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From ... in Biology —

‘Ozempic Face’ — A Troubling Side Effect of Weight Loss Drugs

Prescriptions for weight loss medications have skyrocketed in recent years.

‘Ozempic Face’ — A Troubling Side Effect of Weight Loss Drugs

By the end of 2024, the market valuation is expected to grow to a whopping $21.09 billion. Today, one of the most popular options are GLP-1 agonist drugs that are sold under two names, Ozempic and Wegovy. Both are from the Novo Nordisk drug company — Ozempic is sold as a diabetes drug, while higher-dose Wegovy is approved for weight loss. The popularity of GLP-1 agonist drugs for weight management has boomed in recent years, and it shows — quite literally. Today, more users are struggling with a side effect

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dubbed the "Ozempic face" — a condition that occurs when a person loses too much facial fat, leading to a hollowed, gaunt appearance, as a result of taking these drugs.

How Do GLP-1 Mimetics Work?

Glucagon-like peptide-1 (GLP-1) receptor agonists work by boosting the hormone GLP- 1. The drug was first approved in 2017 to manage blood sugar levels in diabetics, and, in 2021, the FDA approved Wegovy to address obesity. Semaglutide is the active ingredient in both. Your body naturally makes GLP-1 in the small intestines, and its primary function is to slow down digestion, increase satiety, block glucagon secretion (a hormone used to control blood sugar levels) and trigger the pancreas to release insulin. When used as an injectable medication, semaglutide mimics the hormone, so the medication binds to the receptor and triggers the same effects. As a result, the passage of food through your stomach slows down, making you feel fuller longer. According to an article published in El Pais: "Ozempic gives the feeling of being forever full, so that you can say goodbye to snacking, and be satisfied with smaller portions of food. Soon, though, nausea, vomiting, diarrhea or constipation can appear. After a few months, the ‘Ozempic face' may show up in the form of prematurely aged skin."

Trims Inches Off the Waist, but Adds Years to Your Face

When you take semaglutide, it doesn't just cause you to shed fat from specific body problem areas; it can also deplete your facial fat resulting in lost volume. When your body slims down very rapidly, the elasticity of your skin, especially on the face, can be severely affected. The result — sunken eyes, fine lines, indents and wrinkles, drooping cheeks, sagging skin (including under the chin) and changes in the size of the lips and chin.

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Semaglutide has helped some to slim down, but at the cost of ageing skin, particularly in your face. In a Forbes article, Mojgan Hosseinipour, D.O., a board-certified dermatologist, says, "Subcutaneous facial fat provides structural support; with volume loss, there is an accelerated aged appearance of the face with noticeable lines and wrinkles." These physical effects may be more apparent in people with thin faces who have experienced drastic weight loss. Aesthetic doctor, Mar Mira, explains in an El Pais article: "[I]n overweight or obese patients, weight loss does not usually result in significant facial skeletonization. However, shadows underneath the cheeks may be accentuated by reabsorption of fat compartments, and facial fiaccidity can become more pronounced around the jowls and jaw line due to the loss of temporal and preauricular fat compartments, which are usually the first to be reabsorbed during the aging process."

Skincare Companies Are Taking Advantage of the Ozempic Face

A 2023 study notes how the increasing number of people with Ozempic face are impacting the field of plastic surgery. According to the researchers, "As the popularity of Ozempic grows, facial plastic surgeons must be aware of both the impact on facial appearance and perioperative considerations." The study also mentions that methods like dermal fillers, skin tightening techniques and surgery may be needed to manage excess skin and restore a patient's facial volume. This has prompted some skincare companies to prepare for the surge of people who may want to address the aging effects caused by Ozempic. In a Bloomberg article, skincare firm Galderma's CEO Flemming Ornskov said their Sculptra skin treatment, which boosts collagen production, and other fillers can help "restore" patients' facial features.

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Some physicians have also commented on the changes they see among people who took Ozempic. In an article published in Allure, Julius Few, MD, a Chicago-based, board- certified plastic surgeon, says, "I have seen a number of patients for facelifts who are on Ozempic, and the way their tissue behaves is not the same. The skin has more of a doughy consistency." What's more, Few comments that people in their 20s and 30s are now going beyond fillers — they're also inquiring about procedures like facelifts, which are usually tailored for those over 50 years old.

Ozempic's Side Effects Can Be Alarming

But aside from the facial changes, Ozempic and other GLP-1 drugs can have other more disturbing side effects. A Woman's World magazine article, for example, demonstrated the drastic weight loss that Sharon Osbourne underwent after taking Ozempic. The 70- year-old TV personality lost a whopping 42 pounds.

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The change to her facial appearance is noticeable and has become one of the most startling examples of the Ozempic face. However, the article quotes an interview with Piers Morgan that Osbourne did back in September 2023, where she further shared her unpleasant experience after using the drug: "At first, I mean, you feel nauseous. You don't throw up physically, but you've got that feeling. It was about two, three weeks where I felt nauseous the whole time. You get very thirsty and you don't want to eat. That's it. You can't stay on it forever. I lost 42 pounds now and it's just enough. I didn't actually want to go this thin, but it just happened, and I'll probably put it all on again soon." Reality TV personality Scott Disick has also spoken up about his dramatic weight loss courtesy of Ozempic, and that he is "seeking help" to get off the drug after fans raised their concerns over his alarming transformation, including his gaunt face and sunken eyes. He has stopped taking the drug and is now working with a nutritionist to manage his weight.

