Weight-loss drugs like Ozempic are continuing to skyrocket in popularity, leaving those taking them sometimes dealing with a range of side effects, from nausea to constipation to diarrhea and abdominal pain, according to Ozempic's maker, Novo Nordisk.
Another effect of taking weight-loss drug has come to be known as Ozempic face, and it can be especially surprising to users. It refers to the sagging in the face that some people see after losing a large amount of weight on the medication.
A New York City-based dermatologist, Dr. Paul Jarrod Frank, actually coined the term after he observed a number of his patients who were taking weight-loss drugs complaining about the phenomenon as they started to become more popular. In early January 2023, he told the TODAY show he was seeing it "every day."
Ozempic is approved by the U.S. Food and Drug Administration to treat Type 2 diabetes, though it can induce weight loss. Its sister drug, Wegovy, which has the same active ingredient, is approved to treat obesity. Novo Nordisk previously told TODAY.com in a statement: “We do not promote, suggest or encourage off-label use of our medicines,” which includes using Ozempic for weight loss.
Sagging skin due to rapid or substantial weight loss can actually occur in any part of the body — not just the face. That's why there have also been reports of Ozempic butt and Ozempic arms.
What is Ozempic face? What other changes may drugs like Ozempic cause? Is there a way to prevent or reverse Ozempic face? Here's what to know.
How does Ozempic lead to weight loss?
Ozempic and Wegovy both have the same main ingredient, known as semaglutide. The way they work is by mimicking a hormone that the body produces when it consumes food, known as GLP-1. This leads you to eat less and have fewer cravings. These drugs may also slow stomach emptying so your body absorbs calories over a longer period of time.
What is Ozempic face?
Ozempic face is a term coined by Frank to describe how the faces of patients who lose a lot of weight quickly on weight loss medications may become sagging and even look older. This is because the drugs can make people lose facial fat.
Frank said it's especially comment in patients middle-aged and older.
"One of the most common things I notice with any form of weight loss in middle-aged and older patients is we don’t all lose it in the areas we want," Frank said. "When we get older, definitely the facial volume changes and shifts around. But when you lose weight so acutely and quickly ... we’re seeing these types of changes in their face where it’s actually making them look older.”
Natasa Valocchi told TODAY that she noticed Ozempic face. At the time, she had lost 68 points in a little over a year. "As the weight goes, your face does go, and you do get a gauntness," she said on today.
"As we age, we get gaunt anyway, so I think it was just a little bit more excessive," she continued. "People have definitely noticed in my face, 'Oh, Wow you are looking very thin these days.' So it's maybe a bit much for me, and I think I could use a little bit extra volume."
For Valocchi, the Ozempic face appeared mostly in the lower jaw area. "Your jowls start to sag because there isn't really the (plumpness) to hold it in anymore," she said.
What does Ozempic do to your face?
If you experience fast weight loss while taking Ozempic, especially a large amount, you may see facial changes, which Frank referred to as "global facial wasting." This can mean "wrinkling" and "heaviness" around and under the eyes, temples, jawline and mouth, he said.
“There are certain diseases that cause (global facial wasting), but this is happening in a much milder sense with the use of these medications,” Frank explained.
That said, these facial changes are likely not a direct result of the Ozempic itself, Jastrebroff and Dr. Rocio Salas-Whalen, Valocchi’s endocrinologist, say. It's likely a downstream effect of losing a lot of weight over a shorter period than usual, Salas-Whalen says. (Salas-Whalen worked for Novo Nordisk in the past but on projects unrelated to Ozempic.)
The recommended weight loss rate on Ozempic, Salas-Whalen notes, is 1 to 2 pounds per week. Valocchi lost weight at this pace, but other factors cancontribute to Ozempic face, per Salas-Whalen. These include the natural aging process, genetics and menopause, as the lack of estrogen can contribute to wrinkles and sagging skin.
You’re also more likely to see Ozempic face traits the more weight you lose, Salas-Whalen says. Patients who take Ozempic to lose 15 to 20 pounds — and there are legitimate medical reasons for doing so, she stresses — won’t see as many facial changes as those who lose 100 pounds, Salas-Whalen says.
Jastreboff agrees the phenomenon “is related to the weight reduction rather than specifically to the way that weight reduction is attained.”
She adds that one of the reasons Ozempic face may be catching people off-guard is that semaglutide is “highly effective” at treating obesity.
“Patients are losing weight at a faster rate than what we’ve seen with other types of obesity treatments,” Jastreboff explains. “With bariatric surgery, patients also have potentially changes in their in their facial appearance, and I think potentially why it’s coming up is because we’re not used to seeing that degree of a change in the amount of fat that is carried in someone’s face with a medication.”
How does Ozempic affect the skin?
Fast weight loss, which people taking Ozempic may experience, can lead to changes in the skin of the face, such as sagging or becoming more gaunt, Frank told TODAY. But the medication itself doesn't seem to affect the skin beyond these changes from weight loss, Jastreboff says.
Salas-Whalen adds that losing weight quickly “is definitely going to affect how the skin adapts to the new weight. And that’s why we always recommend slow weight loss, especially at the beginning."
There also may be mild skin side effects from injecting Ozempic, as it and its sister drug Wegovy are taken as shots. “When you take a little shot, sometimes you can have a very little bruise or something, but usually that does not occur,” she says.
How to avoid Ozempic face
Frank said fillers can be used to treat Ozempic face, but it's costly.
"When you have global facial volume loss, it can take a significant amount of filler. Whereas someone in middle age may normally spend $1,000 or $2,000, they could spend $5,000 and up to reflate the face from the volume loss," he added. "(For) patients in their late 50s and 60s, often replacement of volume is not enough, and it will require facial plastic surgery."
For those concerned about developing Ozempic face, Frank stressed the importance of staying in contact with your endocrinologist, dermatologist and other relevant specialists "to help you along the (weight loss) journey slowly."
What does Ozempic butt look like?
Another concern some people taking GLP-1 agonists like Ozempic may have is that the weight loss will alter the appearance of their buttocks, a phenomenon that has come to be referred to as Ozempic butt.
While not an official medical diagnosis, Ozempic butt refers to loose and even sagging skin in the rear-end due to rapid or substantial weight loss. It can occur with any weight-loss medication, not just Ozempic or Wegovy, Dr. F. Clarissa Yang, dermatologist-in-chief at Tufts Medical Center and a professor at Tufts University School of Medicine, previously told TODAY.com.
The sagging skin occurs because weight gain makes it hard for the skin to stay firm as it damages elastin and collagen in the skin. So once the weight is lost, the skin can retract to some degree but not all the way.
Ozempic butt may also be driven in part by another side effect of the medication, muscle loss, since the buttocks has a lot of muscle, too. Research has shown that up to 40% of the weight people lose on Wegovy is lean mass, including muscle (though the medications still tend to improve heart and physical function overall).
Asked about reports of Ozempic butt, a Novo Nordisk spokesperson previously told TODAY.com: “We work closely with the (FDA) to continuously monitor the safety profile of our medicines. We do not have clinical data evaluating the effect of Wegovy or Ozempic on sagging skin on the buttocks. We recommend that any patients experiencing side effects while taking Wegovy or Ozempic contact their health care provider.”
