Understanding GLP-1 Medications: A Look at Weight Loss Solutions for Women Over 40

You’ve probably seen the headlines — or overheard the whispers at the local caffé or during a lunch break at work:

“She’s on Ozempic and dropped 20 pounds.”

GLP-1 medications like Ozempic, Wegovy, and Mounjaro are being hailed as “miracle weight loss drugs.” But are they truly the magic solution for women navigating perimenopause, menopause, and beyond? Can they finally melt away that stubborn hormonal weight gain?

In this blog, we’ll take a closer look at the science behind these medications — how they work, what the research says, and their risks and benefits. More importantly, we’ll briefly explore why gut health, hormone balance, and sustainable lifestyle shifts remain the foundation for lasting weight loss and overall wellbeing for women over 40.

This blog is written to offer clarity — only science-based, objective information to help you make informed decisions that align with your body, your needs, and your long-term health.

Firstly, What Are GLP-1 Medications and How Do They Work?

GLP-1, or glucagon-like peptide-1, is a natural hormone produced by enteroendocrine cells in your gut after you eat. It helps regulate blood sugar by triggering insulin (which moves sugar from your blood into your cells for energy) and by lowering glucagon (a hormone that raises blood sugar).[1] It also slows down how fast your stomach empties and signals your brain that you're full — helping reduce appetite and control how much you eat.

However, in people with type 2 diabetes, this system doesn’t work properly. They either don’t make enough insulin or their cells don’t respond to it well. GLP-1 receptor agonists — a class of medications originally designed to treat type 2 diabetes — help restore this balance by mimicking the effects of the natural hormone.

These medications:

• Reduce appetite

• Slow digestion

• Improve insulin sensitivity/ Boosts insulin secretion (when needed)

• Slows stomach emptying

• Helps regulate blood sugar and promote satiety.[2]

Over time, these actions not only help manage blood sugar but also support weight loss. That’s why GLP-1 drugs are now also approved to treat obesity — even in people without diabetes — usually at higher doses than those used for diabetes treatment.

Today, there are ten FDA-approved GLP-1 medications used for either type 2 diabetes or weight loss. Some have the same generic ingredient but are marketed under different brand names and dosages depending on the purpose.[3]

Popular GLP-1 Drugs Used for Weight Loss:

• Ozempic (semaglutide): Originally for diabetes, now widely used off-label for weight loss.[4]

• Wegovy (higher dose semaglutide): FDA-approved for chronic weight management. Semaglutide 2.4 mg weekly (Wegovy) has led to significant weight loss in clinical trials — often more than 5% of total body weight.[2]

• Mounjaro (tirzepatide): Dual-acting GLP-1 and GIP receptor agonist, showing strong results in trials. Similarly to other injections, it was prescribed to treat Type 2 Diabetes, but in December 2024 was approved to treat obesity on the NHS.[5]

Potential Side Effects and Risks

Although GLP-1 drugs for diabetes and weight loss have proven to be effective, they do have side effects and the most common are: [3]

• Nausea and vomiting

• Constipation

• Diarrhoea

• Fatigue

• Indigestion

• Risk of low or high blood sugar

Because GLP-1 receptor agonists mimic a natural gut hormone, the most common side effects are gastrointestinal — including nausea, vomiting, diarrhoea, and a feeling of early fullness. These effects are dose-dependent, so gradual dose increases are recommended.

Besides common gastrointestinal issues, Semaglutide has also been linked to temporary worsening of diabetic retinopathy with rapid blood sugar improvements, hypoglycemia, gallbladder problems, thyroid and pancreatic safety, heart health, kidney injury, diabetic retinopathy, and allergic reactions. Most side effects are mild and temporary, particularly GI discomfort and an increased risk of gallstones. Serious concerns like pancreatic or thyroid cancer remain unconfirmed due to their rarity.[6]

While the risk of hypoglycemia is generally low, it increases when combined with insulin or sulfonylureas.[2]

Upper respiratory infections were reported in several trials, particularly with oral semaglutide, though the mechanism remains unclear.

The “Ozempic face”

You might have heard of the term “Ozempic face”, but it’s not unique to Ozempic or even GLP-1 drugs alone. It’s a result of rapid weight loss, which can lead to noticeable fat loss in the face.

This can cause features like:

• A more sunken or hollow look

• Thinner lips or cheeks

• More visible wrinkles or loose skin around the jaw and neck

  
  

These changes tend to be less noticeable with slower, gradual weight loss, but can be more pronounced when weight drops quickly — as often seen with GLP-1 medications.[3]

There’s also an emotional cost: reliance on a medication can create anxiety around eating and body image, especially if weight is regained after stopping.

Why GLP-1s May Not Be the Answer for Most Women Over 40

These drugs don't address the root causes of weight gain in midlife women:

• Hormonal shifts (like declining estrogen)

• Increased stress and cortisol

• Changes in sleep, energy, and metabolism

• Gut microbiome imbalances (which in fact, we know these injections can worsen)

  
  

Most people regain weight after stopping injections unless they've made sustainable changes alongside the medication. For instance, a study from 2022 showed that one year after stopping once-weekly subcutaneous semaglutide 2.4 mg and discontinuing lifestyle intervention, participants regained approximately two-thirds of the weight they had previously lost, along with parallel reversals in cardiometabolic improvements. These results highlight the chronic nature of obesity and indicate that continuous treatment may be necessary to sustain benefits in both weight and overall health.[7]

Let’s look at the Bigger Picture: Gut Health, Hormones & Weight

While the promise of GLP-1 injections like semaglutide for weight loss is compelling, it’s important to step back and consider the bigger picture—especially when it comes to gut health and hormone balance for women in perimenopause.

