Can GLP-1s Help With Perimenopause Weight Gain?

If your body feels like it’s changing (and not in a good way) you’re not imagining it.

Suddenly, the scale won’t budge. Your clothes fit differently. You’re tired in a way you can’t explain. And no matter how healthy you try to eat, it’s like your metabolism is playing a trick on you.

For many women, this is the start of perimenopause — even if you’re still getting your period and still feel “too young” for menopause.

At the same time, you may have heard about GLP-1 medications, sometimes called “the shot,” and how they’re helping women lose weight, curb cravings, and finally feel in control again.

So, can these medications actually help with perimenopause weight gain?

Let’s break it down — and share the story of one Josie patient who found out the hard way that perimenopause can start earlier than you think.

Josie’s TL;DR

• Perimenopause can start in your mid-30s. Hormone shifts—especially dropping progesterone—make weight gain feel sudden and hard to reverse.
• Belly fat shows up first. It’s biology, not willpower. Your metabolism, stress response, and insulin sensitivity all change.
• GLP-1s help quiet food noise. Many Josie patients say it’s the first time they’ve felt “back in control” of cravings.
• You’re not too young. If you feel off, there’s likely a reason. You deserve real support—not shame.

Perimenopause Can Start Sooner Than You Think

For many women, perimenopause begins in their late 30s to early 40s — yes, even if your cycle is still “regular.” This transition phase before menopause brings subtle but significant hormonal changes, especially in estrogen and progesterone. As these hormones fluctuate, your metabolism may slow, fat storage patterns shift, and weight — particularly around the belly — becomes harder to manage.

Meet Erica (37) - A Josie Patient for over a Year

Erica was 37 when she first started feeling “off.” Her energy dropped, she wasn’t sleeping as well, and she noticed weight creeping onto her stomach — even though her eating and workouts hadn’t changed.

“I honestly thought I was just tired from life,” she told us. But when her clothes kept feeling tighter, she brought it up to her OBGYN.

Her doctor ran a hormone panel and a few other tests commonly used to evaluate perimenopause (including FSH and estradiol levels). The results confirmed it: Erica was in perimenopause.

“I was shocked. I thought I had at least 10 more years before this started,” she said.

Erica’s story isn’t unusual. At Josie, we see women every week who are experiencing these shifts years before they expected — and struggling with the sudden weight gain that comes with it.

Let’s break down what’s really happening in the body.

What’s Happening to Your Hormones?

Belly fat shows up first in perimenopause because hormone shifts, especially in estrogen and progesterone, change how your body stores fat.

As estrogen fluctuates and declines, your body becomes more likely to store visceral fat in the belly. At the same time, progesterone drops steadily, which can lead to more bloating, water retention, and overall weight gain — especially around the midsection.

Even if the number on the scale doesn’t change, your shape often does. That waistline softening? It’s one of the first physical signs women notice in early perimenopause.

Toss in the effects of cortisol (from stress, poor sleep, or just life in general), and your body gets the signal to store energy — right around your belly.

At 37, Erica still had regular periods — but something felt off. She was exhausted, gaining weight around her belly, and struggling to focus. Her OB ran lab work to check her hormone levels.

Her estradiol was under 40 pg/mL (far lower than her usual peak of 200+ mid-cycle), and her progesterone was barely detectable — less than 1 ng/mL. Despite her age, her doctor confirmed: She was in perimenopause.

She was shocked. “I thought I was too young,” Erica told us. “But having an explanation — and a plan — made all the difference.”

It’s Biology, Not Willpower

Losing weight in perimenopause isn’t just harder — it’s biologically different. That's why many of you reading this that are dieting - it's not working as good as it used to.

Hormone shifts impact everything from how your body stores fat to how it responds to stress. With lower estrogen and nearly absent progesterone, your body becomes more insulin resistant, more inflamed, and more likely to hold onto fat — especially in the midsection.

Cortisol (your stress hormone) doesn’t help either. When you’re juggling work, kids, aging parents, and life… your body stays in a state of stress. That stress tells your body, “Hold on to fat. Don’t let go.”

“I wasn’t eating more,” Erica told us. “At least I didn’t think I was.”

But between stress, sleep struggles, and constant hunger — her body was changing. She was eating the same meals, but now it felt like they just stuck to her. “I didn’t realize how much hormones played a role until I saw the lab results,” she said.

After starting compounded tirzepatide through Josie, the cravings eased. “It was like food stopped being in control,” she said. “I could finally listen to my body again.”

How Do I Know If I’m in Perimenopause?

Perimenopause can start in your 30s or 40s — even if your periods are still regular.

Some of the earliest signs aren’t about your cycle at all. Many women first notice:

• Worsening PMS or mood swings
• Trouble sleeping
• Weight gain, especially around the belly
• Brain fog or forgetfulness
• Feeling “off” without knowing why

Hormone levels can start shifting years before your period changes. That’s what happened to Erica, 37, who still had predictable cycles. But she was gaining weight, exhausted, and felt unlike herself. Her OB ran a hormone panel — and the numbers confirmed what she already knew: something was changing.

