(P28-03-26) Nearly Half of U.S. Perimenopausal Women Meet Eligibility for GLP-1–Based Anti-Obesity Medications: NHANES 2013–2023

Objectives: To quantify national eligibility for GLP-1 receptor agonist (GLP-1RA) anti-obesity medications among U.S. perimenopausal women and to characterize the cardiometabolic risk profile of treatment-eligible individuals using NHANES data.

Methods: We conducted a cross-sectional analysis of U.S. women aged 42–60 years using pooled NHANES 2013–2023 data. Perimenopausal status was defined using reproductive health questionnaire responses. Eligibility for GLP-1 receptor agonist anti-obesity medications was based on FDA-aligned criteria (BMI ≥30 kg/m² or BMI ≥27 kg/m² with ≥1 obesity-related comorbidity). Survey-weighted estimates and adjusted logistic regression models were used to assess eligibility patterns.<

Results: The analytic sample included 2,167 women aged 42–60 years with complete reproductive and clinical data. Overall, 48.0% (95% CI, 44.4–51.5) of perimenopausal women met FDA-aligned eligibility criteria for GLP-1 receptor agonist anti-obesity medications, compared with 35.4% (95% CI, 34.3–36.4) of non-perimenopausal women. Eligibility prevalence was consistently high across age strata ( < 45, 45–54, ≥55 years), remaining near 45–50%. Most eligible perimenopausal women qualified based on BMI ≥30 kg/m² (75.1%), while 24.9% qualified via BMI 27.0–29.9 kg/m² with comorbidity. Cardiometabolic burden among eligible women was substantial: 70–80% reported dyslipidemia and 40–69% reported hypertension. After adjustment for age, race and ethnicity, education, income-to-poverty ratio, smoking status, and insurance coverage, perimenopausal status was independently associated with higher odds of eligibility (adjusted OR 1.22; 95% CI, 1.01–1.46).

Conclusions: Nearly half of U.S. perimenopausal women meet FDA-aligned eligibility criteria for GLP-1 receptor agonist anti-obesity medications and carry a high burden of cardiometabolic risk. Although the independent association with perimenopausal status was modest, the magnitude and consistency of eligibility across midlife age groups underscore perimenopause as a critical window for obesity risk identification and intervention. These findings provide national context for rising GLP-1RA use and highlight the need for proactive cardiometabolic screening and integrated obesity care in midlife women.

Funding Sources: None