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

Area of Science:

• Reproductive Endocrinology
• Metabolic Health
• Cardiovascular Risk Management

Background:

• Women undergo significant body composition changes during the menopausal transition, including increased central adiposity and decreased lean mass.
• These changes are associated with the exacerbation of cardiometabolic risk factors such as insulin resistance, dyslipidemia, and impaired vascular function.
• Understanding these physiological shifts is crucial for developing effective health interventions.

Purpose of the Study:

• To summarize the impact of menopause on body composition and cardiometabolic health.
• To review the efficacy of lifestyle interventions in mitigating these adverse changes.
• To explore the potential of pharmacological agents, including novel therapies, in managing menopausal-related health risks.

Main Methods:

• Literature review of studies focusing on menopause, body composition, cardiometabolic risk factors, and treatment interventions.
• Analysis of data on the effects of diet, exercise, antiobesity medications, bariatric surgery, and GLP-1 receptor agonists.
• Synthesis of evidence regarding the timing and effectiveness of interventions during the menopausal transition.

Main Results:

• Menopause is characterized by increased body fat (especially central) and loss of lean body mass.
• Cardiometabolic risk factors like insulin resistance, dyslipidemia, and poor vascular function worsen during this period.
• Combined diet and exercise interventions are effective, particularly when initiated during the menopausal transition.
• Emerging evidence suggests glucagon-like peptide 1 receptor agonists show promise for managing body composition and cardiometabolic risks.

Conclusions:

• The menopausal transition presents a critical window for intervention to address detrimental changes in body composition and cardiometabolic health.
• Lifestyle modifications, including diet and exercise, are foundational for mitigating these risks.
• Pharmacological options, notably GLP-1 receptor agonists, offer a promising avenue for preventing and treating adverse menopausal-related health outcomes.