“I thought perimenopause was something for my 50s,” she told us. “But getting an answer made me feel less crazy — and finally gave me a plan.”

If you’re noticing any of these symptoms, it’s worth bringing up with your provider. Even if you don’t need medication, just having clarity can be a huge relief.

Enter GLP-1s: A New Tool for Perimenopause Weight Gain

GLP-1 medications weren’t designed specifically for perimenopause — but for many women in this stage of life, GLP-1s are proving to be a powerful support tool. Why? Because they address two major issues that show up in midlife weight gain: increased hunger and disrupted blood sugar.

Let’s break it down.

Can GLP-1s Quiet Hunger & Cravings?

Yes, GLP-1s reduce appetite by acting on the areas of your brain that control hunger and satiety.

In perimenopause, declining estrogen can cause a rise in ghrelin (your hunger hormone) and lower leptin sensitivity (your fullness signal). This hormonal chaos often leads to increased cravings, mindless snacking, and a constant feeling of “never quite full.”

GLP-1s help reset a woman's body over 35. They slow down how fast your stomach empties, which keeps you fuller longer — and they communicate with your brain to tell you you’re satisfied. Many women say they finally feel in control around food again.

Erica’s experience: Within the first two weeks of starting compounded tirzepatide through Josie, Erica noticed her cravings ease. “It felt like food stopped yelling at me,” she said. “For the first time in years, I wasn’t thinking about snacks all day.”

Can GLP-1 Help Insulin Resistance in Perimenopause?

Yes, and this is one of the biggest reasons GLP-1s work so well for many midlife women.

As estrogen drops, your cells become more resistant to insulin — meaning your body has a harder time processing carbs and sugar. This leads to more fat storage (especially around the belly), energy crashes, and a cycle of cravings that’s tough to break.

GLP-1s help by improving insulin sensitivity and slowing the release of glucose into your bloodstream. That means fewer blood sugar spikes and crashes — and more stable energy throughout the day.

Erica’s experience: Before starting GLP-1s, Erica felt like she was on a roller coaster. “I’d eat a sandwich and feel like I needed a nap an hour later,” she said. “Now, I can go for hours without crashing. I feel steady — mentally and physically.”

How fast do GLP-1s work? - Early Wins Women Notice in Weeks 1–4

Most women don’t drop pounds overnight. But within the first few weeks, they often notice something even better: relief.

Here’s what many Josie members report during weeks 1–4:

• Feeling full after smaller meals
• Fewer snack cravings in the afternoon and evening
• Less emotional eating during stress or boredom
• More stable energy (thanks to better blood sugar control)
• A sense of mental clarity or “quiet” around food

For Erica, those first few weeks were powerful.

“I didn’t realize how much food noise I had until it stopped,” she told us. “I could finally focus on other things — like getting back into strength training and spending time with my kids without constantly thinking about what to eat next.”

Weight loss may begin slowly, but for many women, these early shifts are what keep them going.

What It Looks Like to Pair GLP-1s With Lifestyle Changes in Perimenopause

GLP-1s are powerful for women in perimenopause, but they’re just one piece of the puzzle. For real, sustainable results in perimenopause, the women seeing the biggest changes are also doing three key things:

Prioritizing Protein at Every Meal

As estrogen dips, muscle loss speeds up — which means your body needs more protein to maintain and build lean mass.

Most women aren’t getting enough. But when they increase their protein (think: 25–30g per meal), they notice:

• More satiety
• Fewer cravings
• Better energy
• Easier fat loss — especially when paired with strength training

Tip: Many Josie members use macro-based recipes or protein drinks to make this easier.

Strength Training 3–4x Per Week

This is the real metabolism boost.

Muscle is what helps your body burn more calories at rest — and feel stronger, more capable, and more in control.

Bethany, 47, was totally new to strength training and nervous to start. But after committing to just 30-minute workouts with the Simply Strong App (designed for busy women 35+), she felt the difference:

“It’s my time. I feel better than I have in years.”

She now says pairing GLP-1s with strength training is what helped her feel supported — not just slimmer.

Managing Stress (and Cortisol)

GLP-1s don’t fix burnout. And chronic stress raises cortisol, which increases belly fat and disrupts sleep.

That’s why managing stress is part of the plan — not a bonus.

For Erica, that meant creating a simple morning routine and actually protecting her sleep. She didn’t do it perfectly, but the changes added up.

“My energy came back. I stopped feeling like I was treading water every day.”

Are GLP-1s Safe During Menopause?

Yes, when prescribed responsibly, GLP-1s are considered safe for women in their 30s, 40s, 50s and beyond.‍

They don’t interfere with reproductive hormones like estrogen or progesterone, and they’ve been used safely for years in both the diabetes and weight loss communities.

But like any medication, they work best — and most safely — when your provider understands your full health picture.

At Josie, every prescription is guided by a licensed U.S. provider who considers your entire health history, not just your weight.

Let’s break down what that safety really looks like.

Safety Data & Provider Oversight

GLP-1s like semaglutide and tirzepatide have gone through rigorous trials and are FDA-approved for weight loss in adults with overweight or obesity. They’re also widely prescribed off-label for midlife women dealing with hormonal weight shifts.

