Weight gain during midlife is common and includes shifts in hormones, metabolism, and fat distribution, in fact, many individuals experience increased abdominal fat and changes in insulin sensitivity that can impact overall health and cardio-metabolic risk. Carrying excess belly fat isn’t just about appearance — it’s linked to higher risks of high blood pressure, diabetes, and other cardio-metabolic conditions.

In some instances these medications can improve overall health and quality of life by helping people reduce weight and associated risk factors.  We do need to look at what we eat, how and when we eat, why we eat and where can we make realistic and sustainable changes, and when to ask for help.  It I sales important to think about all aspects that affect our health including sleep, movement, community /purpose and relationships.  At Coastal well Woman we believe in a whole-person approach so we can support your success.

And for women when coupled with hormone replacement therapy,  recent research by Mayo Clinic demonstrates that postmenopausal women with overweight or obesity, and concurrent use of hormone therapy was associated with greater weight loss and improved cardiometabolic outcomes during semaglutide and tirzepatide treatment.

So what’s available to support your optimal weight journey:

Currently there are six weight-loss drugs have been approved by the U.S. Food and Drug Administration (FDA) for long-term use:

• bupropion-naltrexone (Contrave)
• liraglutide (Saxenda)
• orlistat (Xenical, Alli)
• phentermine-topiramate (Qsymia)
• semaglutide (Wegovy)
• tirzepatide (ZepBound)
• setmelanotide (Imcivree)

Most Commonly used today include: 

FDA-approved medical treatments for weight management include weekly injections like Wegovy (semaglutide) and Zepbound (tirzepatide), which suppress appetite and increase fullness. Wegovy (semaglutide) also has an FDA-approved oral option that is taken by mouth daily.  

Other options are daily or weekly injections like Saxenda (liraglutide), oral medications such as Contrave (bupropion/naltrexone) and Qsymia (phentermine/topiramate), and fat-blocking pills like Xenical (orlistat).  Additionally, Setmelanotide is approved for weight management in individuals with rare genetic disorders like PCSK1 deficiency. 

Injectable medications

• Wegovy: (semaglutide) Weekly injection or oral tablet that is approved for use in obesity and older and to reduce heart-related events.
• Zepbound: (tirzepatide) Weekly injection that was approved in 2023 for chronic weight management and also for obstructive sleep apnea in 2024.
• Saxenda: (liraglutide) Daily injection that acts on the brain to reduce appetite and increase feelings of fullness. 

Oral medications

• Contrave: (bupropion/naltrexone) Contains an antidepressant and an anti-addiction medication to suppress hunger and cravings.
• Qsymia: (phentermine/topiramate) A combination medication approved for chronic weight management.
• Xenical: (orlistat) Blocks the absorption of dietary fat. A lower-dose version, Alli, is available over-the-counter. 
• Wegovy: (semaglutide) Weekly injection or oral tablet that is approved for use in obesity and older and to reduce heart-related events.

Other options

• Setmelanotide: Approved for weight management in patients six years and older with specific genetic disorders that cause obesity, such as PCSK1 deficiency. 

All of these medications require a prescription and are intended to be used in combination with a reduced-calorie diet and increased physical activity.  It is essential to consult a healthcare professional to determine the most appropriate and safest treatment option for your individual

At Coastal Well Woman we partner with the manufacturers to provide patients the safety and effectiveness of FDA-approved branded products.  In some case we look to accredited and reputable compounding pharmacies to provide the best formulation to support weight loss and weight maintenance when needed or appropriate.  If you’re ready to get the support you need, we are ready to partner with you to find the safest, most affection option while supporting you through nutrition, exercise and lifestyle modification per your best health.

References:

1. https://www.fda.gov/consumers/free-publications-women/menopause-medicines-help-you
2. https://obesitymedicine.org/blog/weight-loss-medications/
3. https://www.niddk.nih.gov/health-information/weight-management/prescription-medications-treat-overweight-obesity
4. https://www.fda.gov/medical-devices/products-and-medical-procedures/weight-loss-and-weight-management-devices
5. Hurtado MD, Tama E, Fansa S, Ghusn W, Anazco D, Acosta A, Faubion SS, Shufelt CL. Weight loss response to semaglutide in postmenopausal women with and without hormone therapy use. Menopause. 2024 Apr 1;31(4):266-274. 
6. Castaneda, Regina et al. The role of menopause hormone therapy in modulating tirzepatide-associated weight loss in postmenopausal women with overweight or obesity: a retrospective cohort study. The Lancet Obstetrics, Gynaecology, & Women’s Health, Volume 0, Issue 0