Does Ozempic Help with Menopause Weight Gain?

Most women gain an average of a pound a year during the menopause transition, with 20 percent gaining 10 pounds or more. ¹ While diet and exercise remain foundational tools for weight loss, healthcare providers are increasingly prescribing Ozempic for menopause weight gain and to support long-term health.

Ozempic (semaglutide) and other glucagon-like peptide-1 (GLP-1) receptor agonist medications target underlying issues that drive weight gain during menopause, such as insulin resistance and metabolic shifts, explains endocrinologist and obesity specialist Alex Watson, M.D.

Still, you may be wary of taking a drug that has no long-term data, especially during menopause, a mysterious black-box stage of life that’s only now getting the attention that it deserves. Here’s what research and experts say about using medications like Ozempic to reverse menopause weight gain.

About the Experts

Michelle Cooper, MD, a board-certified OB-GYN and menopause specialist

Alex Watson, M.D., a board-certified endocrinologist and obesity specialist

Caroline Messer, M.D., a double board-certified endocrinologist and founder of Well by Messer.

Jayne Morgan, M.D., a cardiologist and adjunct associate professor of medicine at The Morehouse School of Medicine, VP of medical affairs at Hello Heart and founder of The Stairwell Chronicles.

Ozempic For Menopause Weight Gain

Ozempic isn’t FDA-approved for weight loss, but its pharmaceutical cousin, Wegovy, is approved for chronic weight management, including for women in menopause. Other GLP-1 medications for weight loss include Liraglutide (Saxenda), Dulaglutide (Trulicity), and Tirzepatide (Mounjaro).

Both medications contain GLP-1 receptor agonists. Drugs in this class mimic the GLP-1 hormone, which regulates appetite, slows digestion, and improves insulin sensitivity.

Studies show that people taking GLP-1 drugs can lose up to 20 percent of their total body weight. ² People taking retatrutide—a newer GLP-1 now in phase III trials—lost an average of 24 percent of their body weight in just under a year. ³

Emerging research suggests GLP-1 medications may be particularly effective for menopause weight gain:

• A 2025 study presented at the Menopause Society meeting found that postmenopausal women on hormone replacement therapy (HRT) lost 19.9 percent of their body weight on tirzepatide—significantly more than the 15.6 percent loss seen in postmenopausal women not using HT. ⁴
• A 2025 study in Metabolic Syndrome and Related Disorders found that postmenopausal women taking low-dose semaglutide lost fat at a rate comparable to premenopausal women, despite having a higher baseline weight and fat mass. ⁵
• Another small 2024 study in Menopause showed that postmenopausal women with overweight or obesity lost 12 percent of their initial body weight on semaglutide. Women in menopause taking both semaglutide and hormone replacement therapy (HRT) lost 16 percent of their body weight (a statistically significant difference). ⁶

“I recommend semaglutide for all of my patients who are gaining weight in menopause absent other changes and any contraindications,” says double-board certified endocrinologist Caroline Messer, M.D.

Menopause specialist Michelle Cooper, M.D., agrees on the benefits of prescribing ozempic for menopause weight gain. “Every single one of my patients [on ozempic in menopause] has lost weight and seen their metabolic numbers improve, they feel happier and more vital. A lot of things get better.”

Why Menopause Weight Gain Is Worth Fighting

Weight gain in menopause is more than a cosmetic issue; it increases the risk of serious health conditions.

Increased visceral fat in menopause

Women in perimenopause are more likely to experience an increase in visceral fat, which climbs from 5 to 8 percent of women’s total body fat before menopause to 15 to 20 percent after.

One contributor? Estrogen inhibits an enzyme called lipoprotein lipase (LPL), which breaks down triglycerides for storage in fat cells. As estrogen declines during menopause, LPL activity increases and weight accumulates, often around the midsection (commonly known as “menopause belly”).

Abdominal (visceral) fat is a particularly dangerous part of menopause weight gain because it releases pro-inflammatory cytokines that promote insulin resistance, the primary contributor to type 2 diabetes. ⁷ Visceral fat also contributes to cardiovascular disease, arthritis, and chronic obstructive pulmonary disease (COPD). ⁸

Metabolic syndrome in menopause

Due in large part to these estrogen-related metabolic changes, menopausal women are twice as likely as premenopausal women to develop metabolic syndrome—a cluster of conditions that raise the risk of heart disease and diabetes. ⁹ Metabolic syndrome is closely related to overweight and obesity.

You might have metabolic syndrome if you have three or more of these conditions:

• High percentage of visceral fat
• High blood sugar
• High blood pressure
• High blood triglycerides
• Low HDL (good cholesterol)

“High blood pressure, rising cholesterol, and diabetes are all independent risk factors for heart disease,” says cardiologist Jayne Morgan, M.D. “And during menopause, many women have them all at once.”

Menopause, weight gain, and mental health

Research has found that mental health conditions like depression often accompany weight gain, particularly in menopause.

Menopause weight gain can chip away at self-confidence, making you less likely to do the things you love—taking a yoga class or stripping down to have fun in the bedroom—and more likely to turn to food for comfort, according to a 2017 study published in Menopause. ¹⁰

Declining ovarian function during menopause is associated with increased proinflammatory cytokines that have been linked to a higher risk of depression and mood disorders, including interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). ^{11 12} Carrying extra weight and making less-than-healthy food choices also increases these markers.

