Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart FoundationSep 16, 2026

Obesity, hormone-based diabetes treatments, and heart disease in women

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗OA ↗

Updated Sep 17, 2026

Abstract

Obesity in women is associated with significant long-term cardiometabolic risks, including increased heart failure and ischemia.

Hormonal fluctuations from menarche to menopause influence fat distribution and metabolic risk in women.
Conditions specific to women, such as pregnancy-related weight retention and polyendocrine metabolic ovarian syndrome, may increase cardiometabolic risks.
Emerging pharmacological treatments for obesity, like incretin-based therapies, could provide substantial weight loss and cardiovascular benefits.
There is insufficient research on sex-specific differences in the efficacy and tolerability of new obesity treatments.
Reproductive health and access to care present unique challenges for women with obesity.

Simplified

Obesity in women is a growing and multifaceted public health challenge, driven by complex interactions among biological, hormonal, and psychosocial factors across the life course. From menarche to menopause, hormonal fluctuations influence fat distribution, energy balance, and metabolic risk, contributing to sex-specific trajectories of weight gain. Moreover, women-specific conditions, such as pregnancy-related weight retention, hypertensive disorders of pregnancy, and polyendocrine metabolic ovarian syndrome, further amplify long-term cardiometabolic risk. Women with obesity have an increased risk of heart failure with preserved ejection fraction and ischemia with non-obstructive coronary arteries.Emerging pharmacological treatments for obesity, including incretin-based therapies, offer an evidence-based addition to lifestyle interventions and metabolic and bariatric surgery and have demonstrated substantial weight loss effects and cardiovascular benefits. However, sex-specific differences in efficacy, tolerability, and long-term outcomes of these new pharmacological treatments remain insufficiently researched. Moreover, concerns regarding reproductive health and access to care uniquely affect women. This review addresses the need for a life course and sex-specific approach to obesity and its treatment, integrating metabolic, reproductive, and cardiovascular perspectives.

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Obesity, hormone-based diabetes treatments, and heart disease in women

Abstract

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