‘Ozempic Face’ Has Nothing To Do With The Diabetes Drug Itself

·6 min read
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What Is ‘Ozempic Face?’Gravity Images - Getty Images

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Ozempic is one of the most talked about weight-loss drugs these days. While celebs and influencers rave about dropping pounds quickly with the medication, few have mentioned the downsides. Now that Ozempic has gone mainstream, at least one side effect has come to light: "Ozempic face."

The phrase refers to a gaunt appearance of the face in those who take Ozempic, says Joshua Zeichner, MD, an associate professor of dermatology and the director of cosmetic and clinical research in dermatology at Mount Sinai. To be clear, though, the medication itself does not have a direct effect on your face, but rather it "leads to rapid weight loss that has an impact both on the body and the face," he says.

ICYMI, Ozempic is an FDA-approved prescription medication used to treat type 2 diabetes in adults, explains Natasha Bhuyan, MD, a family medicine physician with One Medical.

Ozempic itself is not FDA-approved for weight loss. But the active ingredient in the drug, semaglutide, is and it's available at a higher dose in another medication, Wegovy, which is used to treat obesity related to high blood pressure, type 2 diabetes, or high cholesterol. "Some clinicians do prescribe Ozempic off-label for weight loss. But doctors use careful criteria to determine if the medication is right for an individual," Dr. Bhuyan says—such as BMI or body-fat percentage.

Meet the experts:

Joshua Zeichner, MD, is an associate professor of dermatology and the director of cosmetic and clinical research in dermatology at Mount Sinai.

Benjamin Bikman, PhD, is a professor of cell biology and physiology at Brigham Young University who studies metabolic function.

Natasha Bhuyan, MD, is a family medicine physician with One Medical.

Here's what you need to know about "Ozempic face," other side effects you may experience while on the medication, and what you can do to reverse the changes to your skin.

First: What is Ozempic and how does it work?

Ozempic is a weekly injection designed to improve blood sugar control. Its active ingredient semaglutide mimics the action of a hormone naturally found in the body that stimulates insulin release after you eat called glucagon-like peptide-1 (GLP-1). The extra insulin helps lower blood sugar and prevent spikes. GLP-1 also signals fullness, helping to suppress appetite and reduce food intake.

Basically, Ozempic works by slightly elevating metabolic rate and increasing fat burning from fat cells, says Benjamin Bikman, PhD, a professor of cell biology and physiology at Brigham Young University who studies metabolic function and co-founder of HLTH Code.

Why does “Ozempic face” happen?

The name may sound new and scary, but "Ozempic face" is simply skin sagging caused by rapid weight loss, not unlike what you'd see after bariatric surgery and extreme dieting. "Think of your face as an over-inflated balloon: If you let the air out, the stretched out balloon will sag as it shrinks down to its smaller size," explains Dr. Zeichner.

The sagging is the result of a loss of fat and muscle under the skin. "As people lose weight, they tend to lose muscle mass, which can result in skin laxity. Rapid weight loss will cause skin laxity and loss of elasticity, especially if people aren't exercising and getting appropriate nutrition," adds Dr. Bhuyan. "Genetics can also play a role."

Note that so-called Ozempic face does not happen to everybody who takes the medication. This is another reason why it’s important to have careful medical monitoring when taking Ozempic, Dr. Bhuyan notes.

What other side effects can Ozempic cause?

The side effects associated with the use of this drug include nausea, diarrhea, abdominal pain, constipation, headache, says Dr. Bhuyan.

The best way to avoid these effects is checking with your doctor to make sure Ozempic is a good fit for you. "Only people with a certain BMI or higher should be prescribed this," says Dr. Bhuyan. "And it’s important to understand their goals of taking this and their ability to make other lifestyle changes before prescribing this to anyone."

For those who don’t meet the BMI threshold, there are alternative paths to lose weight. "Some people benefit from meal planning, using an app to track their activity, a nutrition consult, and more,"Dr. Bhuyan says.

People with a personal or family history of medullary thyroid carcinoma, a cancer that forms in the inside of the thyroid gland, or multiple endocrine neoplasia type 2 syndrome, which causes tumors to form on the endocrine glands, should definitely stay away from this drug. "There are other conditions, like pancreatic disorders, where the medication might not be safe," Dr. Bhuyan adds. When in doubt, talk to your doctor first.

So, can you fix “Ozempic face?”

Please note: The facial impact of Ozempic does not truly need to be "fixed" since there is nothing technically wrong with it, Dr. Zeichner says. Still, if how your skin looks after starting Ozempic really bothers you, there are a number of dermatological treatments that can restore lost volume under the skin.

  • Injectables and fillers. "It’s not about filling a line or a fold, but rather full facial volume restoration," explains Dr. Zeichner. "This can be accomplished with a variety of fillers, including Restylane, Juvederm, Sculptra, or Radiesse. It’s important to touch base with your doctor to decide which product is right for you."

  • Face lift. If you're in your 40s and above, you may be a candidate for a face lift, says Amir Karam, MD, a facial plastic surgeon in San Diego, California. "People have these types of surgeries all the time after bariatric surgery when they're morbidly obese and have massive weight loss," he says. "They undergo a full body post-bariatric transformation, including contouring and tightening, as a result of all that loose extra fascia and skin that is unable to retighten following weight loss."

Note that these treatments are usually not covered by insurance and they can be pricey. "Generally speaking, fillers cost between $800 and $1,200 per syringe. In some cases, patients may require up to five or six syringes to see significant improvements," says Dr. Zeichner. "But the good news is that the effects are long-lasting and can remain for upwards of two years."

Ultimately, Ozempic may not be the safest (or healthiest) way to lose weight if you are not a legitimate candidate for the drug. "I’ve had patients request Ozempic because they want to use it short-term to jumpstart weight loss," says Dr. Bhuyan. "However, studies show that when people stop using Ozempic, many regain some of the weight they have lost. This is why it’s important to truly understand different aspects of the medication before using it. It might be the right approach for some people, but others might not benefit."

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