The “Ozempic face”, a visible sign of excessive weight loss

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In recent months, Ozempic and Wegovy have been in the news because many people have used these drugs in order to quickly lose a lot of weight. But as they lost pounds and dress sizes, some noticed surprising changes in their appearance, such as having what is now known as the “Ozempic face.”

Unexpectedly, the drug can also cause “Ozempic butt” (which, like “Ozempic face,” is neither an official medical term nor diagnosis). These phenomena, which have become viral on social networks, are linked to very rapid weight loss obtained thanks to the use of glucagon-like peptide-1 analogues (such as Ozempic and Wegovy). Affected people may end up with a gaunt, more wrinkled face due to loss of volume and fat in the face, or a flabby butt with loose skin due to loss of fat there.

“This is in no way a phenomenon specific to Ozempic, but a consequence of weight loss. If you use the drug for this purpose, you risk having excess skin, especially on the face, such as after bariatric surgery,” explains Lawrence Cheskin, professor and former chair of the Faculty of Nutrition and Food Studies at George Mason University and assistant professor of medicine at Johns Hopkins School of Medicine. “There is no major weight loss in the face. You just notice it more on the face because it’s always visible. »

Ozempic and Wegovy are the same drug (semaglutide, a GLP-1 analog), but they are marketed differently: the US Food and Drug Administration has approved Ozempic to treat type 2 diabetes when Wegovy is for weight loss. Both are only available on prescription.

“These medications are a game changer because they are very effective for weight loss,” says Cheskin. Indeed, research showed that adults with a body mass index of 30 or higher who received a weekly injection of 2.4 milligrams of semaglutide, and who made lifestyle changes, lost an average of 15% of their body weight over time .

But here’s the problem: “When you lose weight quickly, you’re more likely to suffer from adverse effects,” notes Cheskin.

“Any type of weight loss is associated with visceral fat loss [autour des organes abdominaux]subcutaneous fat [sous la peau] and muscles,” says Caroline M. Apovian, an obesity medicine specialist and co-director of the Center for Weight Management and Wellness at Brigham and Women’s Hospital. “We lose fat absolutely everywhere, but our genetic predispositions determine the places where we will lose the most. »

And as countless dieters have unfortunately discovered over the years, it’s impossible to control which areas the body sheds excess fat from.

“We can’t target weight loss to one place in the body,” says Robert Kushner, an obesity medicine specialist and professor in the department of medicine and medical education at the University’s Feinberg School of Medicine. Northwestern University, Chicago.

Where you’re likely to lose subcutaneous fat depends at least partly on genetic factors and the quality of your diet. The good news is that if you lose a lot of weight, there will be less visceral fat around organs, such as around the liver, kidneys and heart, which can help those organs function better, says Apovian. “You will undoubtedly be healthier metabolically. »

She also points out that weight loss reduces pressure on joints and alleviates joint inflammation. “If you lose five kilos, it’s like taking about fifteen kilos of pressure off your joints,” Cheskin points out. In addition to alleviating wear and tear on joints, lighter weight can improve mobility because the body is moving less weight.

Unfortunately, such weight loss leads to loss of muscle mass, says Kushner. “This is not good for you because it can cause body weakness, fatigue, and even lead to sarcopenia,” a progressive loss of muscle mass and strength that occurs with aging. This is why it is essential to have sufficient protein intake and regular strength training alongside weight loss.

You may also experience skin changes and hair loss following significant weight loss. “The faster the weight loss and the greater the calorie deficit, the more the body begins to downregulate systems that are not essential to its survival,” says Kushner. This can hinder the proliferation of hair, nail and skin cells, resulting in hair loss, brittle nails and loss of skin elasticity. These functions will eventually recover, but it will likely take time.

At the same time, your face may display laxity of the skin, particularly at the temples, a deepening of the tear valley and jaw, as well as more pronounced wrinkles, notes Elizabeth O’Neill, surgical resident. plastic and reconstructive at Rush University Medical Center in Chicago. “People want to lose fat, but forget that it’s fat that makes us look young. »

Of the research demonstrated that people who lost weight drastically could appear up to five years older than people their own age.

In comparison, “by losing weight slowly, you can avoid these skin and hair changes to some extent,” says Cheskin. “This gives the skin more time to adapt and retract. »

To prevent rapid weight loss, doctors may prescribe a lower dose of these medications and increase it slowly, if necessary.

“If you are taking these medications, you should be monitored by a healthcare professional to monitor the extent of weight loss and adjust the pace,” says Kushner.

You also have the option of changing medications: “if you lose weight too quickly with Ozempic, you can switch to Mounjaro [un médicament qui associe un analogue du GLP-1 et un polypeptide insulinotrope dépendant du glucose] or vice versa,” says Cheskin. “People react differently to medications, even if they are in the same class. »

In addition to taking treatment, it is important to eat a balanced diet, including plenty of nutrient-rich fruits and vegetables, dairy products, whole grains and lean proteins, and to drink plenty of water to maintain hydration of the skin and other tissues. THE research suggest that it is best to distribute protein intake evenly throughout the day to preserve muscle mass during weight loss.

To do this, Apovian recommends consuming 1 to 1.5 grams of protein per kilogram of body weight. For a person weighing 70 pounds, that’s 70 to 105 grams of lean protein per day.

Another essential measure: practicing significant physical activity, combining resistance or weight training exercises two to three times a week to help you maintain your muscle mass, and regular aerobic exercises for the good of your cardiovascular health and to maintain your weight loss, says Apovian.

Ultimately, obesity medicine specialists believe these cosmetic changes represent a minimal trade-off compared to the benefit of these breakthrough drugs. After all, with the exception of muscle loss, these are cosmetic problems, not medical problems.

“These drugs save lives,” says Apovian. “If they become more accessible, we can change the face of society by ending the obesity epidemic. »