When managed carefully:

• They’re not addictive
• They don’t affect estrogen or progesterone levels
• They’re monitored closely for side effects and dose tolerance
• You’ll have provider check-ins to adjust your plan as needed

Why it matters: Midlife women often have increased sensitivity to changes in appetite and digestion — so a personalized, low-and-slow approach is key.

Common vs. Serious Side Effects

What most women experience early on:

• Nausea
• Bloating or gas
• Fatigue
• Headache
• Changes in digestion (constipation or diarrhea)

These usually ease within a few weeks — especially when women stay hydrated, eat protein-rich meals, and give their body time to adjust.

“Erica told us she felt tired and slightly nauseous the first week, but by week three, her appetite had steadied and her energy came back stronger than before.”

Less common but more serious side effects include:

• Severe abdominal pain
• Ongoing nausea or vomiting
• Gallbladder issues
• Signs of pancreatitis

At Josie, our providers check in regularly — so if anything feels off, we catch it early.

Stopping, Starting, and Financial Breaks

Yes, you can pause GLP-1s — and yes, you can restart.

That’s one of the most common questions we hear from women in their 30s and 40s, especially when life (or finances) gets in the way.

Why Someone Might Take a Break

Maybe you’re traveling, switching jobs, or just need a financial breather.

Maybe you’ve hit a milestone and want to see how your body does on its own for a bit.

Whatever the reason, stopping a GLP-1 doesn’t mean all your progress disappears — especially if you've been building the right habits alongside it.

However, you can’t realistically expect your results to stick, if you haven’t built the right habits - protein, strength training and stress management.

Rachel’s Story: Strength Training Made Her Transition Smoother

Rachel (44) had been using compounded semaglutide through Josie for seven months. She lost 28 pounds and felt better than she had in a decade. But when her family’s expenses spiked, she needed to hit pause.

What helped her most?

She never stopped strength training. Thanks to the Simply Strong app, she’d built a realistic routine — and even when her medication paused, her body felt strong, supported, and in rhythm. She was prioritizing protein and managing her stress levels.

Three months later, she was able to restart GLP-1s through Josie without missing a beat.

“I was nervous to stop,” she told us, “but I didn’t feel like I was starting over. I just kept showing up for myself.”

Can You Restart After Stopping?

Yes. At Josie, we have many women who return after a break — whether it’s weeks or months later. Your provider will review your updated health history, reassess your goals, and adjust your plan as needed.

We understand that wellness isn’t always linear. That’s why our model is built with flexibility and long-term support in mind — not pressure or rigid timelines.

Bottom Line: Taking a GLP-1 During Perimenopause Is Support, Not a Shortcut

Perimenopause throws your body into change mode — not just hormonally, but metabolically. And when traditional advice (“just eat less, move more”) stops working, it’s easy to feel stuck or even blame yourself.

But here’s the truth:‍

If you’re gaining weight in your 30s or 40s, struggling with cravings or energy dips, or just not feeling like you anymore… it’s not a willpower problem. It’s a biology shift.

That’s why GLP-1s are helping so many women through this chapter — not by replacing your effort, but by making your effort work again.‍

At Josie, we see it every day.

Hormones change. Life gets busy. But with the right support — medication, strength training, protein, community — you can feel good again in your body.

Want to Hear Real Stories?

Read how other women in their 30s, 40s, and 50s are navigating perimenopause with Josie’s support — including GLP-1s, coaching, and real-life strength training wins.

👉 Explore Their Stories

FAQs

How do I know if I’m in perimenopause?

Many women don’t realize they’re in perimenopause because their periods are still regular. But common early signs include trouble sleeping, mood swings, unexplained weight gain (especially around the belly), brain fog, and feeling “off.” A provider can check your hormone levels to help confirm.

Can I take a GLP-1 if I’m still getting my period?

Yes. Many Josie members are still menstruating and qualify for GLP-1 treatment. What matters more is your symptoms, health history, and goals — not whether your cycle is “normal.”

Is it safe to take a GLP-1 in your 30s or 40s?

GLP-1s are generally safe for women in midlife when prescribed by a licensed provider. At Josie, we review your full health picture before prescribing — and stay with you through the journey.

Will a GLP-1 help balance my hormones?

GLP-1s don’t directly change your hormone levels (like HRT does), but they can help stabilize your blood sugar and appetite, which are often affected by hormone shifts. Many women feel more in control when using a GLP-1 during perimenopause.

What happens if I stop the medication?

Weight regain is possible, but not guaranteed. That’s why we pair GLP-1s with education, strength training, and protein-focused nutrition — so you’re not starting from scratch if you pause or stop.

Can I restart a GLP-1 later if I need to?

Yes. Many women take financial breaks or pause during vacations or big life changes, and restart later. Your Josie provider will guide you safely if you choose to resume.

Is it better to take oral tablets or injections?

It depends on your preference and lifestyle. About 30% of Josie members prefer tablets (especially if new to meds), while others like the ease of a once-weekly injection. Both can be effective.

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