CagriSema in Women: 25% Weight Loss Across Every Menopause Stage
Dr. Ethan Lazarus, MD, DABOM, DABFM, MFOMA | Clinical Nutrition Center | October 26, 2026
Most obesity trials treat women as one undifferentiated group. Reproductive stage gets ignored, which is strange when you consider that more than 86 million women in the US are 40 or older, precisely the years when perimenopause and menopause happen.
Novo Nordisk brought two analyses of data from the REDEFINE 1 trial to The Menopause Society meeting in San Diego on October 20.
What the numbers showed
In 2,309 women with obesity or overweight, CagriSema 2.4/2.4 mg was associated with 25.0% average weight loss at week 68, against 3.0% on placebo. For context within the same analysis, semaglutide alone came in at 19.0% and cagrilintide alone at 13.4%.
A second analysis of 1,902 women split by menopause stage:
- Premenopausal: 26.7%
- Perimenopausal: 24.8%
- Postmenopausal: 23.1%
All three were significant against placebo.
What this does not mean
It does not mean younger women respond better and older women should expect less. Three reasons to hold that thought.
These were looks back at data after the trial was over. Novo states plainly they are a starting point for more research. Menopause status was derived after the fact from age, medical history and recorded symptoms. It was not prospectively staged and not biochemically confirmed.
The lead author, Dr. Maria D. Hurtado Andrade of Mayo Clinic, puts it the right way: the numerical differences highlight the need for further research into how reproductive aging influences weight loss.
The caveats that matter
The 25.0% figure is the best case, where every patient stayed on the drug and used no other weight loss therapy. It is not what an average patient achieves.
Tolerability was a significant concern. Gastrointestinal adverse events occurred in 79.6% on CagriSema versus 39.9% on placebo, nausea in 55% versus 12.6%, and 5.9% discontinued for adverse events versus 3.5%.
Finally, CagriSema is not approved. Novo filed its application in December 2025 with a decision expected in the fourth quarter of 2026.
Why this matters in Colorado
I practice in Greenwood Village and see patients across the Denver metro, and a large share are women in their forties and fifties managing the menopause transition alongside their weight. They ask whether the transition changes what they should expect from medication. Until now the answer has been that nobody studied it well enough to say.
Takeaway: women across every reproductive stage lost substantial weight here, which is reassuring and unsurprising. The more useful finding is that someone finally bothered to stratify by menopause stage at all. Ask for this to be part of all future weight loss medication trials.
Dr. Lazarus
Clinical Nutrition Center
Greenwood Village, Colorado
Frequently Asked Questions
How much weight did women lose on CagriSema?
In a look back at data from the REDEFINE 1 trial, 2,309 women with obesity or overweight taking CagriSema 2.4/2.4 mg lost an average of 25.0% of their weight at week 68, compared with 3.0% on placebo. That is the best case, where every patient stayed on the drug and used nothing else. It is not the result an average patient should expect in routine care.
Does weight loss on CagriSema differ by menopause stage?
In a second analysis of 1,902 women, average weight loss at week 68 was 26.7% in premenopausal women, 24.8% in perimenopausal women and 23.1% in postmenopausal women, all significant against placebo. The difference between the groups was small, and the study was not built to show that the stages differ from one another. We cannot say one group responded better than another.
How reliable are these menopause findings?
Treat them as a starting point, not a settled answer. Both were looks back at data after the trial was over, and menopause stage was worked out from age, medical history and symptoms rather than measured directly. The lead author, Dr. Maria D. Hurtado Andrade of Mayo Clinic, said the differences between groups highlight the need for more research into how reproductive aging influences weight loss outcomes.
What were the side effects?
In REDEFINE 1, gastrointestinal adverse events occurred in 79.6% of participants on CagriSema compared with 39.9% on placebo. Nausea affected 55% versus 12.6%, constipation 30.7% versus 11.6%, and vomiting 26.1% versus 4.1%. Discontinuation due to adverse events was 5.9% versus 3.5%. Events were mostly transient and mild to moderate, and were mainly gastrointestinal.
Is CagriSema available yet?
No. CagriSema is not approved for use in the United States and its safety and efficacy are not established. Novo Nordisk filed a New Drug Application with the FDA in December 2025, and a decision is expected in the fourth quarter of 2026. Anyone currently offering it outside a clinical trial is not offering an approved product.
Why does menopause staging matter in obesity research?
More than 86 million women in the United States are 40 or older, the years in which perimenopause, menopause and postmenopause occur, yet reproductive stage is rarely evaluated as a factor in obesity research. Hormonal shifts across these stages can increase abdominal fat accumulation and affect body composition, weight and cardiometabolic risk. Stratifying by stage is a basic design step that has mostly been skipped.
