Impact of Obesity in Women Health and Approach to Optimize Obesity Care with Glucagon-like Peptide-1 Receptor Agonist

Obesity has a disproportionate impact on women’s health across the life course, influencing reproductive, metabolic, cardiovascular, and functional outcomes from menarche to menopause and beyond. This chapter examines the burden of obesity in women and its interface with polycystic ovary syndrome (PCOS), infertility, and heart failure with preserved ejection fraction (HFpEF), while positioning semaglutide as a phenotype-driven therapeutic option within women-centered obesity care. The chapter integrates epidemiologic data, women-specific pathophysiology, and contemporary clinical evidence, including PCOS literature, fertility-related weight-loss data, the 2022 American Heart Association/American College of Cardiology/HFSA heart failure guideline, and Semaglutide Treatment Effect in People with Obesity and HFpEF (STEP-HFpEF)/STEP-HFpEF with diabetes findings. Obesity in women is linked to hyperinsulinemia, hyperandrogenism, chronic inflammation, impaired ovulation, infertility, visceral and epicardial adiposity, and obesity-related HFpEF. Across these domains, semaglutide is presented as a clinically meaningful intervention that can support weight reduction, metabolic improvement, reproductive benefit, and cardiometabolic risk reduction. The chapter emphasizes early risk identification beyond body mass index alone, individualized counselling across reproductive stages, and outcomes-based monitoring relevant to women’s health. Overall, semaglutide is positioned as an important adjunct within a comprehensive strategy to optimize obesity care in women through metabolic, reproductive and cardiometabolic pathways.