Weight loss outcomes in premenopausal versus postmenopausal women during behavioral weight loss interventions: a systematic review and meta-analysis

Thomson, Zoe O.; Kelly, Jaimon T; Sainsbury, Amanda; Reeves, Marina M.

doi:10.1097/gme.0000000000001684

Cited by 5 publications

(4 citation statements)

References 37 publications

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“…It can be assumed that short-term differences in weight loss outcomes may have little impact long-term. Moreover, data available so far suggest that weight loss interventions may not need to be tailored to women’s menopausal status [ 20 ].…”

Section: Sex-specific Considerationsmentioning

confidence: 99%

Obesity management: sex-specific considerations

Kantowski,

Schulze zur Wiesch,

Aberle

et al. 2024

Arch Gynecol Obstet

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Obesity is a global health issue that has grown to epidemic proportions. According to World Health Organisation (WHO), overweight and obesity are responsible for more than 1.2 million deaths in Europe each year, representing > 13% of the region's total mortality. Highly processed, calorie-dense foods and reduced physical activity are considered as primary drivers of obesity, but genetic predisposition also plays a significant role. Notably, obesity is more prevalent in women than in men in most countries, and several obesity-related comorbidities exhibit sex-specific pathways. Treatment indication depends on BMI (body mass index), as well as existing comorbidities and risk factors. To reduce obesity-associated comorbidities, a permanent reduction in body weight of (at least) 5–10% is recommended. Treatment guidelines suggest an escalating stepwise approach including lifestyle intervention, pharmacotherapy, and bariatric-metabolic surgery. As cumulative evidence suggests differences in weight loss outcomes, there is growing interest in sex-specific considerations in obesity management. However, most trials do not report weight loss or changes in body composition separately for women and men. Here, we discuss state-of-the-art obesity management and focus on current data about the impact of sex on weight loss outcomes.

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Section: Sex-specific Considerationsmentioning

confidence: 99%

Obesity management: sex-specific considerations

Kantowski,

Schulze zur Wiesch,

Aberle

et al. 2024

Arch Gynecol Obstet

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“…Obesity in postmenopausal women is associated with increased morbidity and mortality [9]. However, a 2020 review highlights the lack of research accounting for menopause stage when examining weight changes during the menopausal transition [10]. Further, few weight management intervention studies last longer than 26 weeks, making it difficult to assess the long-term sustainability of a single intervention [10].…”

Section: Andandmentioning

confidence: 99%

“…However, a 2020 review highlights the lack of research accounting for menopause stage when examining weight changes during the menopausal transition [10]. Further, few weight management intervention studies last longer than 26 weeks, making it difficult to assess the long-term sustainability of a single intervention [10]. Nevertheless, the impact that the menopausal transition has on weight requires recognition and knowledge of the changes that occur during the hormonal phases.…”

Section: Andandmentioning

confidence: 99%

Menopause, weight, and metabolic health – considerations for a patient centered, multidisciplinary approach

Lowy¹,

Kasianchuk

2023

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of reviewTo examine the complexity of weight and metabolic changes during the menopausal transition and propose a multidisciplinary care approach to support long-term metabolic health. Recent findingsMenopause, weight and metabolic health changes are influenced by many interplaying factors, and therefore, require a multipronged, multidisciplinary patient centered approach. This approach should start with a medical history and examination. Additional key components include: behavior change principles, mental health evaluation, gynecological care, nutrition, exercise recommendations and sleep care. In addition, when appropriate, weight loss pharmacotherapy and surgical options should be considered. Metabolic health is a long-term chronic process and improvement requires a chronic management approach.

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“…While effective lifestyle modification is a key component of PCOS management, the evidence of higher obesity prevalence and longitudinal weight gain in community-recruited populations [ 11 ], combined with high attrition rates in clinical lifestyle interventions [ 12 ] suggests that women with PCOS experience challenges with weight management and implementing and sustaining lifestyle changes. Literature shows all women of reproductive age with or without PCOS are at greater risk of dropout when compared to women of older age [ 13 ]. This is likely due to factors such as family responsibilities, fatigue, lack of time, poor partner support, low mood and lack of exercise facilities to name a few.…”

Section: Introductionmentioning

confidence: 99%

Providing lifestyle advice to women with PCOS: an overview of practical issues affecting success

Pirotta

Mousa

et al. 2021

BMC Endocr Disord

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Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder affecting up to 13 % of women. Lifestyle interventions are first-line treatments, however attrition in women with PCOS is high. This review summarises current evidence on barriers to lifestyle management in PCOS and suggested strategies for overcoming these challenges, mapped to the Capability, Opportunity, Motivation and Behaviour model.Physical capability for lifestyle changes may be impacted by altered gut hormone regulation and energy expenditure in PCOS. This may contribute to difficulties with weight management. The higher prevalence of eating disorders, disordered eating, fatigue and sleep disturbances are further barriers. Psychological capability may be reduced due psychological symptoms and lack of critical health literacy. Women with PCOS face similar challenges in terms of Opportunity to make lifestyle changes as other women of reproductive age. However, these are complicated by features more common in PCOS including body dissatisfaction. Motivation to adopt healthy lifestyles may be impacted by suboptimal risk perception and intrinsic motivation.To address these barriers, screening for and management of eating disorders, disordered eating, depression, and Obstructive Sleep Apnoea should be undertaken as per international evidence-based guidelines. A weight-neutral approach may be appropriate with disordered eating. Building capability among health professionals to better partner with women with PCOS on their management is essential in addressing health literacy gaps. Behavioural strategies that target risk perception and build intrinsic motivation should be utilised. More research is required to understand optimal self-management strategies, risk perception, energy homeostasis and overcoming attrition in women with PCOS.

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Weight loss outcomes in premenopausal versus postmenopausal women during behavioral weight loss interventions: a systematic review and meta-analysis

Cited by 5 publications

References 37 publications

Obesity management: sex-specific considerations

Obesity management: sex-specific considerations

Menopause, weight, and metabolic health – considerations for a patient centered, multidisciplinary approach

Providing lifestyle advice to women with PCOS: an overview of practical issues affecting success

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