{"id":5236,"date":"2025-12-02T10:01:42","date_gmt":"2025-12-02T10:01:42","guid":{"rendered":"https:\/\/blogs.imperial.ac.uk\/imperial-medicine\/?p=5236"},"modified":"2025-12-02T11:07:07","modified_gmt":"2025-12-02T11:07:07","slug":"weight-hormones-and-health-rethinking-research-for-women-and-older-adults","status":"publish","type":"post","link":"https:\/\/blogs.imperial.ac.uk\/imperial-medicine\/2025\/12\/02\/weight-hormones-and-health-rethinking-research-for-women-and-older-adults\/","title":{"rendered":"Weight, hormones and health: Rethinking research for women and older adults"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" width=\"1181\" height=\"660\" class=\"size-full wp-image-5238 aligncenter\" src=\"https:\/\/blogs.imperial.ac.uk\/imperial-medicine\/files\/2025\/12\/Untitled-design-28.png\" alt=\"Dr Chioma Izzi-Engbeaya\" \/><\/p>\n<h2 class=\"Theme-Layer-BodyText-Heading-Small Theme-SubTitle Theme-Layer-BodyText-Heading-Large Theme-Title Theme-TextSize-xxsmall\"><strong>This festive period, Three Wise Women from the Faculty of Medicine give us the gift of wisdom.<\/strong><\/h2>\n<p><a href=\"https:\/\/profiles.imperial.ac.uk\/c.izzi\"><b><span data-contrast=\"none\">Dr Chioma Izzi-Engbeaya<\/span><\/b><\/a><b><span data-contrast=\"auto\">, Honorary Clinical Senior Lecturer in the <\/span><\/b><a href=\"https:\/\/www.imperial.ac.uk\/metabolism-digestion-reproduction\/\"><b><span data-contrast=\"none\">Department of Metabolism, Digestion and Reproduction<\/span><\/b><\/a> <strong>and Consultant Endocrinologist at <a href=\"https:\/\/www.imperial.nhs.uk\">Imperial College Healthcare NHS Trust<\/a><\/strong><b><span data-contrast=\"auto\"><strong>,<\/strong> explores how decades of research into obesity and metabolic health are beginning to translate into better care for women and older adults \u2013 from fertility and menopause to cancer and liver disease. But as she explains, the work is far from over: true progress means making sure no group is left behind.<\/span><\/b><\/p>\n<hr \/>\n<p><span data-contrast=\"auto\">We live in exciting times. Decades of scientific and clinical research have deepened our understanding of the factors driving metabolic conditions such as obesity and metabolic dysfunction-associated steatotic liver disease (MASLD, also known as \u2018fatty liver disease\u2019).<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Alongside this progress, we\u2019ve seen a rapid rise in treatment options for metabolic conditions, with a variety of ever-increasing options on the horizon. However, significant challenges remain. Access to effective treatments is still limited for many people, and there are gaps in the evidence needed to guide how best to manage specific groups of patients.<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><!--more--><\/p>\n<h2><b><span data-contrast=\"auto\">Spotlight on women and older adults<\/span><\/b><span data-ccp-props=\"{}\">\u00a0<\/span><\/h2>\n<p><span data-contrast=\"auto\">In recent years, there has been growing attention on women\u2019s health and the health of older adults. This focus is long overdue \u2013 both groups have been historically under-represented in many areas of research.<\/span><\/p>\n<p><span data-contrast=\"auto\">Take polycystic ovary syndrome (PCOS), for example \u2013 a condition affecting more than one in ten women in the UK, which involves both reproductive and metabolic problems. While weight loss through lifestyle changes can improve some of the problems associated with PCOS, it is often difficult to maintain.\u00a0<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">At Imperial, the <\/span><a href=\"https:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(24)00538-5\/fulltext\"><span data-contrast=\"none\">BAMBINI trial<\/span><\/a><span data-contrast=\"auto\"> showed that bariatric surgery \u2013 a type of weight-loss surgery that reduces the size of the stomach and\/or changes the digestive system \u2013 not only supports significant weight loss and improved metabolic health, but can also increase spontaneous ovulation in women with obesity and PCOS. Emerging evidence suggests that some weight loss medications may also improve reproductive function in this group of women. <\/span><\/p>\n<p><span data-contrast=\"auto\">However, these interventions come with important considerations. Because of potential risks to foetal growth in the first one to two years after bariatric surgery, and possible foetal abnormalities linked to weight loss injections, women undergoing these treatments are advised to use reliable forms of contraception and postpone attempts to conceive.<\/span><\/p>\n<h2><b><span data-contrast=\"auto\">Weight, cancer and reproductive health<\/span><\/b><span data-ccp-props=\"{}\">\u00a0<\/span><\/h2>\n<p><span data-contrast=\"auto\">Endometrial cancer, which affects the lining of the womb, is the fourth most common cancer affecting women in the UK \u2013\u202fand it\u2019s strongly associated with obesity. Research suggests that bariatric surgery can lower the risk of developing this cancer in women with obesity.