I've been on it at the 0.75 dosage since my complete hysterectomy (BEST THING I EVER DID) about 10 yrs ago.
I've never had any issues. In the beginning I used it exactly as Dr ordered and changed 2x per week. In the last 2 yrs, I have not been as routine and usually change it about once a week. Dr. said that is fine because at 49 if I wean off of it, it is no big deal.
The only thing I noticed is 1 time when I went 2 weeks without it to "experiment" I had my first hot flash. I went back on at 2x week until it leveled out and I stick to 1 per week now.
I never had weight gain, but then I've never had any type of weight issue. I am 5'5", petite size 2 about 116#. My boobs did get bigger which was a perk for me!! I am a perky natural 34DD and before surgery I was probably a large C-small D. Sex drive skyrocketed but I don't know if that is due to the patch or the newfound freedom of knowing there could be no oopsie!
All RX have pros and cons. This is the only RX I use. For me, it was the best decision.... I've never felt better in my life!