Management of Obesity in Menopause: Lifestyle Modification, Medication, Bariatric Surgery and Personalized Treatment

Postmenopausal women are at a higher risk to develop obesity. Forty four percent of postmenopausal women are overweight while twenty three percent of whom are considered obese with a body mass index (BMI) above 30 kg/m². Large increases in weight have been shown to amplify the risk of: coronary artery disease, cerebrovascular disease, hypertension, hyperlipidemia, type II diabetes, cholelithiasis, pulmonary embolism, sleep apnea, gynecological problems, osteoarthritis, and psychiatric illness. Obesity leads to a higher risk for gynecologic cancer, cardiovascular disease, venous thromboembolism, osteoarthritis, and chronic back pain. Decline in estrogen levels associated with depression and physical inactivity are the major causes of the postmenopausal obesity. Thus, lifestyle modification including weight loss and physical activity is necessary to prevent these diseases by reducing the use of medications and by prolonging survival. In the present study we review current information about postmenopausal obesity, its origin and consequences and try to provide strategies for its treatment. Weight gain during the menopausal transition may be inevitable and unpreventable, but lifestyle alterations may help to minimize it. It must also be noted that these treatments may or may not be effective for every person; obesity may now need "personalized treatment".

Keywords: Menopause, Obesity, Energy Expenditure, Breast Cancer, Cardiovascular Disease, Diabetes, Hypertension, Osteoporosis, Depression, Lifestyle Modification, Medications, Hormone Replacement Therapy (HRT), Bariatric Surgery, Physical Activity, Polyunsaturated and Monounsaturated Fatty Acids, Estrogen, Progesterone, Leptin, Ghrelin, Personalized Treatment.