Integrating obesity management into menopause care recommendations comments on the 2025 European Society of Endocrinology clinical practice guideline for evaluation and management of menopause and the perimenopause

Obesity is highly prevalent among women during the menopausal transition, yet current guidelines still offer limited direction on how to address it in this context. In this Letter, we emphasize the need to incorporate obesity assessment and treatment into menopause care. Obesity worsens vasomotor and genitourinary symptoms and alters the risk profile of menopausal hormone therapy, particularly increasing thromboembolic risk with oral formulations. A more integrated approach-combining hormone therapy with obesity management strategies-could improve metabolic outcomes, relieve symptoms, and lower long-term cardiovascular and oncologic risks. Future guidelines should explicitly address this overlap to support more individualized care for women in midlife.