Does Veozah Cause Weight Gain?
Key Takeaways
- Weight gain was not identified as a common side effect of Veozah in clinical trials.
- Veozah is a non-hormonal medication that treats hot flashes and night sweats by targeting temperature regulation in the brain.
- Some people may notice weight changes during menopause for reasons unrelated to Veozah, including hormonal shifts, sleep disruption, and lifestyle factors.
- Liver-related side effects are monitored closely with Veozah and are more clinically relevant than weight changes.
- A healthcare provider can help determine whether weight gain is related to Veozah, menopause itself, or another medical condition.
What Is Veozah?
Veozah is the brand-name prescription drug fezolinetant, approved by the FDA to treat moderate to severe vasomotor symptoms of menopause. Vasomotor symptoms include hot flashes, hot flushes, and night sweats, which are among the most disruptive symptoms of menopause and perimenopause.
Veozah is a non-hormonal medication, meaning it does not contain estrogen or progesterone and does not function as hormone replacement therapy (HRT). Instead, it targets a specific pathway in the brain involved in regulating body temperature.
The active ingredient, fezolinetant, was developed by Astellas and is taken once daily as an oral prescription drug.
How Veozah Works in the Body
Veozah works by blocking neurokinin B signaling at the neurokinin 3 receptor in the hypothalamus. This area of the brain helps regulate body temperature.
During menopause, declining estrogen levels disrupt temperature control, leading to severe hot flashes, night sweats, and trouble sleeping. Neurokinin B activity becomes overactive, contributing to these vasomotor symptoms.
By acting as a receptor antagonist, Veozah reduces abnormal heat signaling without altering estrogen levels. Because it does not affect estrogen or progesterone, it avoids many of the systemic effects associated with hormone therapy.
Importantly, this mechanism does not directly influence appetite, fat storage, or energy metabolism.
Is Weight Gain a Side Effect of Veozah?
Weight gain is not listed as a common side effect of Veozah in FDA-approved labeling or clinical trials. In placebo-controlled studies, weight gain rates were similar between people taking Veozah and those receiving a placebo.
This suggests that Veozah itself does not cause weight gain.
Unlike hormone replacement therapy, which can sometimes influence fluid retention or body composition, Veozah does not alter estrogen levels and therefore does not carry the same metabolic considerations.
Why Some People Notice Weight Changes While Taking Veozah
Although Veozah does not appear to cause weight gain directly, weight changes are common during menopause for several reasons.
Menopause-related hormonal changes
Menopause is associated with shifts in estrogen levels that can affect fat distribution, insulin sensitivity, and energy balance. These changes occur regardless of whether a person takes Veozah, hormone therapy, or no medication at all.
Sleep disruption and fatigue
Night sweats and severe hot flashes often disrupt sleep. Poor sleep can influence hunger hormones, physical activity levels, and overall weight regulation. If Veozah improves sleep, some people may notice improved energy and even modest weight loss over time.
Reduced activity due to symptoms
Back pain, fatigue, or discomfort related to menopause can reduce physical activity. Lower activity levels may contribute to gradual weight gain that is unrelated to medication.
Other medical conditions
Conditions such as liver disease, kidney disease, thyroid disorders, or metabolic changes can affect body weight.
What Clinical Trials Show About Veozah and Weight
In clinical trials evaluating Veozah for severe vasomotor symptoms, researchers focused on the frequency and severity of hot flashes, night sweats, and quality-of-life measures. Weight gain was not identified as a clinically meaningful adverse effect.
Rates of reported weight gain were comparable between the Veozah and placebo groups, suggesting no causal relationship.
The most common side effects observed in trials included headache, abdominal pain, back pain, and elevations in liver enzymes, not changes in body weight.
Common and Serious Side Effects of Veozah
Common side effects
The most common side effects of Veozah reported in clinical trials include:
- Headache
- Abdominal pain
- Back pain
- Nausea
- Diarrhea
- Trouble sleeping
These side effects are usually mild to moderate and often improve as your body gets used to the medication.
Liver-related side effects
Veozah can affect liver function, which is why liver enzymes are monitored with blood tests before starting treatment and periodically thereafter.
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Possible signs of liver problems include:
- Elevated liver enzymes
- Yellowing of the skin or eyes
- Dark urine
- Persistent abdominal pain
People with cirrhosis, active liver disease, or significant liver damage should not take Veozah.
Serious side effects
Serious side effects are uncommon but may include:
- Liver injury
- Allergic reaction
- Severe abdominal pain
If you experience any serious or persistent side effects, seek immediate medical attention.
Drug Interactions
Veozah can interact with certain prescription drugs that affect liver enzymes involved in drug metabolism.
Examples include:
- Fluvoxamine
- Ciprofloxacin
These drug interactions can increase fezolinetant levels in the body and raise the risk of side effects, particularly liver-related effects. Always review prescription drugs, over-the-counter medications, and supplements with a healthcare provider before starting Veozah.
Veozah Compared to Hormone Therapy
Hormone replacement therapy, which may include estrogen or combined estrogen and progesterone, can sometimes influence weight through fluid retention or changes in body composition.
Veozah works differently. As a non-hormonal medication, it does not raise estrogen levels and does not appear to carry the same risk of weight gain associated with some hormone therapies.
For people who cannot use HRT due to breast cancer risk, liver disease, or other medical conditions, Veozah provides an alternative option for managing vasomotor symptoms.
What to Do If You Notice Weight Gain
If you experience weight gain while taking Veozah:
- Do not stop the medication without talking to your doctor first.
- Consider whether menopause-related changes or lifestyle factors may be contributing.
- Review sleep quality, activity levels, and diet.
- Talk with a healthcare professional about blood tests or further evaluation.
Special Populations and Precautions
Liver disease
People with liver disease or abnormal liver function tests require careful evaluation before starting Veozah. The medication is contraindicated in certain liver conditions.
Kidney disease
Kidney problems do not appear to significantly affect Veozah metabolism, but overall medical conditions should be reviewed.
Breastfeeding
It is not known whether fezolinetant passes into breast milk. Medical advice is recommended before using Veozah while breastfeeding.
Bottom Line
Veozah does not appear to cause weight gain. Clinical trials and FDA data do not show a meaningful difference in weight changes between people taking Veozah and those taking a placebo. Weight changes during menopause are common and are usually driven by hormonal shifts, sleep disruption, and lifestyle factors rather than Veozah itself. If weight gain occurs, a healthcare provider can help determine the underlying cause and adjust care as needed.
FAQs
Does Veozah cause weight gain?
Weight gain is not a known or common side effect of Veozah.
Can Veozah cause weight loss?
Veozah is not intended for weight loss, but improved sleep and reduced night sweats may indirectly support healthier routines for some people.
Is weight gain more common with hormone therapy than Veozah?
Hormone therapy can affect weight in some individuals. Veozah does not affect estrogen levels and has not shown the same association.
Should I stop Veozah if I gain weight?
No. Always consult a healthcare provider before stopping prescription drugs.
Sources
- Veozah- fezolinetant tablet, film-coated [package insert]. Astellas Pharma US, Inc. Last updated 12/2024. Accessed Jan 5, 2026.