When Jana Stewart, 54, a hormone and midlife health coach and bodybuilder, first hit perimenopause she was doing everything “right.” Between regular exercise and healthy eating, “I’d never had a problem losing weight before,” she tells ESSENCE. But, she still gained about 15 pounds that just wouldn’t budge. “Suddenly, everything that used to work perfectly just stopped working,” she says. So, her hormone specialist suggested Wegovy.
An injectable medication like Ozempic, Zepbound, and Mounjaro, Wegovy is a synthetic version of the GLP-1 hormone—a hormone that manages blood sugar, makes us feel full, and regulates appetite—our body naturally produces. After taking a full dose to lose the initial weight, dropping from 140 to 123 pounds in a year, Stewart switched to micro-dosing. Now, she takes just 10 units every Saturday to maintain her goal weight: 125 pounds. “The difference is that micro-dosing isn’t about weight loss for me anymore—it helps tremendously with cravings and inflammation, which are huge for managing perimenopause symptoms,” she says. And, she’s not alone.
“Weight gain during menopause is incredibly common,” says Dr. Roxanne Pero, OBGYN MD, FACOG, FACLM, IFMCP, who is on O Positiv’s Medical Advisory Board. 60 to 70 percent of women in midlife report weight gain during the menopausal transition, with total gain reaching up to 22 to 25 pounds from the start of perimenopause, and even more after menopause.
According to Pero, Black women often start menopause with a higher body weight and more abdominal fat compared to White women. “They may not gain as much additional weight during the menopause transition itself—but tend to hold onto that existing body fat and then see more weight gain after menopause,” she says.
While weight gain is completely normal as we age, Black menopausal women have been turning to GLP-1s to take control over stubborn pounds. Celebrities like Serena Williams, Whoopi Goldberg, Oprah, and most recently, Vanessa Williams, have all admitted to being on the jab, just like one in eight Americans who have tried the weight loss drug.
“GLP-1 medications like Ozempic and Wegovy are a class of medications that increase the activity of GLP-1, a hormone in the gut responsible for increasing feelings of fullness and regulating blood sugar,” says Dr. Melynda Barnes, MD, and chief medical officer at Ro. “The medications are popular because they’re the most effective tools to help people successfully manage their weight by helping them feel full faster, alongside exercise and a healthy diet.”
Stewart agrees. “The weight came off quickly.” However, she did notice other changes in her body. In addition to loose skin, “I did lose a little muscle initially,” she says. “As a bodybuilder, I should have known to up my weight training right away.” Meanwhile, others claim they’ve noticed hair loss, body sagging, and a gaunt face (a.k.a. “Ozempic face”), which is why some women are hesitant to start the medication. Now, with GLP-1 pills finally hitting the market, it’s making dosing even easier than before. But, is it even safe?
Since 2023, class action lawsuits against GLP-1 drug makers, like Novo Nordisk (known for Ozempic and Wegovy) and Eli Lilly (known for Mounjaro) have been popping up all over the United States. The lawsuits claim taking GLP-1s can cause severe side effects like gastroparesis, which was not included on the drugs’ warning labels. According to the National Institute of Diabetes and Digestive and Kidney Diseases, gastroparesis, also known as delayed gastric emptying or stomach paralysis, is a disorder that slows or stops the movement of food from your stomach to your small intestine, even though there is no blockage in the stomach or intestines. Symptoms include fullness after meals, pain, nausea, vomiting, weight loss, belching and bloating.
As of 2026, there are over 3,000 pending lawsuits concerning gastroparesis and other gastrointestinal injuries, and 29 claiming vision loss. Although GLP-1s emerged with the first FDA approval of Byetta (exenatide) in 2005 for type 2 diabetes, which stemmed from research dating back to the 1980s and ‘90s, it wasn’t until 2017’s Ozempic boom that the drug was siphoned for what it’s known for now: weight loss. While using GLP-1s for weight loss are all the rage right now, it’s worth raising questions on if the use has even been around long enough to know the long-term risks.
However, it’s also worth noting, while the GLP-1 lawsuits are not exclusively for higher doses, a significant portion of the allegations claim these severe side effects often occur or worsen when users are on higher doses or on the drug for a longer period of time. Although gastrointestinal issues, like diarrhea, constipation, and stomach pain, can still occur while microdosing, the side effects are generally more mild as your body adjusts.
But, microdosing during menopause comes with its own unique caveat. “During menopause, these changes can be compounded by hormonal shifts—declining estrogen and testosterone levels naturally reduce muscle mass and can contribute to hair thinning,” Pero warns. “Prioritizing adequate protein intake, nutrient-dense meals, and regular weight training are key to preserving muscle and minimizing hair loss.”
However, with hair loss often temporary and muscle mass easy to rebuild, the benefits of microdosing outweigh the side effects for many menopausal women. “I have many patients on Tirzepatide at micro-doses—which just means below the standard FDA dose—and they are noticing decreased inflammation, weight loss, less ‘food noise’, better mental clarity and other benefits,” says Dr. Sarah De La Torre, double board certified physician and clinical lead at Respin. She says the drug can be “extremely beneficial” to women in menopause.
Like many women, Stewart experienced a drop in energy during perimenopause, but after taking Wegovy she noticed a boost in both energy and mood, in addition to another surprising benefit. “It really curbs your desire to drink alcohol,” she says, even though she’s not a big drinker to begin with. (Dry January ought to be easier, huh?)
While micro-dosing GLP-1s can help curb menopausal weight gain, opening up the conversation around women’s health means understanding the realistic risks of partaking in a drug-related fad. But, the real message here is knowing you’re not alone. “So many of us are struggling in silence, not knowing what options are available or feeling like we just have to ‘tough it out’,” Stewart says. And, whether it’s GLP-1s, support groups, or lifestyle changes, “we have resources available to us, and we shouldn’t be afraid to use them.”