<\/span><\/p>\n<p><span data-contrast=\"auto\">Now, studies are exploring whether weight loss injections medications that act on glucagon-like peptide-1 (GLP-1) receptors could improve treatment responses in early-stage endometrial cancer. If proven effective, these approaches could revolutionise care, offering alternatives that do not require removal of the womb.<\/span><\/p>\n<p><span data-contrast=\"auto\">This could make a life-changing difference for older women, as well as younger women who wish to preserve fertility during cancer treatment.<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<h2><b><span data-contrast=\"auto\">Healthy ageing<\/span><\/b><span data-ccp-props=\"{}\">\u00a0<\/span><\/h2>\n<p><span data-contrast=\"auto\">Life expectancy is increasing in many parts of the world \u2013 but so too is obesity, including among people over 65. In England, more than a quarter of people in this age group are living with obesity.<\/span><\/p>\n<p><span data-contrast=\"auto\">Older adults are often under-represented in clinical research studies, leaving limited data to guide safe and effective obesity management for them. There are concerns that weight loss interventions may worsen sarcopenia (low muscle mass or function), which is more common as people grow older.<\/span><\/p>\n<p><a href=\"https:\/\/journals.lww.com\/international-journal-of-surgery\/abstract\/9900\/safety_and_efficacy_of_bariatric_or_metabolic.3235.aspx\"><span data-contrast=\"none\">Our research<\/span><\/a><span data-contrast=\"auto\"> has shown that for appropriately selected older adults with obesity, bariatric surgery can be both safe and effective \u2013 and it may be <\/span><a href=\"https:\/\/www.thelancet.com\/journals\/lanhl\/article\/PIIS2666-7568(25)00091-1\/fulltext\"><span data-contrast=\"none\">linked to a reduced risk of death within 10 years<\/span><\/a><span data-contrast=\"auto\">. These findings highlight the importance of evidence-based care tailored to older populations.<\/span> <span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<h2><b><span data-contrast=\"auto\">Menopause, metabolism and liver health<\/span><\/b><span data-ccp-props=\"{}\">\u00a0<\/span><\/h2>\n<p><span data-contrast=\"auto\">Globally, more than one in three adults are estimated to have MASLD, a condition closely tied to obesity and type 2 diabetes. In people with MASLD, the leading causes of death are cardiovascular disease and cancer \u2013 but increasingly, liver failure is becoming a major concern.<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">After menopause, women face higher risks of developing MASLD compared to pre-menopausal women, and they may also be at higher risk of progressing to more advanced disease. In the US, MASLD is now the number one cause of liver transplantation in women aged over 55. As approximately half of the world\u2019s population is female \u2013 and women spend roughly a third of their lives post-menopause \u2013 understanding these risks is critical.<\/span><\/p>\n<p><span data-contrast=\"auto\">Some of my research focuses on finding ways to improve the health and wellbeing of post-menopausal women with MASLD, and I look forward to sharing new insights as our work progresses.<\/span><span data-ccp-props=\"{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;201341983&quot;:0,&quot;335551550&quot;:1,&quot;335551620&quot;:1,&quot;335559685&quot;:0,&quot;335559737&quot;:0,&quot;335559738&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:278}\">\u00a0<\/span><\/p>\n<h2><b><span data-contrast=\"auto\">Next Steps<\/span><\/b><span data-ccp-props=\"{}\">\u00a0<\/span><\/h2>\n<p><span data-contrast=\"auto\">In recent years, we\u2019ve witnessed remarkable progress in our understanding and management of metabolic conditions. However, it is apparent that there is room for improvement. We must continue to push for inclusivity in research.<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">By ensuring that women, older adults, and other under-represented groups are included in research, we can address the gaps in our knowledge and move closer to truly personalised, evidence-based strategies to manage these health conditions.\u00a0<\/span><span data-ccp-props=\"{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;201341983&quot;:0,&quot;335551550&quot;:1,&quot;335551620&quot;:1,&quot;335559685&quot;:0,&quot;335559737&quot;:0,&quot;335559738&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:278}\">\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>This festive period, Three Wise Women from the Faculty of Medicine give us the gift of wisdom. Dr Chioma Izzi-Engbeaya, Honorary Clinical Senior Lecturer in the Department of Metabolism, Digestion and Reproduction and Consultant Endocrinologist at Imperial College Healthcare NHS Trust, explores how decades of research into obesity and metabolic health are beginning to translate [&hellip;]<\/p>\n","protected":false},"author":521,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[303115],"tags":[272422,708,294,14643,211,81,295897,19316],"class_list":["post-5236","post","type-post","status-publish","format-standard","hentry","category-department-of-metabolism","tag-disease-awareness","tag-equality","tag-global-health","tag-obesity","tag-public-health","tag-research","tag-three-wise-women","tag-women-in-science"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - 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