As more menopausal women turn to GLP-1 medications like Ozempic, Wegovy, and Mounjaro for weight loss, they often do so without the necessary critical support to protect their long-term health.
Currently, too many women are navigating a major metabolic transition without the resources to do so safely. Health, strength, and longevity are the true end goal – not weight loss alone. If the industry fails to provide crucial wraparound care, we risk trading one health crisis for another. Women may shed excess weight but also lose muscle mass and bone density, putting them at greater risk for frailty, fractures, and long-term metabolic decline.
Healthcare and benefits leaders have a responsibility to provide better, more comprehensive obesity care for this patient population to ensure that women receive the full support they need to maintain muscle, bone strength, and metabolic health for the long haul.
GLP-1s are a tool, not a standalone solution
As women transition into menopause, declining estrogen causes metabolism to slow, visceral fat storage to accumulate around the abdomen, and muscle mass to decrease. This creates a higher risk of insulin resistance, cardiovascular disease, and osteoporosis — even for women who are not overweight.
For many, GLP-1 medications effectively manage weight gain, reduce appetite, and improve insulin sensitivity. However, these drugs do not address the full range of metabolic changes that occur during menopause. Hormones, biology, and lifestyle all interact in unique ways for women at this stage of life. Taking a holistic approach to health is much more effective than simply relying on one potent medication for balancing all of those factors.
The hidden risks of rapid weight loss in menopause
Simply prescribing GLP-1s without support is not a sustainable model of obesity care. Losing weight without nutritional and physical intervention can accelerate two of the biggest risks of menopause: muscle loss (sarcopenia) and bone density decline (osteopenia and osteoporosis). As estrogen declines, the body naturally loses muscle mass. GLP-1s can exacerbate this loss if not paired with strength training and adequate protein intake, slowing metabolism further and making long-term weight maintenance harder.
Menopausal women already experience faster bone loss, and rapid weight loss can accelerate this process. Without resistance training and sufficient calcium, magnesium, and vitamin D intake, women may unknowingly increase their risk of fractures and mobility issues later in life.
This creates a disturbing paradox: A woman may successfully lose weight on GLP-1s, but in doing so, she may become weaker, less mobile, and more vulnerable to chronic disease and injury. Still worse, she is likely to regain visceral fat when coming off a GLP-1 if she has not developed healthy habits when on the medication.
Four essential pillars of obesity care for menopausal women
Healthcare systems and employer benefits leaders must expand their approach to obesity care, ensuring that women using GLP-1s or other weight-loss strategies are supported with Medical Nutrition Therapy (MNT), movement programs, and long-term metabolic health tracking. For GLP-1s to be truly effective for menopausal women, they must be integrated into a broader care strategy that includes:
- Nutritional guidance to prevent muscle loss and support long-term metabolic health
- Strength training programs to maintain lean body mass and bone density
- Mental health support to ensure appetite suppression does not lead to disordered eating patterns
- Long-term metabolic monitoring to assess insulin sensitivity, cardiovascular risk factors, and functional strength
These interventions should not be optional — they should be core components of any obesity treatment plan for menopausal women.
For too long, menopausal health has been an afterthought in both healthcare and employer-sponsored benefits. Weight gain during menopause is not just a lifestyle issue — it is a metabolic shift that requires targeted, science-backed interventions. It is time for healthcare leaders, employers, and policymakers to step up and provide the full range of support menopausal women need.
GLP-1s can be an effective tool but cannot replace the critical need for comprehensive, whole-body care that prioritizes muscle, bone, and metabolic health. Women need access to resources that empower them to navigate menopause with strength and confidence. If we continue to treat weight loss as the only metric of success, we will fail an entire generation of women who deserve better, more sustainable care.
Photo: Peter Dazeley, Getty Images
Gretchen Zimmermann is VP of Clinical Strategy at Vida Health.
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