Dr. Herman Weiss
Sep 27, 2026
The question comes up in my world constantly: do the new weight-loss medications still work once your hormones change? Menopause makes weight genuinely harder - estrogen loss pushes fat toward the middle, muscle gets easier to lose than to keep, and many women feel like their body changed the rules without telling them. So when a drug company ran the numbers on whether menopause blunts the effect of its new daily weight-loss pill, the answer mattered. The answer arrived this week: no, it doesn't.
The research. Hoffman and colleagues at Eli Lilly took the data from ATTAIN-1 and ATTAIN-2 - the two big trials of orforglipron, a once-daily pill in the GLP-1 family (the same drug family as semaglutide, but a small-molecule tablet rather than a weekly injection) - and re-analyzed them by menopausal stage. Women in the trials had obesity, or overweight with at least one weight-related condition; the analysis sorted them into premenopausal, perimenopausal, and postmenopausal groups, with 142 to 225 women in each, and followed them for 72 weeks. The results are being presented this week at the European Association for the Study of Diabetes annual meeting in Milan.
What they found. The drug worked the same everywhere. Women lost up to 14% of their body weight on orforglipron, with no meaningful difference between the three menopausal stages, in both trials. Waist circumference fell by up to 12.5 cm (about 5 inches) across groups. Up to 83% of women on the drug lost at least 5% of their body weight, versus 30% on placebo. The menopause transition - the thing that makes weight feel like an uphill fight - did not blunt the medication's effect at all.
What you gain from this. If you're in or past the menopause transition and you've wondered whether these medications are "for" women like you, this is the first clean answer: the biology of midlife doesn't cancel the drug. Now the fine print, because there always is some. This is an analysis run by the manufacturer, presented at a conference - it hasn't been through full peer review as its own paper yet. Orforglipron itself is still an investigational drug; you cannot get a prescription for it today. And the trials measured weight and waistlines, not the things you actually live in: we don't know from this analysis how much of the lost weight was muscle, and muscle is the tissue you can least afford to lose after fifty. If you ever do take a medication like this, the non-negotiables travel with it - enough protein, and resistance training two to three times a week. The drug shrinks the number on the scale; only you decide how much of what's left is strong.
For my PMOS readers: you know this drug family already - GLP-1 medications are increasingly part of the PCOS/PMOS conversation because they hit the insulin resistance at the center of the condition. This analysis didn't include PMOS-specific groups, so it can't answer your question directly. But if you're a woman with PMOS heading toward perimenopause, here's the useful takeaway: the midlife hormone shift doesn't appear to weaken these drugs, and your metabolic starting point is exactly the terrain they were built for. When PMOS-specific trials land - and they will - I'll walk you through those too.
That's the cycle. Bring your doctor the papers, not just the headlines.
Dr. Herman Weiss
(Hoffman HT, et al. Orforglipron in women by menopausal stage: analyses of ATTAIN-1 and ATTAIN-2. European Association for the Study of Diabetes annual meeting, Milan, Sept 28-Oct 2, 2026. via EASD release, medicalxpress.com)
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