GLP-1 receptor agonists can slow our digestion and disrupt the natural rhythm of the gastrointestinal system. Over time, this may lead to uncomfortable side effects like nausea, constipation, or bloating—symptoms that are already common in women, particularly during perimenopause when hormonal shifts impact gut motility and sensitivity.

Moreover, these drugs may also alter the gut microbiome—the diverse ecosystem of bacteria that plays a crucial role not just in digestion, but in immunity, inflammation, and even mental health. A disrupted microbiome has been linked to a range of chronic conditions, including metabolic disorders,[8] which ironically are the very issues GLP-1 drugs are intended to treat.

And then there's estrogen. This key hormone doesn’t just regulate reproductive health—it can also affect insulin sensitivity, fat distribution, and energy metabolism.[9] As estrogen levels fluctuate in midlife, many women experience changes in how their bodies store fat or respond to blood sugar. Addressing these hormonal imbalances—through lifestyle changes, nutrition, or targeted therapies—it’s crucial for long-term metabolic health and sustainable weight loss.

Who Might Benefit from GLP-1s?

While GLP-1 medications offer a powerful tool, they’re not a magic fix. For some individuals—such as those with obesity-related conditions like type 2 diabetes or clinical obesity —they can be life-changing. But for others, especially those struggling with mild weight gain or hormone-driven changes, they may simply mask underlying issues without solving them.

What to Do Instead: A Science-Based, Sustainable Approach

Rather than relying on injections, here are evidence-based strategies to support weight loss naturally:

• Eat whole foods that naturally stimulate GLP-1: fiber-rich vegetables, fermented foods, healthy fats

• Build muscle with resistance training: to boost metabolism and balance insulin

• Balance blood sugar: with protein-rich meals and fewer refined carbs

• Support your gut: through probiotics, prebiotics, and avoiding inflammatory foods

• Manage stress: cortisol impacts belly fat, sleep, and hunger signals

But for most women in perimenopause or postmenopause, the path to sustainable weight loss involves:

• Restoring gut health

• Supporting hormones through nutrition and movement

• Managing stress and sleep

Semaglutide has undeniably opened new doors in managing type 2 diabetes and offers hope for those with obesity-related health risks. In these contexts, indeed,it can be a powerful tool — when used appropriately and under medical guidance. But as it gains so much attention among those simply looking for quick weight-loss fixes, it’s worth asking: are we becoming too reliant on quick and easy solutions?? Are we just looking for “miracle solution” because we simply don't want to put the effort into our diet and lifestyle changes? Don’t get me wrong, semaglutide can help with weight loss, but it's not without side effects, and it's certainly not a substitute for the foundational work of sustainable diet and lifestyle change.

Rome wasn’t built in a day — and neither was your belly fat! So before turning to injections, maybe it’s time to lace up your shoes, rework your plate, and commit to sustainable changes. Lasting health requires a more holistic approach—one that nourishes your gut, balances your hormones, and supports your body in sustainable ways. GLP-1 injections may offer a shortcut, but they’re not a substitute for diet and lifestyle. After all, the real miracle isn't in the drug — it's in the daily choices you make.

References:

1. Drucker, D. J. (2018). Mechanisms of Action and Therapeutic Application of Glucagon-like Peptide-1. Cell Metabolism, 27(4), 740–756. https://doi.org/10.1016/J.CMET.2018.03.001/ASSET/97AAA787-56EA-42F8-9704-304384262DF5/MAIN.ASSETS/GR4.JPG

2. Latif, W., Lambrinos, K. J., Patel, P., & Rodriguez, R. (2024). Compare and Contrast the Glucagon-Like Peptide-1 Receptor Agonists (GLP1RAs). StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK572151/

3. GLP-1 diabetes and weight-loss drug side effects: “Ozempic face” and more - Harvard Health. (n.d.). Retrieved May 28, 2025, from https://www.health.harvard.edu/staying-healthy/glp-1-diabetes-and-weight-loss-drug-side-effects-ozempic-face-and-more

4. Smits, M. M., & van Raalte, D. H. (2021). Safety of Semaglutide. Frontiers in Endocrinology, 12, 645563. https://doi.org/10.3389/FENDO.2021.645563/XML/NLM

5. Mounjaro - Uses, How it Works and Side Effects | Diabetes UK. (n.d.). Retrieved May 29, 2025, from https://www.diabetes.org.uk/about-diabetes/looking-after-diabetes/treatments/tablets-and-medication/glp-1/mounjaro

6. Humphrey, C. D., & Lawrence, A. C. (2023). Implications of Ozempic and Other Semaglutide Medications for Facial Plastic Surgeons. Facial Plastic Surgery, 39(6), 719–721. https://doi.org/10.1055/A-2148-6321,

7. Wilding, J. P. H., Batterham, R. L., Davies, M., van Gaal, L. F., Kandler, K., Konakli, K., Lingvay, I., McGowan, B. M., Oral, T. K., Rosenstock, J., Wadden, T. A., Wharton, S., Yokote, K., & Kushner, R. F. (2022). Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes, Obesity and Metabolism, 24(8), 1553–1564. https://doi.org/10.1111/DOM.14725

8. Vijay, A., & Valdes, A. M. (2021). RETRACTED ARTICLE: Role of the gut microbiome in chronic diseases: a narrative review. European Journal of Clinical Nutrition, 76(4), 489. https://doi.org/10.1038/S41430-021-00991-6

9. de Paoli, M., Zakharia, A., & Werstuck, G. H. (2021). The Role of Estrogen in Insulin Resistance: A Review of Clinical and Preclinical Data. The American Journal of Pathology, 191(9), 1490–1498. https://doi.org/10.1016/J.AJPATH.2021.05.011