Management of obesity in the menopause transition and postmenopausal period

Background: The menopause transition and postmenopausal period represent inevitable life stages characterized by physiologic changes that can pose significant health risks, primarily through the effects of estrogen decline on multiple organ systems. The prevalence of obesity during and after menopause is significant. Symptoms derived from menopause, such as poor sleep, sexual dysfunction, and mood changes are often exacerbated in the setting of obesity. Therefore, treating and managing obesity during menopause is essential. Objectives: The purpose of this review article is to explain the impact obesity bears on midlife and postmenopausal patients, discuss the treatment options available for weight management in this stage of life, including behavioral, medical, and surgical interventions, and review special considerations for hormone therapy in women with increased adiposity experiencing climacteric symptoms. Methods: A literature review was conducted from February to April 2025. Conclusions: Many women who seek treatment for obesity and bariatric surgery are perimenopausal or postmenopausal. Raising awareness of the unique considerations in this population can help optimize patient care.