The prevalence of obesity is rising dramatically, impacting adversely on health and well-being at the menopause and across the lifespan. With menopause, abdominal adiposity selectively increases. The impact of obesity and abdominal adiposity on chronic disease, including diabetes and cardiovascular disease, is significant and quality of life is adversely affected. Yet accurate perception of the weight-related health-risk profile is lacking and there is inadequate focus on prevention and treatment of obesity and its complications. Research aimed at prevention and management of obesity at menopause is limited. Accurate risk perception, education and translation programs highlighting obesity risks and supporting sustainable lifestyle changes are needed, particularly around menopause.