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Beyond hormonal changes, several interconnected factors may contribute to perimenopausal weight gain: Metabolic slowdown : Basal metabolic rate naturally decreases with age, meaning the body burns fewer calories at rest Muscle mass loss : Sarcopenia (age-related muscle loss) accelerates during perimenopause, further reducing metabolic rate Sleep disruption : Night sweats and insomnia, common perimenopausal symptoms, interfere with hormones regulating appetite and glucose metabolism Mood changes : Anxiety, depression, and stress during this transition may lead to emotional eating patterns Reduced physical activity : Fatigue, joint pain, and other symptoms may decrease exercise tolerance Research suggests women may gain weight gradually during perimenopause, though individual experiences vary considerably

Instead, medical experts recommend working with your provider to slow weight loss by reducing dose, increasing nutritional support (especially protein, iron, and vitamins), adding treatments like minoxidil, and giving your body time to adjust

Meier, J

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NICE has appraised its use within specialist weight management services, subject to BMI and eligibility criteria [12] Liraglutide (Saxenda) another licensed GLP-1 receptor agonist available for weight management in adults, subject to MHRA-approved indications and prescribing criteria Orlistat (Xenical/Alli) a lipase inhibitor available on NHS prescription and, at lower dose, over the counter Tirzepatide (Zepbound) a dual GIP/GLP-1 receptor agonist authorised by the MHRA specifically for chronic weight management in adults

26,27 Suggestive evidence of hemoglobin A1c-lowering being the cause of the reported worsening with GLP-1/GIP agonists can be derived by comparing the results of two recent retrospective cohort studies assessing retinopathy outcomes between subjects treated with GLP-1/GIP agonists and sodium-glucose cotransporter-2 (SGLT2) inhibitors