Navigating menopause and weight loss medications

During perimenopause and menopause, changes in hormone levels can bring hot flushes, disrupted sleep and other symptoms. You may also notice changes in your weight or body shape, even if your usual habits have stayed much the same. 

If you’re considering a weight loss medication, or already taking one, it’s natural to wonder how it fits into this stage of life. Our expert nutritionist, Mark Gilbert, explains what we know about GLP-1s and menopause, and why looking after your muscle and bone health matters alongside weight loss. 

Does menopause cause weight gain? 

Menopause does not mean you will inevitably gain weight. However, hormonal changes, ageing and changes in activity or sleep can make weight management feel harder. Fat distribution can change too, with more fat stored around the abdomen. 

This includes visceral fat, which sits deeper in the abdomen, around internal organs. Higher levels of visceral fat are associated with an increased risk of conditions such as type 2 diabetes and cardiovascular disease. So, looking after your health during menopause means considering more than the number on the scales. 

Can GLP-1 medications help with menopausal weight gain? 

For people who meet the prescribing criteria, GLP-1 and related medications can support weight loss. They are not treatments for menopause symptoms such as hot flushes or brain fog, and research focused specifically on women during and after menopause remains limited.  

There is no single “best” weight loss medication for menopause. A prescriber can assess whether medication is appropriate for you based on your health, medical history and treatment goals. 

Menopause may be a good time to address excess visceral fat. However, weight loss with GLP-1 medications can also involve a loss of lean mass, including muscle. As menopause already increases the risk of muscle and bone loss, adequate nutrition is particularly important during treatment. 

Why muscle and bone matter during weight loss 

As we age, we tend to lose muscle mass, and the menopausal transition may accelerate this change. Research shows that lean mass was, on average, 2.5% lower in perimenopausal women and 5.7% lower in postmenopausal women than in premenopausal women across the studies reviewed. Bone health also becomes particularly important during menopause.  

Weight loss while taking GLP-1 medication can include a loss of muscle as well as fat. Because these medications can reduce appetite, eating less may also make it harder to get enough protein and other nutrients. When every meal is smaller, what you eat needs to work harder for you.  

These overlapping changes make it important to look after your muscle and bone health during weight loss and menopause. Eating enough protein, getting nutrients such as calcium and vitamin D, and doing regular resistance training can all help. 

How can you support your health while taking GLP-1 medication? 

Stay on top of your protein  

Protein supports the maintenance of muscle mass, making it especially important if you’re navigating menopause while taking weight loss medication. There is no agreed protein target specifically for women in this position. The standard adult reference intake is around 0.8 g per kilogram of body weight a day, but higher intakes may be appropriate during weight loss.  

Many experts suggest that some people may need up to 2.2g per kilogram of body weight, depending on their circumstances. For example, the maxiumum amount of 2.2g may be recommended for athletes or those lifting heavy weights and around the 1.6g mark for those who are doing heavy exercises. Your ideal target is best discussed with a healthcare professional. 

Try including protein throughout your daily meal plan. Chicken, fish and Greek yoghurt are options, while protein shakes or snacks may be easier to manage when your appetite is smaller. 

Incorporate vitamins and minerals  

Vitamins such as vitamin A, B-complex, C and D can help aid the normal function of muscle.  

Calcium and vitamin D contribute to the maintenance of normal bones, while magnesium contributes to normal muscle function. A varied diet helps you get the nutrients your body needs while you’re eating less. Think about how to include a range of nutrient-rich foods across your meals rather than focusing on protein alone.

Add in resistance training 

Resistance training can help maintain muscle mass and strength during weight loss. It is also an important part of looking after bone health through menopause. You could start with exercises using your body weight or resistance bands, then build up gradually as your strength grows. 

Does microdosing GLP-1 help with menopause? 

“Microdosing” usually refers to taking amounts smaller than the prescribed doses. Despite discussion online, there is not enough evidence to show that it helps with menopause symptoms or offers a proven approach to weight management. If you have concerns about your medication or side effects, speak to your prescriber before changing your dose. 

Nourishment alongside weight loss 

Managing weight during menopause is about supporting your health as well as reaching a number on the scales. If you’re eating less while taking prescribed medication, planning for protein, varied nutrients and regular movement can help you look after your strength. 

For convenient protein options when appetite is smaller, explore PortionIQ’s Mixed Berry Shake and Very Berry Bites. 

Shop now.