lead to more visceral fat storage. So, if we also feel stressed and have higher cortisol levels, this can lead to more visceral fat storage.
High visceral fat levels can increase blood pressure, contribute to cardiovascular disease, and increase insulin resistance.
Key points
- Over 70% of women may experience weight gain during menopause
- The hormonal changes that occur during menopause can increase hunger and our desire to eat
- Energy expenditure and physical activity levels may also decrease during menopause
- Women may also store more body fat in and around their internal organs during menopause due to the decrease in oestrogen
2) How can Ozempic or Wegovy help with menopause weight gain?
The drug in Ozempic and Wegovy, semaglutide, may attenuate the impact of other hormones in the body that contribute to menopausal weight gain.
One critical change that can contribute to weight gain during menopause is the increase in the hunger hormone ghrelin.
Ghrelin stimulates food intake by increasing hunger and inhibiting the actions of fullness hormones like CCK.
Typically, ghrelin rises between meals to increase hunger and encourage food intake. However, research suggests that GLP-1 may help to keep ghrelin levels lower.
One study in humans showed that injecting the hormone GLP-1 and maintaining a ‘steady state’ of the hormone in the blood significantly reduced the levels of ghrelin in the hours after.
This suggests that GLP-1 interacts with the brain to lower hunger and the desire to eat and helps to keep the hunger hormone ghrelin lower.
Semaglutide is a drug that mimics the actions of GLP-1, so it’s a reasonable suggestion that semaglutide may also have a similar effect on lowering ghrelin levels to keep appetite lower, even during menopause.
Additionally, we know that GLP-1 medications like semaglutide reduce hunger and appetite by communicating with the brain’s appetite control centre, the hypothalamus.
Taken together, Ozempic and Wegovy can help with menopause weight gain and support weight loss by improving the hormonal balance of the body, reducing hunger and the desire to eat.
Key points
- The hunger hormone ghrelin is higher in women during menopause, which increases our hunger and desire to eat
- Ozempic and Wegovy can mitigate the impact of this rise by lowering ghrelin levels and hunger over time
3) Practical tips for avoiding menopausal weight gain
While HRT and semaglutide can support weight loss during menopause, it’s still critical to maintain healthy habits to support long-term health and wellbeing.
So, here are our three top tips on how to avoid menopausal weight gain or lose weight during menopause:
1 – Eat a diet based on wholefoods
A diet rich in ultra-processed foods is more likely to lead to weight gain, particularly during menopause.
By eating a balanced diet based on whole foods, we can naturally manage our hormonal levels so that we’re more likely to lose weight or avoid menopausal weight gain.
From Second Nature’s perspective, a balanced diet encourages the consumption of:
- High-quality protein sources: Fish, meat, eggs, tofu, tempeh, yoghurt, cheese, and seafood.
- Fat from whole foods: Meat, fish, eggs, dairy products (rich in calcium), nuts, seeds, avocado, and extra virgin olive oil.
- High-fibre carbohydrates: Whole grains like quinoa and brown rice, sweet potato, white potatoes, pumpkin, legumes like lentils, chickpeas, beans, and butternut squash.
- Fruits and vegetables: Take your pick
2 – Be physically active
There’s a long-held belief that exercise is all about ‘burning calories’. The truth is that the benefits of exercise go far beyond the number of calories you burn per hour.
Moving more regularly and undertaking formal exercise enables your body to maintain a healthier hormonal balance and receive more accurate signals from the body.
If you’re physically active, your brain is more likely to be receptive to the fullness signals sent from the gut, and therefore, it can help you feel less hungry and support weight loss.
Despite using energy, exercise gives us more energy and can help us feel more motivated to carry out everyday habits like cooking and preparing fresh foods.
If you’re short on time, you could try exercise snacking, which involves doing short bursts of activity throughout the day, like doing 10 push-ups while the kettle boils or 10 star jumps every time you go to the toilet.
3 – Have a consistent sleep schedule
Good evidence shows that if you sleep more, your hunger hormone levels are lower, and you’re less likely to snack and overeat throughout the day.
One of the best ways to get a better night’s sleep is to have a consistent sleep schedule. So, going to bed at the same time and waking up at the same time each day.
You can also try avoiding screens 30 minutes before bedtime and engaging in calming activities in bed, such as reading, journaling, or meditating.
Take home message
Menopause is an extremely challenging time for most women, and one of the unfortunate side effects of the hormonal shift that occurs is often weight gain.
The increase in hunger and negative impact on metabolism can mean that many women gain a lot of weight without seemingly changing much about their eating or lifestyle.
However, the new generation of weight-loss injections offers a possible solution for women during menopause, whether they’re on HRT or not, to lose weight or avoid menopausal weight gain altogether.
Second Nature has two medication-supported programmes: a Wegovy weight-loss programme and a Mounjaro weight-loss programme.
Why should you choose Second Nature over other medication providers if you’ve decided to try Mounjaro or Wegovy (assuming you’re eligible)?
For peace of mind.
Second Nature has worked with the NHS for over 6 years, providing weight-loss programmes across the UK.
While our Wegovy and Mounjaro weight-loss programmes are private and not currently used by the NHS, we’ve built the programmes focusing on scientific evidence, patient safety, and data security.
We hope that our 6+ years of working with the NHS and building a track record of effective weight-loss results will give you peace of mind to give us a try.