Changes to the muscle-to-fat ratio in menopause

Lean muscle mass declines up to 8 percent after age 30. ¹³ Estrogen helps maintain muscle, so its decline in menopause accelerates muscle loss, which in turn slows metabolism.

Muscle is more metabolically active than fat, says Watson. With less muscle to burn calories, metabolism slows down, leading to weight gain.

Do GLP-1s Work Differently in Menopause?

While GLP-1 medications like Ozempic don’t work differently in menopause, they may be especially beneficial for menopausal women.

Semaglutide medications mimic a hormone, GLP1, that your intestines produce after eating to regulate blood sugar. The GLP-1 hormone suppresses appetite by acting on the hypothalamus, the brain region that controls hunger. It also slows stomach emptying and affects the release of insulin and glucagon from the pancreas, helping to stabilize blood sugar levels.

Another benefit of Ozempic for menopause weight gain? GLP-1s have been found to significantly reduce visceral fat, according to a 2023 PLoS ONE study. ¹⁴ They also reduce more fat mass than muscle mass, according to a 2025 study in Diabetes, Obesity and Metabolism, improving the muscle-to-fat ratio. ¹⁵

Can You Take Ozempic With HRT?

You can take Ozempic and HRT together, and doing so may enhance weight loss in menopause. A 2024 study published in Menopause found that postmenopausal women on both semaglutide and HRT lost significantly more weight than those on semaglutide alone. ¹⁶

The researchers note that ozempic and HRT might share mutual benefits because of the room for improvement in insulin resistance, as well as for lifestyle reasons. “If you’re sleeping better and feeling better, you might be more motivated to eat better and work out,” Messer says. Better sleep alone has been shown to help with weight loss by reducing calorie intake. ¹⁷

What Are the Potential Drawbacks of Ozempic During Menopause?

The side effects of Ozempic in menopausal women are the same as in the general population and may include nausea, bloating, reflux, and constipation.

Of particular concern for menopausal women, however, is muscle loss, which research shows is a side effect of GLP-1 medications. Although, as Cooper points out, all weight loss has the potential for muscle loss, so this effect isn’t unique to Ozempic.

Reduced lean muscle raises the risk of fracture and osteoporosis—already a concern for women in menopause. However, Watson notes that Ozempic might also indirectly improve bone density. “If you lose weight and decrease inflammation, and that makes for more comfortable exercise, you’re more likely to get moving, which protects bone density,” Watson says. A 2024 JAMA Network Open study confirms regular exercise helps preserve bone strength while taking GLP-1s. ¹⁸

Are There Other Benefits of Taking Ozempic in Menopause?

Emerging research suggests Ozempic offers women in menopause benefits beyond weight loss, including: ^{19 20 21 22}

• Lowered risk of heart attack, stroke, and other cardiovascular events
• Reduced risks of seizures
• Lessened addiction to alcohol, cannabis, stimulants, and opioids
• Decreased risk of suicidal ideation, self-harm, and psychotic disorders such as schizophrenia
• Decreased risk of neurocognitive disorders such as Alzheimer’s and dementia.
• Ease depression
• Improved knee osteoarthritis
• Lessened obstructive sleep apnea

Ozempic for Heart Health in Menopause

Ozempic may reduce the risk of heart disease that surges when estrogen declines in menopause. One 2023 Cleveland Clinic study showed that GLP-1s lowered users’ risk of heart attack and stroke by 20 percent. ²³ And a 2024 study showed improvements in cardiometabolic risk specifically among menopausal women taking semaglutide. ²⁴

Ozempic for Menopause Hot Flashes

Losing weight can ease hot flashes, so Ozempic may reduce how many of the heat waves you experience, suggests a study in Menopause. ²⁵

Ozempic may work particularly well for reducing night sweats (hot flashes that happen at night) because it decreases the stress hormone cortisol, which can disturb sleep when it spikes at night, Watson says. ²⁶

Ozempic for PCOS in Menopause

Polycystic ovary syndrome (PCOS) is a condition that disrupts ovulation and causes irregular periods, weight gain, facial hair, and acne. Leading up to menopause, it becomes more of a metabolic disorder, as insulin resistance increases the risk for type 2 diabetes and cardiovascular disease, according to a 2021 study in the Journal of Midlife Health. ²⁷

“PCOS is insulin resistance and dysregulated androgens,” Watson explains. “If you’re controlling insulin resistance, then you have healthier ovaries that will produce less of the androgens.” Messer has been prescribing GLP-1s for the condition since 2006. “It completely eradicates PCOS in the vast majority of patients,” she says.

Talking to Your Doctor About Ozempic for Menopause

Ozempic and other GLP-1s are approved for people with a body mass index of 30 or higher or a BMI of 27 or higher and a weight-related condition like diabetes, hypertension, or sleep apnea.

However, many menopause and obesity specialists are willing to prescribe Ozempic or another weight loss medication off-label if they feel the benefits outweigh the risks.

Watson recommends seeking out a clinician with expertise in either GLP-1s, menopause, or both. “The overlap is not necessary, as long as the person is up on the prevailing recommendations.”

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About the author

Aviva, Hone's Executive Editor, is an award-winning health-science journalist and former executive editor of Psychology Today, Reader's Digest, and The Healthy. She has written for national print and digital publications including Health, Prevention, Women’s Health, Men’s Health, Shape, Fitness, SELF, New York Magazine, and more.

About the reviewer

Carol Lynn, MD is a board-certified OB/GYN who specializes in menopause management. She is a member of the American Board of OB/GYN (ABOG) and the North American Menopause Society (NAMS).