Clinical evaluation and treatment of obesity in women across selected life stages: a narrative review.

PURPOSE: This study was performed to synthesize current evidence on evaluating and treating obesity in women across selected life stages relevant to women's health nursing practice.

METHODS

For this invited narrative review, targeted searches of PubMed and guideline and regulatory sources available through July 2026 identified current diagnostic and staging frameworks, Korean and international guidance, pharmacotherapy evidence, official prescribing information, and literature on reproductive and menopausal physiology for synthesis. Sources were selected purposively rather than systematically.

RESULTS

The Lancet criteria for clinical obesity, the Edmonton Obesity Staging System, and a four-domain assessment of mechanical, metabolic, mental, and social milieu factors offer complementary ways to confirm adiposity, diagnose illness, stage severity, and assess health beyond body mass index. Medication selection should be based primarily on approved indications, efficacy, safety, comorbidities, reproductive plans, access, and patient preferences; phenotype-guided matching remains investigational. Care for women of reproductive age should address polycystic ovary syndrome, pregnancy intention, and the oral hormonal contraceptive precautions specific to tirzepatide. During pregnancy and lactation, appropriate weight trajectories and medication safety for the individual agent take precedence over pharmacologic weight loss. Declining estradiol during the menopausal transition is associated with central fat redistribution, while lean mass loss also reflects aging; an independent effect of follicle-stimulating hormone remains unestablished. Menopausal hormone therapy should be prescribed for established menopausal indications rather than for weight loss.

CONCLUSION

Obesity care for women should integrate disease-based assessment, individualized treatment supported by evidence, medication counseling tailored to life stage, nonstigmatizing communication, and shared decision-making. Nurses should support assessment, education, monitoring, and coordination within their scope of practice.