Attack of ‘Ozempic skin’

As the novelty of the medications wears off, side effects are becoming a focal point as users complain of stomach discomfort, muscle loss and now loose skin. 

So what exactly is ‘Ozempic’ skin? 

“So-called ‘Ozempic skin’ or ‘Ozempic butt’ is loose, sagging skin on the face or buttocks that occurs as a result of rapid weight loss,” said Gene Bruno, chief scientific officer at Nutraland USA. “To be clear, this isn’t an adverse effect specific to Ozempic. It would occur in any scenario resulting in rapid weight loss. Essentially, with the weight loss that occurred, the skin has less tissue to cover which makes the skin seem saggy."

Ozempic is one of the medications belonging to the glucagon-like peptide-1 (GLP-1) receptor agonist class, mimicking the action of GLP-1, regulating appetite and promoting weight loss. It can lead to rapid weight loss, which often becomes noticeable in the face, Paula Simpson, founder of Nutribloom Consulting Nutricosmetics Innovation, Product Development & Branding Expert, explained.

"Facial volume, primarily from fat, is key to a youthful appearance," she said. "Rapid fat loss in patients taking semaglutide or similar GLP-1 receptor agonists can make wrinkles more prominent and cause skin sagging in areas like the temples, cheeks, tear troughs, jawline, marionette lines and nasolabial folds, disrupting facial balance. 

"The gaunt appearance patients experience is due not only to volume loss, but it may also cause changes in the facial skin, including a reduction in collagen, elastin and essential nutrients. These effects are particularly pronounced in older individuals, whose skin already has diminished levels of collagen and elastin. Additionally, the loss of fatty acids can compromise the skin barrier, leading to dryness and a dull complexion. The rapid depletion of vitamins and nutrients on very low calorie diets may result in malnutrition, exacerbating these issues, therefore it's important for patients to closely monitor their diet to ensure they meet their nutritional needs."

New name, old issue 

Even though 'Ozempic skin' is a new term, Jacqueline Jacques, ND, fellow of the Obesity Society, said that skin changes after shedding a lot of weight is nothing new. 

"While ‘Ozempic skin’ is the latest catch phrase, skin changes with massive and/or rapid weight loss have been known about for a long time," she said. "What we are seeing now is that because many more people have access to effective medical treatment for weight loss, the number of people experiencing this at one time is much larger, so we are just more aware."

And the number of users is only growing. In the U.S. alone, 30 million GLP-1 users are expected by 2030​— that’s a lot of saggy faces and butts. 

Can 'Ozempic skin' be avoided? 

One way to prevent loose skin is to lose weight at a slower pace. "But let’s be honest—everyone wants to lose weight quickly, not slowly," Bruno said. 

In order to avoid weight loss-induced saggy skin, Bruno suggests:

• Lose no more than 1 to 2 pounds per week
• Make sure strength training is part of the approach to weight loss in order to build muscle while losing fat
• Do everything possible to maintain collagen content of the skin which will help reduce sagging
• Stay hydrated to maintain the moisture content of the skin

From a topical standpoint, Simpson said that she has read different views from medical aesthetic and dermatology experts and generally speaking, treatments that focus on skin tightening or fillers are being used to rebalance skin texture, volume and firm the skin.  

"From a nutritional standpoint, it is important to avoid potential nutrient imbalances/deficiencies key for skin tissue," she said. "Very low/low calorie diets should be complemented with supplementation. Beyond multivitamins, targeted macro and micronutrients for skin health could be warranted here to encourage healthy collagen production and barrier function."

Simpson suggested ingredients such as collagen peptides, MSM, vitamin C, lipids, phytoceramides and certain probiotics that can improve skin moisture and encourage a healthy skin barrier. 

"What we really should be doing is supporting nutrition for people throughout their weight loss journey," Jacques said. "Since loss of fat is the target, we don’t want to and can’t prevent the skin changes that are due to fat loss. What we can focus on is providing the kinds of ingredients that help with skin integrity, elasticity and even general skin health like skin immunity."

Jacques noted that collagen is probably the most important ingredient overall. 

"When you are rapidly losing weight, your protein requirements go up," she said. "It’s often recommended that individuals who are actively losing weight target something in the range of 1.5 g protein per kilogram of targeted bodyweight.

"The focus is often on proteins with high branched-chain and essential amino acid content to combat muscle loss, which is important, but the amino acids that support skin—those that can be provided by collagen—are frequently forgotten. Collagen in the range of 10 to 20 g/day improves skin appearance, hydration and elasticity. It stimulates the production of both new collagen and elastin and may increase natural production of hyaluronic acid and ceramides. As a bonus, it’s also good for bone health—another risk of significant weight loss."

Other ingredients Jacques recommended are vitamins A and C, zinc, niacin, CoQ10, astaxanthin and Pycnogenol, as well as other polyphenols such as those from green tea and cocoa. 

Opportunity 

J.P. Morgan Research forecasts the GLP-1 category will exceed $100 billion by 2030, driven equally by diabetes and obesity.

From a systemic standpoint, Simpson said the beauty-from-within industry could look to support dermal tissue while on weight loss programs. Once the weight is lost and medication use is discontinued, she said formulations to help reduce the likelihood of weight regain could be useful.  

“Based on preliminary findings on potential side effects associated with medication use, fortifying ingredients for hair health could also be considered,” she added. 

When it comes to practitioners working with the cosmeceutical industry to tackle the 'Ozempic skin' challenge, Jacques said the opportunity is there. 

"Many consumers want both education and validation from their health professionals," she said. "A lot of individuals are going to turn to cosmetic procedures as well—for skin tightening, removal of excess skin, etc.—so multiple kinds of health professionals may be playing a role in supporting these patients."

Obesity drugs are already having a significant impact on a number of sectors, including nutraceuticals. From digestive support to muscle health and now skin, GLP-1 medications are the gift that keeps giving.  With so many opportunities the supplement industry can leverage, the sector is ripe for innovation and hungry for solutions for the 9% of Americans expected to be on GLP-1s by 2030.