Understanding the interplay between aging, hormonal changes, and lifestyle factors is crucial for effective obesity management in midlife and menopausal women. This review is timely given rising rates of obesity and associated comorbidities, the rapid evolution of pharmacologic interventions for obesity, and the growing recognition of the impact of midlife weight gain on women’s long-term health.

Glucagon-like peptide-1 receptor agonists (GLP-1 RA) have emerged as a leading pharmacologic for managing weight gain across most populations, including peri and postmenopausal women who frequently suffer from weight gain. There is a paucity of data about this specific population and how they respond to these medications. This review aims to discuss the data available about the use and effects of GLP-1 RAs in the peri and postmenopausal populations.

Women exhibit unique vulnerabilities in health, especially regarding mental health and neurodegenerative diseases. Biological, hormonal, and metabolic differences contribute to sex-specific risks that remain underrepresented in clinical studies. Diseases such as major depressive disorder (MDD) and Alzheimer’s disease (AD) are more prevalent in women and may be influenced by hormonal transitions, particularly during menopause. Chronic low-grade inflammation is emerging as a shared mechanism underlying both conditions, and this inflammatory state can be worsened by dietary habits. During menopause, mood and sleep disturbances can influence dietary behavior, leading to enhanced snacking and consumption of high-glycemic and comfort foods. Such foods, low in nutritional value, promote weight gain and elevated inflammatory markers. Their consumption combined (or not) with a preexisting Western diet pattern—already linked to inflammation—could reinforce systemic inflammation involving the gut–brain axis. Moreover, the symptoms “per se” could act on inflammation as well. Peripheral inflammation may cross the blood–brain barrier, sustaining mood disorders and promoting neurodegenerative changes. Finally, MDD and AD are both associated with conditions such as obesity and diabetes, which occur more frequently in women. The review highlights how menopause-related changes in mood, sleep, and diet may heighten susceptibility to mental and neurodegenerative diseases.

In postmenopausal women, optimizing muscular strength and physical performance through proper resistance training (RT) is crucial in achieving optimal functional reserve later in life. This study aimed to compare if a higher-load-to-lower-load (HL-to-LL) scheme is more effective than a lower-load-to-higher-load (LL-to-HL) scheme on muscular strength and physical performance in postmenopausal women after 12 and 24 wk of RT.

Weight gain is an independent risk factor for decline in cardiometabolic and overall health-related quality of life in midlife women. The AIIMS-DST initiative aims to develop and validate stepwise recommendations specific for weight management in midlife women. The key clinical questions specific to weight management in midlife women were finalized with the help of a multidisciplinary team of experts in the guideline development group. Phase I including a systematic and/or narrative review, grading of evidence, and expert opinion was sought to develop clinical practice recommendations for each clinical question. Phase II focused on validation of clinical practice recommendations using the peer-review, Delphi method, and GRADE approach. The guidelines provide clinical practice points to address challenges encountered by midlife women in their attempts to manage obesity via lifestyle modification techniques. The initiation of discussion would help the health-care provider to identify the weight management needs of the women, educate women on different modalities of weight management, and empower them to incorporate corrective lifestyle behaviors. Before initiating the management, a comprehensive assessment of clinical and lifestyle-related parameters should be completed. A personalized behavioral lifestyle modification program addressing the midlife-specific barriers for optimal metabolic, musculoskeletal, and mental health should be planned. A consistent follow-up is required for maintenance of corrective eating and activity habits by addressing midlife-specific barriers for sustenance of healthy weight. These recommendations will be useful in opportunistic screening and management of obesity in midlife women across health-care settings.Copyright: © 2022 Journal of Mid-life Health.

Menopause and obesity are interrelated conditions that collectively increase the risk of cardiometabolic diseases, impair quality of life, and pose challenges to gynecologic care. In menopausal women, hormonal decline facilitates fat accumulation, while obesity exacerbates menopausal symptoms and surgical complications. This review synthesizes current evidence on the pathophysiological interplay between menopause and obesity, evaluates behavioral, pharmacological, and surgical strategies for weight management, and discusses the implications for gynecologic minimally invasive surgery (MIS). A comprehensive literature review was conducted, focusing on clinical guidelines, randomized trials, and meta-analyses concerning obesity management in midlife women. Lifestyle interventions form the cornerstone of obesity treatment, but pharmacologic agents–particularly glucagon-like peptide-1 receptor agonists and dual incretin therapies–have demonstrated superior efficacy in achieving weight loss and cardiometabolic improvements. Bariatric surgery remains the most effective long.term option for severe obesity. Minimally invasive gynecologic procedures, although technically more challenging in obese patients, remain preferable when preoperative weight optimization and multidisciplinary care are applied. A multidimensional, personalized approach to obesity management in menopausal women is critical for improving metabolic outcomes and optimizing surgical safety. Importantly, preoperative optimization of obese menopausal women enhances the feasibility and outcomes of gynecologic MIS, thereby directly addressing a core concern of gynecologic practice. The emergence of novel injectable pharmacotherapies shows great promise and warrants further investigation in this population.