In Full Bloom: GLP-1s, Weight Loss, and Menopause

GLP-1 medications have changed the way physicians treat obesity, offering patients more options for managing their weight and improving their overall health. But with their growing popularity come questions about effectiveness, side effects, and long-term use, particularly for women navigating perimenopause and menopause. 

In this episode of In Full Bloom, we welcome Dr. Emily Watters, general surgeon and board-certified obesity medicine surgeon at GBMC, to discuss GLP-1 medications and their role in women's health. 

It's not just about weight. Obesity is a chronic condition that can increase the risk of developing diabetes and hypertension, while also impacting fertility and pregnancy outcomes. GLP-1 medications have become another tool for treating obesity, particularly for patients who may not qualify for bariatric surgery. Options include semaglutide (Ozempic and Wegovy) and tirzepatide (Mounjaro and Zepbound), which work through different hormone pathways, which means treatment needs to be individualized, taking into consideration a patient's health, goals, medication tolerance and insurance coverage. 

Common side effects of GLP-1 medications include nausea, vomiting and constipation because the medications slow stomach emptying. Dr. Watters stresses the importance of working with a physician to adjust dosages and manage side effects. Nutrition and exercise are also essential components of treatment. 

"I always say get your protein in first because the medication will make you feel full," says Dr. Watters. 

She also recommends adequate hydration, strength training and cardiovascular exercise. Maintaining muscle mass is particularly important for women, as weight loss can involve losing both fat and muscle. 

For women navigating perimenopause and menopause, weight management can become increasingly challenging. Dr. Blomquist explains that menopause has a greater impact on body composition and fat distribution than on weight gain itself. Declining estrogen levels are associated with increased abdominal fat and decreased lean body mass. Emerging research is exploring whether estrogen and GLP-1 medications may work together to improve outcomes. However, Dr. Blomquist emphasizes that this remains theoretical and more research is needed. 

Because obesity is a chronic condition, some patients may need to continue GLP-1 medications indefinitely. Dr. Watters discusses adjusting maintenance doses based on individual needs while acknowledging that research on microdosing remains limited. Bariatric surgery may be the more appropriate and then using medications before or after surgery to support. Ultimately, a team-based approach to obesity treatment is needed, one that considers each patient's overall health, lifestyle and goals. 

Listen to this episode of In Full Bloom to learn more about GLP-1 medications, women's health and the evolving options for managing obesity.