GLP-1 Medications for weight loss at menopause

Lucy Jones RNutr
Jul 31
7 min read

Updated: Sep 5

If you’re going through perimenopause and menopause and have been struggling with weight gain, you’re not alone. Many women find that hormonal changes during the menopause transition make fat loss feel harder than ever.

Recently, GLP-1 medications like Ozempic, Mounjaro and Wegovy have been making headlines for their fat loss success. But what are these drugs, how do they work, and are they safe and effective for women at menopause?

In this blog, we’ll explore:

What GLP-1 medications are and how they work
The evidence behind their use for fat loss - and whether you should or shouldn’t be using them
Who they’re suitable for and considerations to make
Diet and lifestyle advice for those using GLP-1 medication

Hand holding an insulin pen, pointing outward. Blurred background with skin tones suggests a personal healthcare setting.

What are GLP-1 medications?

Glucagon-like peptide-1 receptor agonists (GLP-1) medications are used to manage type 2 diabetes and obesity (2). GLP-1 is a type of incretin hormone, which plays an important role in regulating blood sugar levels after eating. These medications mimic the effects of natural GLP-1 hormones in the body (1,3).

How do GLP-1 medications work?

GLP-1 medications mimic the action of GLP-1 hormones produced in the gut. These hormones play a key role in insulin secretion, helping to lower blood sugar levels after eating (4). GLP-1 medications can also reduce the amount of sugar produced by the liver (5).

In addition, GLP-1 hormones slow gastric emptying (i.e. digestion), reduce appetite, and increase feelings of fullness and satiety (2,4). This means you feel fuller for longer and are likely to eat less.

What are the different types of medications?

You may have heard of different names and types of GLP-1 medications - let’s break these down.

Semaglutide

Semaglutide is a GLP-1 agonist only.

There are three brands available:

Ozempic: this is prescribed for type 2 diabetes only (1, 5). It comes as a weekly injection (5).
Wegovy: this is prescribed for weight loss only (1,5). It comes as a weekly injection (5, 18).
Rybelsus: this is prescribed for type 2 diabetes only (1,5). It comes as a daily tablet (5).

Tirzepatide

Tirzepatide is a GLP-1 and GIP (glucose-dependent insulinotropic polypeptide) receptor agonist (6). GIP is another type of incretin hormone. It’s thought the dual action of two incretin hormones offers greater benefits for blood sugar and weight regulation.

There is one brand name widely available: Mounjaro, which can be prescribed for both type 2 diabetes and weight loss. It’s taken as a weekly injection (1,6,7).

Are GLP-1 medications effective for weight loss?

The short answer is yes - GLP-1 medications have been shown to support significant weight loss when combined with lifestyle changes.

Research suggests these medications can help individuals with obesity lose 10-25% of their body weight within one year, alongside diet and lifestyle changes (8).

One study found that people with overweight and obesity taking 3mg/day of liraglutide (which is another type of GLP-1 medication) combined with a calorie reduced diet and exercise regime, lost more weight than those who followed lifestyle changes only (9).

In the STEP-1 Trial, participants taking 2.4mg/week of semaglutide along with lifestyle changes lost 14.9% of their body weight over 68 weeks. This is compared to just 2.4% in the group making lifestyle changes alone (10). The STEP-5 Trial extended these findings - after 104 weeks, participants taking the same semaglutide dose lost 15.2% of their body weight, which was 12.6% more than the lifestyle only group (11). This suggests that 2 years of continued use of semaglutide can help maintain weight loss.

It’s important to note all current research on GLP-1 medications include lifestyle changes (such as calorie reduced diets and exercise) alongside medication. There are no studies evaluating GLP-1 medication use without lifestyle interventions. This emphasises just how important lifestyle changes are whilst taking these medications.

Who can use GLP-1 medications?

While GLP-1 medications have been shown to be effective for fat loss, they are not suitable for everyone, nor are they intended as a quick fix. Many people can successfully lose fat and maintain that loss through lifestyle changes alone.

According to NICE guidelines, semaglutide should only be used (13):

Alongside a calorie reduced diet and increased exercise
In adults with at least one weight-related health condition
And a BMI of:
At least 35kg/m², or
BMI of 32.5kg/m², or 30-30.49kg/m² if you meet criteria for referral to a specialist overweight and obesity management service.

The NHS have provided adjusted criteria specifically for Wegovy for certain ethnic groups. For people of Asian, Chinese, Middle Eastern, Black African or African-Caribbean origin, the BMI criteria are slightly lower (14):

32.5kg/m², or
27.5-32.4kg/m² if you meet criteria for referral to a specialist overweight and obesity management service

Where can you get GLP-1 medications from?

GLP-1 medications are prescription only, meaning they can only be obtained through a consultation with a licensed healthcare professional (1). They are available via both private clinics and the NHS.

The NHS may offer GLP-1 medications, particularly for managing type 2 diabetes, and increasingly for weight management. However, availability can vary by location and is currently part of a phased rollout to expand access for those who meet the criteria (12).

