Relationship between BMI trajectories and cardiometabolic outcomes in postmenopausal women: a growth mixture modeling approach

•The prevailing understanding is that most women gain weight in the postmenopausal period. Many studies on obesity in older adults have relied on a single point exposure and self-report height and weight to assess the relationship between BMI and adverse health outcomes.•We found limited evidence of BMI change, either gain or loss, over time in this large sample of postmenopausal women.•Despite the lack of change in BMI, there was a clear relationship between high BMI with higher likelihood of diabetes and cardiovascular disease.•It is important for researchers and clinicians to understand the lack of change in women's BMI after menopause. However, that does not mean BMI in older women is uninformative. Women with high BMI should be counseled with effective interventions to lower BMI even though they are in an older age group.