Why Weight Loss Treatment for Women Can't Be One-Size-Fits-All, According to an Obesity Medicine Doctor

A woman's relationship with her weight looks different at every life stage, and according to Nida Latif, M.D., who is board-certified in family and obesity medicine and founder of Canton Medical Clinic, that reality should shape how providers approach treatment. "One of the important things that changes across a woman's life is her metabolism," Latif said, pointing to the natural decline that occurs over time, layered with the very different metabolic demands of puberty, pregnancy and the transition through perimenopause into menopause.

She noted that even within a single life stage, patients vary widely. During puberty, for example, "people already struggling with weight through their childhood years, their metabolism is going to be very different from somebody not struggling with weight from before." Pregnancy, she added, is shaped as much by cravings and mood as by metabolic rate itself. And by menopause, many women notice a shift regardless of their habits: "Most women will notice, regardless of what they're doing, belly fat," which can eventually lead to elevated liver enzymes and fatty liver if diet and exercise aren't consistently addressed.

Why PCOS Treatment Often Misses the Root Cause

Latif described polycystic ovary syndrome (PCOS) and weight as deeply intertwined, calling it "a vicious cycle because the PCOS causes infertility, but obesity also promotes that because it's a whole hormone change that kind of feeds into each other." She said many young patients are prescribed birth control as a quick fix for irregular periods, acne and excess hair growth, the symptoms that typically bring them in, without addressing the metabolic issue underneath. "It doesn't address the underlying cause, which is the metabolism," she said.

That disconnect requires significant patient education, Latif explained, since metabolic treatment works on a much slower timeline than birth control. "If you only treat the metabolism issue, [and] you talk to them about the weight loss, they're going to probably walk out feeling very dissatisfied," she said. But when patients stick with it, the results can be transformative. "It's so rewarding to see once you treat the metabolism, you get them to lose the weight, and they come back telling you, 'Oh, I'm pregnant.'"

Menopause Weight Gain Isn't Inevitable

Latif confirmed that visceral fat gain and muscle loss around perimenopause and menopause are well documented in the research, but she pushed back on the idea that weight gain during this stage is unavoidable. "Things that reverse it are higher protein intake and resistance training," she said, noting that the data consistently supports resistance training as a tool for preventing that muscle loss.

Addressing Weight Stigma in the Exam Room

Latif also spoke candidly about weight stigma in health care, a reality she said became far more visible to her after training with the Obesity Action Coalition. "Women who are overweight feel it more," she said, adding that stigma keeps many women from seeking care altogether out of fear of being shamed. She pointed to small, practical changes that can make a difference, such as offering armless chairs in waiting rooms and larger blood pressure cuffs.

What Women Should Know Before Starting New Obesity Medications

For women who are pregnant, breastfeeding or planning a pregnancy, Latif was direct: "There are not enough trials or enough data to suggest women use these medications during pregnancy or while nursing." She also flagged an important and often overlooked risk, that weight loss itself significantly increases fertility. "Fertility is increased significantly when you lose weight, and fertility needs should be addressed at a patient’s first visit," she said, noting she routinely discusses contraception and pregnancy planning with patients starting treatment, including which medications need to be avoided if pregnancy is a possibility.