Due to high demand for GLP-1 medications, counterfeit versions are being sold by unregulated sources. These fake products may be unsafe and cause harmful side effects. Always ensure you are receiving medication from a genuine pharmacy, prescribed by a qualified healthcare professional (1).

What are the potential side effects of GLP-1 medications?

While GLP-1 medications are shown to be effective, they are not without side effects. Your healthcare professional should outline these prior to prescribing these medications.

Gastrointestinal side effects can be common and can include (1, 17):

Nausea
Diarrhoea
Stomach pain
Constipation

Other side effects can include (17):

Reduced appetite
Low blood sugar levels (hypoglycaemia)
Headaches
Skin reactions (if injected via skin)

Other less common side effects include the risk of acute pancreatitis and gall bladder disorders (1,15).

Some studies suggest that rapid weight loss with GLP-1 medications may lead to muscle loss, not just fat loss (19). This makes eating a healthy, balanced diet with sufficient protein and participating in resistance exercise important in helping to preserve muscle.

Can GLP-1 medications affect HRT?

Tirzepatide may impact the absorption of oral progesterone medication (15,16). This is likely due to the medication’s effect on slowing gastric emptying.

If you are taking HRT - particularly oral forms - it’s important to speak with your healthcare professional before starting and during use of GLP-1 medications. They may recommend alternative forms of HRT or adjust your dosage if needed.

Is it cheating to use GLP-1 medications to lose weight?

No, using GLP-1 medications to support weight loss is not cheating.

These medications are only prescribed to people who meet specific clinical criteria, as outlined earlier. In most cases, individuals using GLP-1 medications have already tried making lifestyle changes but have found it difficult to lose weight or keep it off.

There are many reasons why weight loss can be challenging. For example, we live in an obesogenic environment - high calorie foods are widely available and exercise is often limited. In some cases, dysregulation of hormones, such as incretin hormones, may make it harder for someone to manage their weight.

Ultimately, how you lose weight doesn’t determine its value. What matters most is that your approach is safe, evidence based and sustainable - whether that includes lifestyle changes alone or alongside medication.

Dietary and lifestyle considerations when taking GLP-1 medications

If you’re taking GLP-1 medications, it’s important to seek lifestyle support from a healthcare professional, such as a Registered Nutritionist or Registered Dietitian. They can offer personalised advice.

Since GLP-1 medication reduces appetite, you may find yourself eating smaller portions. This can limit your intake of essential nutrients, so it's crucial that each bite of food is as nutritious as possible.

Here are some simple, yet effective nutrition tips to support your health whilst on GLP-1 medications:

Eat small, regular meals throughout the day. This makes tolerating food feel more manageable with a reduced appetite.
Aim to fill ¼ of your plate with wholegrains and fibre-rich carbohydrates, while limiting refined carbohydrates
Serve ¼ of your plate with lean protein
Fill ½ your plate with vegetables and fruit, to increase fibre, vitamins and minerals
Limit highly processed foods like biscuits, cakes, crisps and takeaways. If you do include them, enjoy them in small portions less frequently.
Reduce saturated fat by limiting foods like butter, full-fat cheese, pastries and deep fried foods
Keep fruit juice and smoothies to 125ml or less per day, as they’re high in free sugars

These strategies not only help you feel your best but also support long term health and sustainable weight loss while taking GLP-1 medications

Conclusion

GLP-1 medications can be a valuable tool for supporting fat loss in individuals who meet specific criteria. They work by targeting appetite, satiety and blood sugar regulation. However, they’re not a quick fix - long term fat loss still depends on making healthy, sustainable lifestyle changes.

Whether you’re considering GLP-1 medications or already taking them, working alongside a healthcare professional - such as a doctor and registered nutritionist or dietitian - can help you to stay healthy and safe whilst losing fat.

There is no one size fits all approach to fat loss at menopause, and choosing medical support is not cheating. It’s about finding what works for you and taking safe steps towards your goal.

If you’d like personalised support with your diet and lifestyle habits whilst taking GLP-1 medication for fat loss during perimenopause and/or menopause, Lutrition is here to help. You can book your free 15 minute discovery appointment with Founder and Registered Nutritionist Lucy Jones here: https://calendly.com/lucyjonesnutrition/free-nutrition-discovery-session

This blog was written by Registered Nutritionist Lucy Jones, Founder of Lutrition.

Lutrition is founded by Registered Nutritionist Lucy Jones, who provides 1-1 support for those going through perimenopause and menopause who want to lose their stubborn unwanted fat for good, so they can fit comfortably and confidently into their clothes. Consultations are available virtually and in person across Brackley, Towcester, Northampton, Milton Keynes, Bicester and Banbury.

For safe prescribing of GLP1 medications and expert guidance, take a look at The Female Health Doctor clinic, founded by Dr Nikki Ramskill.