What is Ozempic face ? What to know about this possible side effect
Medically Reviewed by Chimene Richa, MD, Ro; Written by Amelia Willson
Last updated: Feb 21, 2023
9 min read
If you’ve spent any time on social media lately, you’ve likely heard of the prescription drug Ozempic. Considering the hashtag #ozempicface has almost 5 million views on TikTok, it’s likely you’ve heard of “Ozempic face,” too. But, what is it exactly?
Ozempic face describes the wrinkling, sagging, and general loss of volume in the face that can occur with significant weight loss — with or without using Ozempic. So, why is it called Ozempic face, and is there anything you can do to prevent it when losing weight?
Read on as we explain.
What is Ozempic face?
“Ozempic face” refers to the changes in facial appearance that can occur when a person experiences a lot of weight loss, which can happen when taking Ozempic. Specifically, a person loses volume in their face, leading to excess skin, more pronounced features, and a generally more droopy, wrinkly, or gaunt appearance. These changes can occur with any kind of weight loss, whether or not you are taking Ozempic (Elander, 2019).
However, because Ozempic has gone viral on social media for its weight loss effects, “Ozempic face” has become a catch-all term for anyone who experiences these changes in their facial appearance as a result of losing weight.
“A lot of fat lies beneath our skin,” shared Dr. Melynda Barnes, Chief Medical Officer at Ro and a double board-certified Facial Plastic and Reconstructive Surgeon and Otolaryngologist. “Whether it’s in your gut, your arms, or your face, subcutaneous fat is where most of our fat tissue lives. When you lose body fat, those fat cells shrink and they take up less space. But your skin is used to being stretched over a larger surface area, so now that the fat tissue shrinks, it shrinks faster than the skin can shrink with it, and the skin in the face looks looser and more wrinkled.”
For an analogy, Dr. Barnes suggests thinking of your fitted sheets at home. “When you spread it over your king-sized bed, it looks nice and smooth. But if you take that same fitted sheet and place it on a twin, it looks wrinkled.”
“These changes occur in anyone who has lost weight, and it doesn’t matter how they lost the weight — whether by exercising, changing their diet, or using medications like Ozempic,” said Dr. Barnes. “It is not at all specific to Ozempic or even GLP-1 medications in general. It is just a natural thing that happens with weight loss.”
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What is Ozempic?
Ozempic (semaglutide) is an injectable medication that’s prescribed to treat type 2 diabetes when dietary changes and exercise do not adequately improve glycemic control. You inject the medicine into your upper arm, thigh, or stomach once a week (FDA, 2020). As a glucagon-like peptide-1 (GLP-1) receptor agonist, Ozempic mimics a hormone your own gut produces, known as GLP-1. Whenever your blood sugar levels get too high, Ozempic works by binding to GLP-1 receptors and signaling to your pancreas that it’s time to release more insulin. This helps people with type 2 diabetes keep their blood sugar levels in check (Blundell, 2017; Chamberlain, 2019; Shah, 2015).
Ozempic does more than encourage insulin release, though. It also reduces the amount of sugar your liver releases, and it slows down your digestion. For people with type 2 diabetes, this prevents their blood sugar from spiking. It also keeps them feeling fuller for longer, since their stomach takes longer to fully empty. As a result, they may lose their appetite sooner, leading them to eat less food and, over time, lose weight (Blundell, 2017; Shah, 2015).
Because Ozempic also helps people lose weight, it can be prescribed off-label for weight loss in people, whether or not they have type 2 diabetes (Blundell, 2017). Indeed, studies have found that when combined with diet and exercise, Ozempic can help people with obesity or overweight lose weight more quickly (O’Neil, 2018; Wilding, 2021).
In one study of adults with obesity, those taking Ozempic experienced an average 14.9% reduction in their body weight 68 weeks later, compared to the just 2.4% reduction experienced by those taking the placebo (Wilding, 2021).
How to fix Ozempic face
Whenever you embark on a weight loss plan, it is possible you’ll experience changes in your face, even if you’re not taking Ozempic. Just as your body changes shape as you lose weight, your face does, too, resulting in excess skin that can droop or sag (Elander, 2019; Kordi, 2015).
“For some people, these effects may happen no matter what,” shared Dr. Barnes. “With pregnancy, for some women the baby comes out and their skin goes right back a month later. For others, it doesn’t. But if you lose weight very fast, there is not enough time for your skin to adjust to that smaller volume of fat. [Ozempic face] is much more likely with rapid weight loss, but it can also happen when losing weight slowly.”
Your age may also play a role in your risk of experiencing Ozempic face, says Dr. Barnes. “Those under 40 years old might not see as much of an impact on their skin because their skin has more elasticity and can adapt better,” she said. “Those over 40 have less elastin and elasticity in their skin, so they may be more likely [to see these effects.]”
There is data available to ease the minds of those taking Ozempic. “The CDC recommends losing no more than one to two pounds per week,” shared Dr. Barnes. “The average person taking Ozempic loses 20% of their body weight by 20 weeks. If you do the math on that for a person weighing 220 pounds, that’s about half a pound per week which is less than the limit recommended by the CDC.”
