Is Ozempic the answer for menopausal weight gain?

Ozempic and menopause weight loss

Share This Post

Last week I was asked to provide comment on a new drink trend sweeping Tiktok called Oat-zempic; a somewhat bizarre concoction of oats, water, lime and cinnamon. You can read my thoughts here in the i newspaper article online.

The fact that this pun-gent drink (see what I did there) has been invented to mimic the effects of the weight loss drug Ozempic, is testament to the tsunami of interest this drug has created. You’ll find plenty of articles discussing Ozempic and weight loss and even some that talk specifically about Ozempic and menopausal weight gain. So, is Ozempic the answer for menopausal weight gain? Let’s explore.

oats for menopause weight loss

Is Ozempic good for menopause weight loss?

I make no secret of the fact I work under a non-diet framework and believe in fiercely advocating for our health irrespective of the numbers on the scale, so where do licensed medications that seem to achieve the sought after weight loss many are after, fit into the bigger picture?

Before we get clear on that, let’s understand what Ozempic is and how it works.   

What is Ozempic?

Ozempic and its counterpart Wygovy are new kids on the block for weight reduction and are both trade names for a class of drugs called semaglutides. Semaglutides work to mimic gut hormones that are responsible for appetite regulation, namely GLP-1 and GIP.

In reality, there’s more than just these 2 gut hormones involved in appetite regulation – about 18 in fact, but its these ones that have been replicated in the form of these drugs.

What do GLP-1 and GIP do?

As food passes through our stomach and into our small intestine, these hormones start to kick in and rise, sending signals to our brain that we are full, so we know to stop eating.

In the body, when left to do their thing, these hormones pass in and out of our system quickly. Scientists got very excited as soon as they figured out how to make them into a form that lasted longer, because that made them viable options to support weight reduction by reducing appetite.

They have been formulated into injections that are taken weekly.

What is the difference between Ozempic and Wygovy?

These are two common versions, licenced originally for different things.

As well as the appetite effects, these drugs also improve the body’s use of insulin, which makes them an effective treatment for diabetes. Ozempic is approved for use in treating type 2 diabetes by lowering blood glucose (sugar) and regulating insulin.

Wygovy has a slightly different formulation and is licensed for weight loss.

Do they actually work?

Trials into these drugs are funded by the company that makes them – Novo Nordisk and we now have 2-year data, referred to as the Step 5 trial.

Of note, the demographic was white women, so we can only draw conclusions from these trials for this ethnic group and can’t be sure if these would be the same for other ethnicities.

Results were remarkably consistent – 50% of people lost 10-15% of their body weight.

One third lost more than 20% of their body weight which is roughly on par with bariatric surgery.

All in all, this is about 3 times as much weight loss as compared to previous drug interventions, hence the excitement.

Massive caveat though – these are trial participants – highly motivated individuals receiving lots of additional support and feeling special because they’re part of a trial.

In the real world we’re not as special and life with all its demands carries on…

Trials also show improvements in blood pressure, Hba1c (measure of long-term blood glucose control), cholesterol and reduced incidences of heart attack and stroke.

Participants also report reduced cravings for both sweet and savoury foods and improved mood. Clients have told me how it reduces desire for food so much, you could literally not bother with it – which of course is not the aim. We still need nourishment!

What are the side effects?

Not surprisingly, gastrointestinal symptoms are common – nausea, diarrhoea, vomiting, constipation. We’re messing with our gut hormones, so some ‘feedback’ from the gut is to be expected.

Loose skin may also occur if weight loss is more rapid.

Other side effects are extremely rare, but we need more data to understand the gravity and significance of these. When suicidal thoughts come under the ‘rare’ section, its not to be dismissed though. In trials these drugs have not been given to those with existing depression.

Fundamentally the drop-out rates from trials are low though, which shows people are complying with these drugs and tolerating them relatively well on the whole. The side-effects are worth the outcome basically!

Does weight stay off long-term?

These work like other drugs prescribed to create a physiological effect – in that when we’re on the drug, it does its thing, and when we’re not, it doesn’t.

For example, we can’t expect blood pressure to stay low if we stop taking our blood pressure medication. The mechanism of these appetite suppressants is innovative and concrete, but when we don’t take them, we won’t have the same outcome, which means we are also likely to regain the weight.

So, we’re risking heading into that familiar brutal revolving door of repetitive failed weight loss methods if we’re not able to stay on the drug.

menopause weight loss

Does Ozempic help your hormones?

Frustratingly, we live in a world that teaches us being in a larger body is a personal choice, entirely within our control, automatically a danger to our health and a personal failing if we cannot change it.

None of these things are true, particularly when it comes to menopause and many other factors play a part in weight gain which you can read more about here.

Reproductive hormonal changes are part of the process of ageing – whilst they may be unwanted, they cannot be reversed.

The real story

Most of my clients are sadly never given the opportunity to develop healthy relationships with food and body without pressure or shame mounting early on in their lives to change themselves. Our genetically predisposed weights are not given a chance to find airtime as complicated connections to food, access to a healthy balance and the belief that we CAN trust our bodies to tell us what they need, totally eludes us.

Imagine if our bodies were given the same privilege of freedom as our shoe size is.

What compounds the problem is the diet and wellness industry ready and waiting to take us under their wing – spinning the line they’re there to help, when all the time, making the situation worse.

There is no doubt from the research that dieting itself is the strongest predictor of weight gain over time.  

  • If we did live in a magical land that was accepting of all bodies and allowed them to naturally find their set point.
  • If we could ensure that all people had access to nutritious food.
  • And if we armed people with a toolkit to cope with stress and life challenges that didn’t involve food, only then could we truly assess the weight vs health debate.

Because without those conditions the picture is messy.

For some, at some point, weight may well be impacting their health and disease risk and perhaps these drugs provide that lifeline. For others, weight does not alter their health status or disease risk, if certain lifestyle behaviours are present – things like exercise, fruit and veg, minimal alcohol and not smoking.

But let’s witness that diet culture vulture circling back – for it is in their best interests for us not to like ourselves, not to be accepting of body change as we go through menopause and age. We should want to make ourselves thinner at all costs.

fruit and veg for weight loss

Can medication help menopausal weight gain?

And it’s for these reasons, we see the drug being used inappropriately – not for health, but for virtue, leading to supply issues and a changing and ever more complex narrative around the use of these drugs.

I’m not brave enough to delve into those issues in detail here, but safe to say weight stigma is real and everywhere – including in academic research.

Looking at the drivers of our eating behaviours, understanding and communicating with our bodies effectively and setting our environments up to help us win are the 3 aspects of health as I see them.

This 3-pronged approach would still be essential alongside any medications being used to support weight loss.

We must take note though that:

  • Weight regain is not a personal failing.
  • Weight regain is not a conscious decision.
  • Weight regain is a complex physiological process that we are yet to ‘fix’ or understand.
  • No medication is ‘an easy way out’ – it may form part of a bigger clinical picture and individual assessment is essential. Not enjoying food anymore.

 

What is the best thing for menopause weight loss?

You can explore my thoughts on weight loss in menopause in articles such as How to Get Rid of Menopause Belly Fat, Does Menopause Cause Insulin Resistance and Is Intermittent Fasting Helpful for the Menopause?.

The fact remains that menopausal women are at the business end of wading through the weight vs health vs societal acceptability vs self-love agenda. We will inevitably get fatter, the extent to which this happens depends on the individual, their lived experience and their genetics. How we handle this also depends on the same.  

More To Explore

Fancy getting some clarity around what to eat and easing the stress in your head?

Download my menopausal meal planner and access Nourish Lounge seminars for education and inspiration in all things midlife health.