Weight Management in Menopause: Diet, Physical Activity, Medication, and Surgery

During the menopausal transition and into early menopause, women gain body fat, particularly centrally, and lose lean mass. There is a worsening of cardiometabolic risk factors including insulin resistance, dyslipidemia, and vascular function. Combined diet and exercise interventions, particularly when employed during the menopausal transition, show evidence for improvement in weight, body composition, and metabolic risk factors. Although there are limited data on the effects of first-generation and second-generation antiobesity medications and bariatric surgery, glucagon-like peptide 1 receptor agonists are promising agents to prevent and mitigate adverse changes in body composition and cardiometabolic risk.