Can a GLP-1 Shrink Your Menopause Belly? What New Science Tells Us
GLP-1 receptor agonists, like semaglutide and tirzepatide, are making headlines not just for dramatic weight loss, but also by proving to help target this hormone-driven transformation.
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But can these drugs really help shrink the hormonal belly bulge? What does the latest science say about GLP-1 safety and effectiveness for midlife women? Here's what you need to know.
Menopause belly refers to the increase in abdominal fat that many women experience during and after menopause.
'This shift is driven primarily by hormonal changes, specifically the decrease in estrogen,' Catherine Metzgar, PhD, RD, director of coaching operations at Virta Health, told Flow Space. 'Estrogen plays a key role in regulating body fat distribution, and when levels decline, fat tends to accumulate more viscerally which is around abdominal organs.'
This is a shift from pre-menopause, when fat tends to accumulate more in the hips and thighs.
Other factors that contribute include:
Insulin resistance or insulin sensitivity—associated with increased fat accumulation.
Muscle loss—decreases with age, less muscles results in a slow metabolism.
Stress and sleep issues—increase cortisol levels, which are linked to abdominal fat storage.
These metabolic shifts do have long-term impacts on our health, added Metzgar. Visceral fat is linked to an increased risk for metabolic syndrome, type 2 diabetes and heart disease.
Originally developed for type 2 diabetes, GLP-1 drugs mimic a gut hormone that regulates blood sugar, curbs appetite and slows digestion. This can result in a reduced appetite, improved insulin sensitivity and weight loss, specifically in visceral fat. These effects are especially relevant during menopause, when insulin resistance tends to rise and metabolism slows.
'These GLP-1 medications can help by slowing the time it takes for your stomach to empty and by making you feel fuller longer,' Dr. Brunilda Nazario, chief medical officer at WebMD told Flow Space. 'These drugs can help restore your metabolism, making it easier to lose weight and improve body shape.'
And now a new study has found that GLP-1 agonist, tirzepatide, can help with overall weight loss, as well as reduce deep abdominal fat and improve key cardiometabolic markers.
Physicians from New York-Presbyterian and Weill Cornell Medicine found that a primary concern for women in menopause is weight gain. In order to better understand GLP-1s efficacy for women in midlife, they conducted a secondary analysis of data from the SURMOUNT clinical trial to determine the efficacy of tirzepatide in women in the premenopausal, perimenopausal and postmenopausal stages of life.
What they found was that regardless of reproductive stage, tirzepatide was associated with significant body weight, waist circumference and waist-to-height ratio reductions in women living with obesity or who are overweight.
Tirzepatide, like other GLP-1s, delay gastric emptying and increase feelings of fullness, which help to reduce appetite and, therefore, food intake. These medications also improve insulin response and glucose control, which also supports weight loss.
'These results are not surprising and are consistent with other research evaluating GLP-1 medications and observed weight loss,' says Metzgar. 'Therefore, the findings can likely be applied to other GLP-1 agonists beyond tirzepatide. Even the authors of the study make a similar conclusion.'
The researchers found that tirzepatide worked by targeting the visceral fat in menopausal women in the same way it targets fat for other individuals who used GLP-1 drugs. They also noted that lifestyle changes, like proper diet and exercise, were also an important piece of the equation to ensure optimal results.
'Based on our research, we believe clinicians prescribing tirzepatide can feel more confident recommending the medication to their patients, especially women reporting menopause-related weight gain,' the researchers concluded. 'The data provides reassurance that this medication is effective in the setting of perimenopause and menopause.'
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"I had worked so hard for a long time to become an intuitive eater and my whole self has changed because I'm in recovery and I eat intuitively," she said. "It's just a totally different relationship with food and body. So I had to start going back to the very beginning of what I did in my recovery, and that was set timers to remember to eat." They would be devastated if they knew why I'm really taking it Rose, who asked a relative to get her Ozempic, saying it was for diabetes As for Rose, she has lost about 45 pounds since starting Ozempic. After her insurance stopped covering it, she began paying $1,000 a month out of pocket for a similar drug, Rybelsus, that a family member — believing she wanted it for her diabetes — helped her procure. "They would be devastated if they knew why I'm really taking it," she said. She has had regular appointments with her endocrinologist, but never discussed her GLP-1 use. In mid May, she ran out of Rybelsus and didn't refill it; it was too expensive. Around this same time she landed in the hospital with low potassium, which doctors blamed on her overuse of diuretics. If she had her way, she'd go back on Ozempic to lose another 45 pounds. She's thinking about buying some online, which won't require a doctor's prescription. This, of course, is dangerous in its own right, as unregulated or unlicensed vendors have been selling fake Ozempic online or in medical spas. In June 2024, the World Health Organization warned about falsified batches of Ozempic; the National Association of Boards of Pharmacy identified thousands of websites illegally selling fraudulent weight-loss drugs. Worldwide, 42 people were hospitalized after taking fake injections, according to the FDA's Adverse Event Reporting System. Some people died. Rose knows she's playing with fire. Still, she isn't ready to give up the drug. "I feel like I'm doing better than I have in a while, but the thoughts of wanting to lose weight or take Ozempic don't ever go away."
