As GLP-1 medications gain popularity for weight loss, more women are taking them in the perimenopause and menopause years. U.S. women ages 30 to 49 are more than twice as likely to have used GLP-1s compared to men of the same age, according to a recent study from RAND. GLP-1s were even more popular for women 50 to 64 — about 20 percent had tried them.

Weight gain, particularly around the midsection, is common during perimenopause and menopause. In fact, you may gain about 1.5 pounds per year as you progress through your 50s. To offset this weight gain, healthcare professionals recommend exercising more, adding resistance training, and eating fewer calories.

But for some people, this extra effort may not produce the results they hope for. “I gain weight despite increasing my activity,” one woman shared in a ThisIsMenopause survey.

GLP-1s, or glucagon-like peptide 1 receptor agonists, are effective at treating type 2 diabetes and promoting weight loss. But just how useful are they during perimenopause and menopause? Here’s what you need to know about GLP-1s for menopausal weight gain, including their risks and benefits.

Why Is Weight Gain Common in Perimenopause and Menopause?

Weight gain during midlife is common. It results from a combination of aging, lifestyle factors, and hormonal changes. While declining estrogen during the menopausal transition contributes to shifts in fat distribution — often toward the abdomen — overall weight gain is largely driven by age-related metabolic changes.

As estrogen levels decrease during menopause, the risk for insulin resistance increases. This resistance means muscle, fat, and liver cells don’t respond effectively to insulin. Insulin resistance makes losing weight more challenging and puts you at risk of developing type 2 diabetes and cardiovascular diseases.

Age also plays a factor in menopausal weight gain, especially as your body starts to lose muscle mass and you become less active overall. This loss of muscle slows your metabolism — or the rate at which you burn calories — while your fat stores increase.

Lifestyle changes, like a change in physical activity levels or a lack of quality sleep, also contribute to how much weight you gain. Genetic factors also influence your body composition. So, if your parents and other family members have extra belly fat, you’re more likely to as well.

Many women find this extra weight gain difficult to navigate. “It’s frustrating doing similar things to lose weight, but the weight just doesn’t budge,” one woman told ThisIsMenopause.

What Are GLP-1s?

GLP-1s are medications originally developed to help lower blood sugar levels in people with type 2 diabetes. These drugs, which have only been around since the early 2000s, also reduce appetite, slow gastric emptying, and sometimes lead to significant weight loss. Because of these effects, several GLP-1 medications are now also approved to treat obesity.

Only two injectable forms of GLP-1s have been officially approved by the U.S. Food and Drug Administration (FDA) for weight loss, semaglutide (Wegovy) and tirzepatide (Zepbound). More recently, the FDA approved an oral version of Wegovy to treat obesity. Healthcare providers will sometimes prescribe other GLP-1s off-label to support weight loss.

GLP-1 drugs have become widely used. A 2025 Gallup poll found that 12.4 percent of Americans had tried some form of GLP-1 for weight loss.

Typically, you’re prescribed a GLP-1 if you have a body mass index (BMI) score of 30 or higher, or if you have a BMI greater than 27 along with another condition such as high blood pressure, high blood sugar, a risk of cardiovascular disease, high cholesterol, or obstructive sleep apnea.

Some of the more common GLP-1 medications include:

• Dulaglutide (Trulicity)
• Exenatide (Byetta)
• Liraglutide (Saxenda, Victoza)
• Semaglutide (Ozempic, Rybelsus, Wegovy)
• Tirzepatide (Mounjaro, Zepbound)

GLP-1s work in a few different ways. Some describe them as reducing “food noise” and cravings. In other words, you may have less interest in food, become more satisfied with what you eat, and feel full longer.

These medications also delay gastric emptying (or the amount of time it takes food to go from your stomach to the small intestine). They can boost insulin secretion, which could result in improved insulin sensitivity. Overall, the weight loss experience will vary, but on average people lose between 5 percent and 21 percent of their body weight while taking a GLP-1 medication.

Are GLP-1s Effective for Women in Perimenopause?

Weight changes during perimenopause and menopause occur as a result of both aging and hormonal changes. While declining estrogen influences body composition and often leads to more fat around the belly, midlife weight gain is largely caused by age-related metabolic changes. Some research, though limited, suggests that these changes might be offset by taking GLP-1s.

In particular, one 2024 analysis of about 100 postmenopausal women found that semaglutide caused weight loss, improved heart health, and reduced cardiovascular risk factors. The benefits were greater for women taking menopause hormone therapy. In fact, they experienced 30 percent more weight loss than those not on hormone therapy.

During perimenopause, it’s common to experience a decrease in muscle mass and more fat in your abdominal area. These changes can increase your risk of type 2 diabetes and heart disease. GLP-1 medications can be effective at addressing insulin resistance, supporting weight loss, and lowering heart-related risks.

What Are the Benefits and Risks of GLP-1 Medications in Perimenopause?

Doctors don’t yet have a definitive picture on whether GLP-1s are the best option to address perimenopausal weight concerns. For this reason, you need to carefully consider your medical history and weigh the benefits and the risks.

Potential Benefits

GLP-1s are very effective at treating type 2 diabetes, and they can promote weight loss. They can also reduce the risk of heart attack or stroke. Tirzepatide is also approved to treat obstructive sleep apnea in people diagnosed with obesity. Some research shows GLP-1s may even improve mental health and quality of life.

Potential Risks

Menopause naturally causes the loss of muscle mass and bone density as estrogen supplies decrease and the body ages. GLP-1s can exacerbate this process, raising the risk for fragile bones and even osteoporosis.

In fact, one 2026 observational study found that those taking GLP-1s had a 4.1 percent increased risk of osteoporosis when compared to those who didn’t take one, who had about a 3 percent risk. GLP-1s also have possible side effects, like constipation, diarrhea, nausea, and increased heart rate. Animal studies have shown a possible connection between GLP-1s and thyroid cancer, but it’s not clear if the risk exists for humans.

Your doctor can help you weigh the pros and cons and decide on the best plan for you.