Ozempic feet: what you need to know

At this rate, the supposed Ozempic side effects popping up on social media are starting to feel like a full-body tour. First, there was “Ozempic face,” then “Ozempic breasts” and “Ozempic butt,” and now, “Ozempic feet.”  

Ozempic feet describes changes in the feet that can result from rapid weight loss, such as that caused by Ozempic and other GLP-1 medications. The changes?  Sagging skin, visible veins, and discomfort, just to name a few.

Read on to learn more about Ozempic feet, from what causes them to how to avoid and manage the potential side effect. 

“Ozempic feet” is a non-clinical term — better yet, a nickname — for the phenomenon of losing weight in the feet while taking Ozempic (semaglutide). It’s characterized by wrinkled or loose skin on the tops of the feet, more prominent veins or tendons, or pain.

Although the term includes the brand-name drug, Ozempic feet can occur with any GLP-1 or similar medication that produces rapid, impactful weight loss. Think: Wegovy and Zepbound. However, it’s not directly caused by the drugs themselves. Rather, it’s typically the result of the quick and impressive weight loss they can cause in people.

"During rapid weight loss, subcutaneous tissue, like fat, is lost, and the skin cannot keep pace," says Neil D'Souza, MD, MHSc, ABOM, a Toronto-based physician. "As a result, the skin is not as tight and will have a saggy appearance." 

Some people may also notice foot discomfort because "fat cushioning is not there to absorb the impact of daily activity," Dr. D'Souza adds.  

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Ozempic doesn’t specifically target the tissue and skin around the foot. So, the drug in and of itself isn't to blame for the changes to your kickers. Instead, it’s the broader changes your body experiences while on Ozempic — like rapid weight loss — that can be linked to Ozempic feet.  

Here’s a closer look at what may be behind the potential side effect. 

Rapid weight loss

Ozempic slows digestion and reduces appetite. This causes you to feel fuller for longer and eat less, which can lead to substantial and rapid weight loss. 

In clinical trials, people taking 2.4 mg of semaglutide (the active ingredient in Ozempic and Wegovy) lost up to 14.9% of their body weight in 68 weeks. Comparatively, those who took a placebo only lost 2.4% of their weight. 

The weight loss from Ozempic doesn’t happen in just one area of the body. Instead, it affects your whole frame, from head (see: “Ozempic face”) to toe. 

Loss of skin elasticity

When you slim down in such a speedy and significant way, you lose tissue or fat just under the skin (aka subcutaneous). And your skin is often unable to recover its shape and becomes saggy or loose. 

Here’s why: Gradual weight loss gives your skin time to adjust. Rapid weight loss, on the other hand, can weaken the skin by damaging its elastin, the protein that helps it stretch and snap back into place. 

In a 2015 study, skin examined after significant weight loss was found to have damaged elastic fibers. This can contribute to worsened elasticity or difficulty tightening up post-weight loss. 

And it’s not just weight loss that can take a toll on your skin. Elastin production naturally decreases as you age, which also makes it harder for skin to bounce back.

Loss of collagen

Collagen, another protein that helps skin stay firm and elastic, is important because it prompts tissue development. This helps with skin turnover and overall health. 

Similar to elastin, collagen production slows as you get older. Without enough collagen, tissue development in your skin is delayed, and wrinkles can form. The above study found that collagen was significantly thinner in people who had experienced rapid weight loss compared to those who had not. 

The TLDR? Not only do your collagen levels dip as you age, but they can also fall after losing a significant amount of weight quickly. 

Nutritional deficiencies

Another potential cause of Ozempic feet? Nutritional deficiencies. 

Ozempic lowers appetite and slows digestion, leading you to consume fewer calories and potentially fewer key nutrients. Nausea and vomiting — two common side effects of the drug — can also decrease how much you are able to eat and, in turn, how many nutrients your body gets.  

Along with quick fat loss and looser skin, nutritional deficiencies may also play a role, especially if weight loss isn’t paired with proper micronutrient intake, says Nayan Patel, PharmD, founder of Auro Wellness and Auro Skincare. "For example, inadequate protein, vitamin C, and zinc can impair collagen synthesis and skin repair."

Unfortunately, there is no way to completely eliminate the risk of Ozempic feet. But there are several steps you can take to mitigate it.

"Optimizing lifestyle changes — such as adequate protein intake, hydration, and resistance exercises — is the basis for long-term, slow, and sustainable weight loss," Dr. D'Souza says. "This will help avoid having the saggy skin appearance, be it on your bottom, face, or feet."

Slower pace of weight loss

When you lose weight slowly, you give elastin and collagen more time to adapt. While the pace of weight loss on Ozempic isn’t always in your control, lowering your dose may allow for a more gradual experience.

But this is not something you should do on your own. If you’re concerned about Ozempic feet, talk to your healthcare provider. They can determine how, if at all, to change your dosing to address your concerns without forgoing effectiveness.  

"The key to preventing Ozempic feet is slow, steady weight loss paired with skin nourishment from the inside," says Sahar Berjis, RD, founder of Inner Health and Wellness in California. And on that note…

Adequate hydration and nutrition

In addition to prioritizing high-quality proteins at every meal, "focus on collagen-rich foods like bone broth or sardines with bones," Berjis says. Other important micronutrients for skin health include vitamins A, D, and E. 