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Others who have been prescribed GLP-1 agonist drugs to address other health issues have also spoken up about the nasty effects of Ozempic. In a Today article, hospital worker Jeannine DellaVecchia said she took the drug to "treat symptoms related to insulin resistance caused by congenital adrenal hyperplasia and polycystic ovary syndrome." Despite losing 30 pounds, she opted to stop using Ozempic because the side effects were "just too much." Aside from the noticeable facial changes, DellaVecchia also struggled with appetite loss, nausea and vomiting.

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Using Weight Loss Drugs Can Have Disastrous Consequences onYour Gut Health

The problem with GLP-1 agonists is that if they cause food passage to slow too much, it can lead to health issues, particularly gastrointestinal disorders. One 2023 study noted that people who are taking GLP-1 agonists had an increased risk of pancreatitis, bowel obstruction and gastroparesis (stomach paralysis). A study using data from Eudravigilance, Europe's system for analyzing adverse reactions to medications, also found that aside from gastrointestinal concerns, metabolic, nutritional, eye, renal, urinary and cardiac disorders also occurred in people who took semaglutide. One study notes the effects on the kidneys occur more often in people who also have adverse gastrointestinal disorders when taking the drug. And, as with DellaVecchia's experience noted above, many people developed "cyclic-vomiting syndrome" — a condition where a person vomits multiple times in a day. According to a CNN article:

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"Emily Wright, 38, a teacher in Toronto, started taking Ozempic in 2018. Over a year, she said, she lost 80 pounds, which she's been able to keep off. But Wright said she now vomits so frequently that she had to take a leave of absence from her job. ‘I've almost been off Ozempic for a year, but I'm still not back to my normal,' Wright said."

Instead of Ozempic, Increase Your GLP-1 Naturally WithAkkermansia

Taking medications to lose weight is one way to endanger your health. Ozempic was designed as a long-term drug. In other words, to maintain your weight loss, you must stay on the drug. One study found that a year after stopping semaglutide, participants gained back two-thirds of the weight they lost — a condition called the "Ozempic rebound." Instead of relying on GLP-1 agonists, consider colonizing your gut with Akkermansia muciniphila to boost your GLP-1 levels naturally. Akkermansia is a type of bacterium that naturally secretes a GLP-1-inducing protein, which raises systemic levels of GLP-1. Research confirms its ability to improve glucose homeostasis and ameliorate metabolic disease through this mechanism. According to the researchers: "A. muciniphila increases thermogenesis and glucagon-like peptide-1 (GLP-1) secretion ... by induction of uncoupling protein 1 in brown adipose tissue and systemic GLP-1 secretion ... [An] 84 kDa protein, named P9 ... is secreted by A. muciniphila. [We] show that purified P9 alone is suficient to induce GLP-1 secretion ..."

How to Restructure Your Microbiome

Akkermansia, highly beneficial bacteria in your large intestine, plays a crucial role in maintaining gut health and should constitute about 10% of the gut microbiome.

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However, it is absent in many individuals, likely due to inadequate mitochondrial function and resultant oxygen leakage in the gut. Eating foods that support Akkermansia, such as polyphenol-rich fruit, and other beneficial bacteria, and avoiding foods like linoleic acid — found in vegetable and seed oils in most processed foods — that destroy these bacteria, will help to restructure your microbiome in a positive way. You can also use an Akkermansia probiotic supplement. One of the reasons Akkermansia is so important is because it produces mucin, a thick, protective gel-like substance that lines various parts of the body, including the gastrointestinal tract. Mucin forms a protective barrier on the gut lining, shielding the epithelial cells of the intestinal wall from mechanical damage, chemical irritation from stomach acids and digestive enzymes, and pathogenic organisms like bacteria and viruses. Mucin also supports the immune system by trapping potential pathogens and other foreign particles, which are then expelled from the body through the digestive process. It also contains antibodies and antimicrobial peptides that help fight off infections. Lastly, mucin serves as a food source for other beneficial gut bacteria. This relationship is essential for digestive health, as the bacteria fed by Akkermansia aid in digestion, produce essential nutrients and help maintain an overall balance of gut flora.

Avoiding Linoleic Acid Can Help With Weight Management

The abundance of linoleic acid (LA) in our diet is another reason why many are struggling with obesity or are overweight. This omega-6 fat is found in seed oils like sunflower, soybean, rapeseed (canola), cottonseed, corn and safflower, and reducing your intake can help support a healthy weight. Make sure to avoid all processed foods, as these also contain high amounts of LA, as well as grain-fed chicken and pork. Ideally, cut your LA consumption down to below 5 grams per day, which is close to what our ancestors used to get before chronic health conditions became widespread. LA is found in nearly all ultraprocessed foods, fast foods and restaurant foods as well. This is why it's best to prepare the majority of your food at home. For more information on linoleic acid, read my article " Linoleic Acid — The Most Destructive Ingredient in Your Diet ."

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