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Weight Loss Strategies in Menopause: What’s New and What Works

by JoAnn Pinkerton | Oct 03, 2017

We're pleased to have a guest post from Dr. Cheryl Kinney.

Kinney, Cheryl 2015

Cheryl C Kinney, MD, FACOG 

NAMS Member

For many menopausal women, weight gain is one of their major health concerns. And rightly so! Most of us know from personal experience what numerous studies have now demonstrated —that the menopause transition is associated with unfavorable changes in body composition and abdominal fat deposition. Although there is no doubt that diet and exercise are important in weight management, help is on the way in the form new medications and surgical procedures.

New Surgical Options

Balloons are changing the surgical strategies for weight reduction. The ReShape Duo is a double balloon that is placed endoscopically during outpatient surgery and filled with salt water (saline). It stays in the stomach to induce feelings of fullness for 6 months, after which it is deflated and removed. Average weight loss is 30 to 40 pounds, with a sustainability rate of 48% at 24 months. The Obalon® is a capsule that contains one balloon. Like the ReShape Duo, the capsule is placed with an endoscope. Once it is in the stomach, the capsule dissolves, and the surgeon fills the balloon with gas. After 4 to 6 months, the balloon is deflated and removed. Weight loss can be 40 pounds or more (or less, depending on how you stick to the protocol). Rare complications have been reported with these procedures, so speak to your healthcare provider about the risks.

To get around the risks of anesthesia and endoscopy, the Elipse was developed. It is a capsuled balloon that is simply swallowed during a brief office visit. Months later it dissolves and passes into the toilet. The Elipse is still under investigation. Also in development is Gelesis100, a pill that you take before meals. It soaks up water and expands in the stomach, making you feel full. Four to six hours later, it dissolves. Then repeat and eat (or at least try too).

The vBloc, a pacemaker-like device for the stomach, was approved by FDA in 2015. It is implanted surgically and can lead to a significant weight loss. It requires recharging every night, which might lessen its charm.

New Medical Options

FDA has approved five medicines for long-term use, including four relatively new drugs—the first drugs approved for obesity in more than 13 years—with solid data on long-term efficacy and safety. Orlistat is a daily pill that works by reducing the absorption of ingested fat. Phentermine/Topiramate ER, also a daily pill, is a combination of an appetite suppressant and a medication that works at the brain level. The average weight loss is 24 pounds. Lorcaserin is taken twice daily, with an average weight loss of 8% of body weight. Naltrexone SR/Bupropion SR works to control hunger and to decrease cravings. Taken twice daily it can result in more than 12% of body weight loss. Liraglutide is an injectable weight loss medication. In studies, one in three patients lost more than 10% of their body weight, and eight out of ten kept it off for at least a year.

Several other new drugs and devices are under investigation and show promising results. But if you are ready to lose weight now, talk to your healthcare provider to review the risks and side effects of the available options.

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Going Mad in Perimenopause? Signs and Solutions

Mood swings, short-term memory loss, and difficulty thinking straight are common complaints from midlife women. However, while many of these symptoms are attributed to menopause, there are other contributing factors to consider as well.

Hormones: During reproductive years, most women become accustomed to their own hormonal rhythm. When this rhythm is disrupted during perimenopause, mood changes may result.

Timing: The timing of menopause may coincide with a multitude of midlife stresses like relationship issues, divorce or widowhood, care of young children, struggles with adolescents, return of grown children to the home, being childless, concerns about aging parents and caregiving responsibilities, as well as career and education issues...

Full story

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