Women taking an experimental weekly weight-loss shot from Novo Nordisk lost about a quarter of their body weight on average, whether they had not yet reached menopause, were going through it, or were past it. That is the finding of two new analyses of a large trial of the shot, called CagriSema, presented at The Menopause Society 2026 Annual Meeting in San Diego, held October 20 to 241. Novo announced the results on October 202.
Over 68 weeks, women on CagriSema lost an average of 26.7% of their weight before menopause, 24.8% around menopause (perimenopause) and 23.1% after menopause. Women who got a placebo (a dummy shot) lost 2.1%, 1.7% and 2.6%2. The women also saw lower blood pressure, blood sugar and blood fats called triglycerides3.
What CagriSema is
CagriSema combines two medicines in one weekly injection. One is semaglutide, a drug that copies the gut hormone GLP-12 and is the active ingredient in Wegovy and Ozempic4. The other is cagrilintide, a long-lasting copy of amylin, a hormone that also helps the body feel full2. Novo has said CagriSema could be the first approved combination of these two types of medicine for weight management2.
The new numbers come from REDEFINE 1, a trial of 3,417 adults without type 2 diabetes who had obesity, or were overweight with at least one weight-related health problem1. People were assigned by chance to CagriSema, semaglutide alone, cagrilintide alone or a dummy shot, and everyone also got diet and exercise support. Neither the volunteers nor the doctors knew who got what5. About two-thirds of the volunteers were women5.
The results by menopause stage
The menopause analysis looked at 1,902 women: 1,441 on CagriSema and 461 on the dummy shot1. Researchers sorted them into premenopausal, perimenopausal and postmenopausal groups, and put women taking menopause hormone therapy in a fourth group of their own1. Women on hormone therapy lost 25.6% of their weight on CagriSema, against 2.3% on the dummy shot1. One trade outlet noted that Novo’s press release did not report this hormone-therapy result5.
Large losses were common in every group. Between 63.2% and 78.3% of women on CagriSema lost at least a fifth of their body weight, the highest share being premenopausal women. On the dummy shot, 1.2% to 3.0% did1. Between 91.0% and 95.1% of women on CagriSema lost at least a tenth of their weight1. Waist size, a rough sign of belly fat, shrank by 19.2 to 21.7 centimeters across the groups3.
A second analysis looked at all 2,309 women in the trial, whatever their menopause stage. Women lost 25.0% of their weight on CagriSema, 19.0% on semaglutide alone, 13.4% on cagrilintide alone and 3.0% on the dummy shot2. Nearly 3 in 10 women on CagriSema (29.5%) lost at least 30% of their weight, against 0.3% on the dummy shot1.
Heart and blood sugar measures
Across the women given CagriSema or a dummy shot, fasting blood sugar fell by 11.8 mg/dL on CagriSema versus 2.0 mg/dL on the dummy shot, and the top number of blood pressure fell by 11.1 mmHg on CagriSema1. A measure of insulin resistance, how poorly the body responds to insulin, also improved more on the shot1.
The poster’s authors wrote that blood pressure, fasting blood sugar and triglycerides improved significantly in every group, “whereas changes in cholesterol were variable”3. These are risk factors, not heart attacks or strokes. The analysis does not report on those events.
What this does not show yet
Several limits matter here, and the researchers and Novo point many of them out themselves.
- Groups sorted after the fact. The trial was not designed to compare menopause stages. Researchers assigned each woman’s stage afterwards, using age, medical history and recorded symptoms, not hormone blood tests or staging collected during the trial2.
- Differences between stages are not confirmed. Weight loss was numerically larger before menopause, but the researchers did not run the statistical test that checks whether menopause stage really changes the response. So the data do not show that it does1.
- Best-case estimates. The figures assume every woman stayed on treatment and used no other weight-loss methods5. The trial’s main report, which counts everyone regardless of whether they stopped, found an average loss of 20.4% on CagriSema versus 3.0% on the dummy shot across all adults5.
- Not peer reviewed. The results were shown as a meeting poster6. Novo called the analyses “hypothesis generating”2, meaning they raise questions for future studies rather than settle them.
Side effects in the full trial were mostly in the gut: 79.6% of people on CagriSema had them, against 39.9% on the dummy shot. These included nausea (55% vs 12.6%), constipation (30.7% vs 11.6%) and vomiting (26.1% vs 4.1%), and were mostly short-lived and mild to moderate, Novo said. Some 5.9% of people on CagriSema stopped because of side effects, against 3.5% on the dummy shot2.
The lead author, Maria D. Hurtado Andrade of Mayo Clinic, told Pharmacy Times that fast, large weight loss calls for close follow-up in midlife and older women, including watching for loss of muscle and possible effects on bone, since women after menopause are already at higher risk of losing both5.
Who is behind it
Novo Nordisk sponsors the REDEFINE 1 trial7. Of the seven authors on the menopause poster, four list Novo Nordisk as their employer. The others are Hurtado Andrade of Mayo Clinic, Emilia Huvinen of the University of Helsinki and Nanette F. Santoro of the University of Colorado School of Medicine6. The poster is hosted on Novo’s own website for health professionals6.
“The weight loss observed in each group is encouraging, and the numerical differences among the groups highlight the need for further research to better understand how reproductive aging may influence weight loss outcomes in women.”
That is how Hurtado Andrade described the findings in Novo’s press release2. Novo argues that menopause stage is rarely examined in obesity research, even though hormonal shifts during menopause can add belly fat and raise heart and metabolic risk2.
How it fits the field
CagriSema’s results so far have been mixed when set against rivals. In a separate head-to-head trial of 809 people, called REDEFINE 4, CagriSema led to 23% average weight loss over 84 weeks but did not meet its goal of matching the highest dose of Eli Lilly’s tirzepatide (sold as Zepbound), which led to 25.5%3. CagriSema differs from Zepbound in which hormone signals it copies: GLP-1 and amylin, rather than GLP-1 and another gut hormone called GIP4.
The menopause analysis does not compare CagriSema with other drugs. It only shows how women in one trial fared against a dummy shot and against each half of the combination.
What to watch next
Novo filed for US approval of CagriSema for weight management in December 2025 and expects a decision from the FDA in the last three months of 20268. Until then, the shot is not approved in the United States8.
REDEFINE 1 also has a follow-up stage. Some volunteers continue for about two more years without any study medicine, so researchers can see what happens to their weight and weight-related illnesses after the shots stop7. A trial that collects menopause stage from the start, with hormone tests, would be needed to show whether stage really changes how much weight women lose on the shot.
