Menopause weight loss supplements or medical weight loss? How to choose what works

Why weight loss works differently during menopause

Your body starts storing fat differently as soon as your oestrogen levels fall. Where fat used to sit mainly on your hips and legs, it shifts to your belly. This belly fat sits deeper, around your organs, and is more stubborn than the fat you were used to.

On top of that, your muscle mass slowly decreases and your resting metabolism slows. So you burn less energy than a few years ago, while your eating pattern has stayed the same. Your insulin sensitivity also falls, which makes your body store fat more readily. Poor sleep caused by hot flushes or night sweats reinforces this: too little sleep increases your hunger.

So you are not doing anything wrong. The rules of the game have changed. That is exactly why the advice to "eat less and move more" is often no longer enough at this stage. In menopause weight gain we explain what happens, hormone by hormone.

What actually helps with weight loss during menopause?

What has been shown to help is the combination of a protein-rich diet, strength training, good sleep and, if that turns out not to be enough, medical treatment. None of these elements works on its own.

At this stage, strength training matters more than cardio, because it helps you maintain muscle mass and therefore keep your metabolism up. Protein helps you feel full for longer and protects those same muscles. Sleep and stress are not side issues: both have a direct effect on your hunger hormones.

If that still does not work, medication is a realistic option. The Dutch guideline on overweight and obesity from 2023 is clear on this: weight-reducing medication is considered as an addition to a combined lifestyle intervention, not as a replacement for it. The medication takes away the hunger; you stay in charge of your diet and activity. Our guide to weight loss during menopause sets out this approach step by step.

Menopause supplements: what can you expect?

Menopause supplements are not weight loss products. Products containing black cohosh, red clover or soy isoflavones target hot flushes, night sweats and mood swings. Weight loss is rarely claimed on the label, and where it is, the evidence is missing.

The Voedingscentrum (the Netherlands Nutrition Centre) is clear about the effectiveness of food supplements containing isoflavones or phyto-oestrogens: "There is not enough evidence that these supplements actually help." What is more, high doses can be harmful and cause side effects such as vaginal bleeding and liver inflammation. Its advice: preferably do not use them, or only after consulting your GP (huisarts) or pharmacist.

An important difference: a supplement is not a medicine. It is not assessed for effectiveness in advance, as medicines are. So "natural" does not mean "tested", nor does it mean "risk-free", especially if you already take other medicines.

What a supplement can do is make up for a deficiency. Vitamin D and calcium are useful for your bones at this stage of life. Just do not expect them to take off any kilos. The same applies to products that present themselves as a natural alternative to weight loss medication: first read what we wrote about GLP-1 supplements.

Which pills can you use to lose weight during menopause?

There is no weight loss pill specifically for menopause. There are, however, three categories of products that are often confused.

1. Over-the-counter weight loss pills. Fat binders, appetite suppressants and fat burners from the chemist (drogist) or the internet. Their effect on lasting weight loss has not been shown, and products from foreign web shops sometimes contain substances that should not be in them.
2. Prescription weight loss medication. This includes the GLP-1 medicines containing semaglutide (Ozempic, Wegovy, and Rybelsus in tablet form) and liraglutide (Saxenda), and tirzepatide (Mounjaro), which acts on two gut hormones at once. There are also orlistat and the combination naltrexone/bupropion.
3. Hormone therapy. Intended for menopause symptoms, not for weight loss. It can help indirectly because you sleep better and have more energy, but it is not a weight loss product. More on this in HRT and weight gain.

For that second category, one strict rule applies: weight loss medicines are only available on prescription and should always be used under a doctor's supervision. The CBG (the Dutch Medicines Evaluation Board) advises against buying these medicines outside that route, because with suppliers that do not require a prescription you do not know what you are taking. That can even be dangerous. If you want to use such a medicine, see a doctor who assesses you, writes a prescription and supervises you.

Does this sound familiar? You have tried everything and the kilos still will not shift. At Qlinic, a BIG-registered doctor (the BIG register is the Dutch register of healthcare professionals) personally assesses whether medical weight loss is right for you. Take the eligibility check →

The "new weight loss pill": what is GLP-1?

What the media call "the new weight loss pill" is usually GLP-1 medication. GLP-1 is a hormone your gut produces itself after eating. It slows gastric emptying, signals to your brain that you have had enough and helps keep your blood sugar stable.

The medication mimics that hormone. As a result, you feel full sooner and the constant urge to eat disappears. It is usually a weekly injection with a thin needle; a tablet form also exists. You can read exactly how it works on our page about GLP-1.

The effect has been well researched. In the STEP 1 trial, published in the New England Journal of Medicine, adults with overweight or obesity lost an average of 14.9% of their body weight after 68 weeks on weekly semaglutide alongside lifestyle support, compared with 2.4% in the placebo group. These are research results, not a promise: the effect varies from person to person.

There is another side too. Nausea, constipation and diarrhoea occur, especially during the build-up phase. Not everyone is suitable for this medication, and if you stop without having changed your habits, your weight can come back. Your doctor discusses the side effects openly with you beforehand, including the rare ones.

Supplement or medical programme? A side-by-side comparison

In short: if you mainly suffer from hot flushes, a supplement or hormone therapy may be useful, in consultation with your doctor. If you want to lose the weight you gained during menopause, a medical programme is the only route with a proven effect.

Medical weight loss with your own doctor beside you

At Qlinic you have one doctor of your own who knows you from start to finish. Not a changing team, but the same BIG-registered doctor who does your intake, writes your prescription and personally reviews your progress with you every 4 weeks.

The programme consists of three steps. You start with a consultation and intake, in which the doctor assesses whether medical weight loss is right for you. Then comes the prescription, with the medication delivered to your home. After that you start losing weight with regular follow-up, in which we adjust the dosage, side effects and pace.

Most women notice the first effect after about 4 weeks, usually because the constant feeling of hunger disappears.

We are deliberately small-scale. So far we have helped around 50 people, and we have a 5.0 rating on Google from more than 20 reviews. If you have doubts or side effects, you discuss them with your own doctor too. The cost of medical weight loss varies per programme; on top of the monthly fee you pay a one-off supervision fee of €400.

Wondering whether medical weight loss is for you? In a few minutes you will know whether you are eligible, after which our doctor personally reviews your situation with you. Take the eligibility check →

Frequently asked questions about menopause weight loss supplements

What actually helps with weight loss during menopause? The combination of a protein-rich diet, strength training, enough sleep and, if that is not enough, medical treatment under a doctor's supervision. Strength training carries more weight than cardio at this stage, because it helps you maintain muscle mass and therefore keep your metabolism up. Supplements make no proven contribution to weight loss.

Which pills can I use to lose weight during menopause? Only prescription weight loss medication, such as GLP-1 medication, has a proven effect on weight. You can only get it through a doctor, who first assesses whether you are suitable. Over-the-counter weight loss pills and menopause supplements have not been proven effective for weight loss.

What is the new weight loss pill called? There is no single new weight loss pill. The products referred to this way are GLP-1 medicines based on semaglutide, liraglutide or tirzepatide, usually a weekly injection and sometimes a tablet. They are all prescription-only and belong in a medical treatment, not in self-medication.

What are the best menopause pills? That depends on your goal. For hot flushes and night sweats, discuss hormone therapy or a supplement with your GP. For weight loss, there is no supplement with a proven effect, and prescription medication, alongside changes to your diet and activity, is the only evidence-based route.