If you and your healthcare provider have determined that Ozempic is the right choice for you, you do have options if you start to notice droopy skin. “The most common options depend on the degree of loose skin, if you’re battling loose skin plus or minus wrinkles, and where it all is,” said Dr. Barnes.
Dermal fillers and other procedures
Soft tissue fillers are one of the most common nonsurgical cosmetic procedures, and side effects are typically minimal, resulting in bruising and or swelling around the injection (Ballin, 2015; Funt, 2015). These injectable fillers can increase the volume in your face and make it appear fuller (Ballin, 2015).
There are a variety of options when it comes to dermal fillers, and their effects can last a couple years to being semi-permanent or permanent (Liu, 2019). “You can even take fat from other parts of the body, like the abdomen, and put that back into the face to restore volume,” said Dr. Barnes.
“There are other procedures with varying degrees of invasiveness that restore collagen and elastin in the face,” added Dr. Barnes. “Microneedling can tighten the face if you have a little bit of loose skin, as can radiofrequency. Ultimately, some patients may choose to undergo surgery, such as a neck lift or face lift, to remove skin.”
The skin feels smoother and fuller when it contains more moisture (Liska, 2019). “Staying hydrated, having a balanced diet, and eating plenty of healthy proteins help to support the skin and keep it as healthy as possible” said Dr. Barnes.
She added, “Think of a grape vs. a raisin. As a grape loses hydration, it turns into a raisin, which is very wrinkly.”
Practicing good skincare
Taking care of your skin through your diet and a good skincare routine is always a smart idea. Increasing your skin’s collagen production (which slows down as we age) may be helpful to those with droopy skin. This protein makes your skin look fuller and firmer, and increases its elasticity. Look for skincare products containing retinoic acid or vitamin A to boost collagen production (Rodan, 2016).
Taking a lower dose of Ozempic
While taking a higher dose of Ozempic can increase the amount of weight you lose, slowing down the dosage can help prevent some of the drug’s side effects, like Ozempic face. Health providers typically start Ozempic at a lower dose for this reason, and gradually increase it as needed based on the patient (FDA, 2020; O’Neil, 2018).
“If your provider is titrating your dose too quickly, you may be more at risk of loose skin in the face,” warned Dr. Barnes. “It is super important that patients be seen by licensed healthcare professionals who have training in patients with obesity and overweight, and know how to prescribe GLP-1s the correct way.”
Additional side effects of Ozempic
While droopy skin can occur with any rapid weight loss, there are some side effects specific to Ozempic. The most common side effects of Ozempic are gastrointestinal in nature, and include (FDA, 2020):
More serious side effects of Ozempic may include (FDA, 2020):
Diabetic retinopathy (diabetes-related vision loss)
Hypoglycemia (low blood sugar)
Allergic reaction to the ingredients in Ozempic, such as a rash or itch at the injection site
Because Ozempic slows down digestion, it can affect the absorption of other medications, so it’s important to let your health provider know about any medications you are taking before using Ozempic (FDA, 2020).
People who are pregnant or breastfeeding should avoid taking Ozempic. If you are planning to get pregnant, talk to your healthcare provider about when you should stop taking Ozempic. The FDA recommends stopping Ozempic at least two months beforehand (FDA, 2020).
Other people who should avoid taking Ozempic include children and those with pancreatitis, multiple endocrine neoplasia syndrome type 2, or a personal or family history of medullary thyroid carcinoma (Chamberlain, 2019; FDA, 2020).
Finally, it’s worth noting that the US Food and Drug Administration (FDA) has issued a “black box” warning for Ozempic due to the results of animal studies, which found that Ozempic increases the risk of thyroid tumors in mice and rats. While it is not known if Ozempic has the same effect in humans, people with multiple endocrine neoplasia syndrome type 2 or a personal or family history of thyroid cancer should not use Ozempic (Chamberlain, 2019; FDA, 2020).
Benefits of weight loss
For many people, losing weight is a healthy goal with myriad health benefits. For example, one recent study found that for people with overweight or obesity, losing 10% or more of their body weight can lead to benefits as wide-ranging as reduced cancer risk to improved quality of life. The participants in the study also experienced improvements related to comorbid health conditions such as sleep apnea, knee osteoarthritis, and fertility issues (Tahrani, 2022).
While more research is needed, other studies suggest psychological benefits from weight loss as well, including improved body image and self esteem, and fewer symptoms of depression (Lasikiewicz, 2014).
Even small amounts of weight loss can improve glycemic control and reduce the risk of type 2 diabetes. And moderate weight loss can improve blood pressure and make periods more regular (Ryan, 2017).
When you take these weight loss benefits into account, some saggy facial skin may not seem so bad after all.
If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
Chimene Richa, MD
Dr. Chimene Richa is a board-certified Ophthalmologist and Senior Medical Writer/Reviewer at Ro.
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