Berjis also recommends you "load up on vitamin C (citrus, strawberries, bell peppers), zinc (pumpkin seeds, chickpeas), and healthy fats (avocados, flaxseed, walnuts) to protect the skin barrier.” 

This is particularly important if you’re taking Ozempic for type 2 diabetes, since the condition can impair the skin barrier.  And when that happens, dryness and cracks can set in, causing or worsening foot discomfort.

Unfortunately, gastrointestinal side effects and appetite changes from Ozempic can make it more difficult to get your fill of skin-friendly nutrients. Working with a healthcare professional knowledgeable in nutrition can help, though. Whether that’s a provider — such as one through Ro — or a registered dietitian, a pro can put together an Ozempic diet plan that fits your needs and goals. (Want to learn more about weight loss through Ro? Check out real patient reviews and a guide to the membership.) 

And don’t forget to stay well-hydrated. Drinking plenty of fluids can maintain and even improve skin elasticity. It can also help reduce skin dryness, fending off further foot issues. 

Support your feet

Well-cushioned, well-fitting shoes can help absorb shock, reduce strain on the arches and joints, and maintain healthy alignment. 

Supportive footwear can also help you avoid stress and fatigue to the feet, says Lindsey Hudson, APRN, MSN, NP-C, CDCES, a nurse practitioner specializing in diabetes management at Your Health. 

Together, these effects can help ease the discomfort of Ozempic feet and let you put your best foot forward — literally — during treatment.

Another way to support your feet? Strength training. Building and maintaining your muscles — particularly the ones around and above your ankle — can help prevent atrophy and changes to your feet as you lose weight, Hudson says. 

Stick with a skincare routine 

You can’t control every skin change with weight loss, but you can help it bounce back. This means regularly incorporating skin-supporting practices into your routine. 

• Use sunscreen daily. Sun exposure can lead to premature skin aging, age spots, wrinkles, and even skin cancer. "Sun damage accelerates collagen degradation and increases skin laxity," Dr. Patel says. The Skin Cancer Foundation recommends using a sunscreen of 30 SPF or higher on your feet and reapplying every two hours or after swimming or sweating.

• Apply moisturizer. Water hydrates your skin from the inside out, and moisturizer hydrates it from the outside in. "Thick emollients like urea-based creams help restore the skin barrier and improve texture," Dr. Patel says. Moisturizing can also help address wrinkling or sagging skin by plumping it with hydration. 

• Use topical antioxidants. Applied to the feet, antioxidant serums or creams could help reduce skin aging and preserve collagen, according to Dr. Patel. He says to look for products with ingredients containing glutathione, coenzyme Q10, or vitamin E.

• Give your feet a massage. Foot massages can improve blood flow to your lower extremities, which can help boost your skin’s elasticity. Dr. Patel recommends daily foot massages — even a quick rub when applying moisturizer! — or using foot rollers to stimulate blood flow and support tissue repair. 

• Incorporate exfoliation. Exfoliating the feet can help slough off dead skin and, in turn, promote the production of elastin and collagen. Reach for chemical exfoliants, such as AHA- and lactic-based ones, according to the experts interviewed and research. Of course, many of these treatments should be done under the care of a healthcare provider, such as a dermatologist. 

When Ozempic feet are primarily characterized by sagging and wrinkles, they’re not typically cause for alarm. “Ozempic feet are just a wake-up call to support your body more intentionally,” Berjis says. 

But when pain and discomfort are present, it’s a good idea to consult your healthcare provider. (After all, it’s always smart to see your provider if you have any concerns about your body and health.) 

According to Hudson, you should schedule a provider visit if:

• Your wrinkles are accompanied by swelling, pain, or changes in color.

• You have dry, cracked skin, calluses, or other sores that won't heal.

• You develop foot pain, discomfort, or have difficulty walking.

• You see a persistent rash.

For people with diabetes, it’s especially important to share even small changes in your feet with your provider. This is because diabetes can increase your risk of diabetic neuropathy (i.e. nerve damage), peripheral artery disease (i.e. reduced circulation), infections, and ulcers. Ozempic feet aside, people with diabetes should inspect their feet daily and see a podiatrist at least once a year. 

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Seeing sagging skin or more prominent veins on your feet may give you pause. Experiencing pain and discomfort may stop you in your tracks, too. But if you’re taking Ozempic, these symptoms may be signs of Ozempic feet. Here’s what to remember: 

• Despite its name, Ozempic feet is not caused by the medication itself. Rather, the side effect is caused by rapid, significant weight loss, such as that caused by Ozempic and other GLP-1 medications.

• Losing a lot of weight in a short amount of time can lead to fat loss throughout your body, including on your feet. This may reduce skin elasticity and, in turn, lead to saggy or loose skin. 

• While it’s not always possible to avoid weight loss-related changes, certain lifestyle habits can help prevent Ozempic feet. These include eating a nutritious diet, strength training, wearing supportive shoes, and following a skincare routine with moisturizing ingredients. 

• Slowing the pace of weight loss can give your skin more time to adjust and reduce loose skin. If you’re concerned about Ozempic feet, talk to your healthcare provider about potentially lowering your Ozempic dose. This may allow for more gradual weight loss and give your skin time to catch up. 

• You should see your healthcare provider if you’re experiencing pain, sores that won't heal, or if you have diabetes. Ozempic feet are usually considered a cosmetic concern. But if something doesn’t feel or look quite right, contact your provider to make sure there isn’t something else going on with your health.