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Obesity prevalence among females in the United States continues to rise across the lifespan, imposing a substantial burden on individuals and the health care system through an increasing number of preventable, excess weight-attributable disabling diseases and mortality. A clearer understanding of the impact of obesity and treatment interventions on outcomes for reproduction, cardiometabolic risk, musculoskeletal health, and mental health at various life stages is critical to optimizing management strategies for women with obesity.

This narrative clinical review synthesizes published literature and expert perspectives regarding obesity-related risk factors, health outcomes, and treatment considerations related to obesity in women, including the impact of obesity medications across the lifespan.

Adiposity influences reproductive, cardiometabolic, musculoskeletal, and mental health outcomes across the female lifespan. During adolescence, early pubertal onset and metabolic dysfunction are common. In reproductive years, infertility, polyendocrine metabolic ovarian syndrome, and pregnancy complications are prominent. Perimenopause is associated with vasomotor symptoms, sleep disruption, and increased cardiovascular risk. In older age, risks for cancer, functional decline, and frailty increase. Pharmacologic therapies, including incretin-based agents, demonstrate efficacy in weight reduction and cardiometabolic improvement, although life stage-specific safety and outcome data remain limited.

Obesity management in women requires individualized, life stage-specific approaches integrating lifestyle interventions and pharmacotherapy. Additional research is needed to clarify long-term outcomes and optimize treatment strategies across the lifespan.