Ozempic May Cause Cosmetic Side Effects Like Sagging Skin, Wrinkly Feet

Recent anecdotal reports have highlighted strange side effects of GLP-1 medications used for weight loss like “Ozempic mouth” and “Ozempic feet.” Elena Popova/Getty Images

• “Ozempic feet” and “Ozempic mouth” are the latest reported cosmetic side effects from GLP-1 medications used for weight loss.
• Experts say wrinkles and sagging skin can result from rapid weight loss due to loss of fat and muscle mass in certain areas of the body.
• You can minimize some of these effects by increasing protein in your diet and incorporating resistance training into your exercise routine.

You can add “Ozempic feet” and “Ozempic mouth” to the growing list of nicknames for strange and unusual side effects from popular GLP-1 medications used for weight loss.

Reports on social media and elsewhere have been highlighting “Ozempic feet,” a GLP-1 side effect resulting in excessively wrinkled feet. A recent photo of a barefoot Sharon Osbourne posted on Instagram set off a flurry of publicity.

There have also been reports of people developing “Ozempic mouth,” which results from rapid weight loss and leads to wrinkles around the mouth, sunken cheeks, and sagging jowls.

Meanwhile, “Ozempic face” describes the general hollowing of the face and an increase of wrinkles as people lose weight. There’s also the “Ozempic butt” phenomenon, which occurs when sagging skin becomes pronounced around the buttocks as a person loses weight.

While the drug Ozempic is most often pegged to these nicknames, the side effects can also be present with other injectable weight loss medications such as Wegovy, Zepbound, and Mounjaro.

Experts say the side effects aren’t a result of the medications themselves, but rather, are byproducts of rapid weight loss. They also note that these side effects are cosmetic and usually not a danger to a person’s health.

Still, these effects can be minimized through modifications in diet and exercise. People could also try to lose weight at a slower pace to help reduce some of these effects.

“You need a team to follow you and help you,” said Dan Azagury, MD, FACS, an associate professor of surgery and the section chief of Minimally Invasive and Bariatric Surgery at Stanford University.

“Get some support and do this in the right way,” he told Healthline. “This is not a sprint. Slow and steady wins this race.”

Side effects of rapid weight loss

Experts say wrinkles and sagging skin may sometimes occur after weight loss because of the loss of fat and the reduction in muscle mass throughout the body.

“Any kind of significant weight loss can have a dramatic change in body habitus and appearance,” said Mir Ali, MD, a general surgeon, bariatric surgeon, and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in California.

“We see the same kind of changes after surgical weight loss as well, so it is more an effect of weight loss, rather than directly because of the medication,” he told Healthline.

Nidhi Pandya, an Ayurvedic doctor, holistic practitioner, and author of the book “Your Body Already Knows,” said people should know the benefits and downsides of weight loss medications.

“While these drugs are highly effective for lowering appetite and improving glycemic control, they also accelerate weight loss in a way that can have systemic consequences,” Pandya told Healthline.

She lists some of the side effects as:

• loss of lean body mass
• altered gut microbiome
• micronutrient deficiencies
• impaired tissue repair

“My advice is to approach these medications as serious metabolic interventions, to be used after a thoughtful evaluation of risks and benefits,” said Pandya.

Kristin Kirkpatrick, MS, RDN, the president of KAK Consulting and a dietitian at the Cleveland Clinic Department of Wellness & Preventive Medicine in Ohio, agreed it’s important to plan your weight loss journey carefully.

“Yes, side effects of rapid weight loss can and do happen, but working with a healthcare provider and focusing on going above and beyond just taking the shot can help,” she told Healthline.

How to minimize side effects like ‘Ozempic feet’

Experts say you can counter these natural side effects through dedicated practices involving diet and exercise.

“Many of these side effects can be minimized by supporting the body’s physiology and metabolism with targeted lifestyle strategies,” said Pandya.

Among her suggestions are:

• consuming at least 1 gram of protein per kilogram of body weight per day
• limiting snacks and meal frequency
• starting meals with fermented foods and high fiber vegetables
• stress management through techniques such as mindfulness and breath work
• structured sleep

“While [these drugs] are powerful pharmacologic tools, the bedrock of metabolic health remains in intelligent, science-backed lifestyle strategies that support the body’s natural signaling and repair mechanisms,” said Pandya.

Kirkpatrick suggested increasing protein intake to help maintain lean muscle mass. She recommended adding protein to every meal and snack and taking a supplement such as creatine HCL.

“I tell my patients that when you are on these drugs you have to get nutritional bang for every bite,” said Kirkpatrick. “The mechanism of these drugs leads to a reduced intake of food and, therefore, you can’t really afford to consume foods that provide no nutritional benefit.”

Kirkpatrick added that resistance training be added to an exercise routine.

“Cardio is great and has many benefits, but resistance training can specifically help with muscle mass,” she said.

Ali noted it’s important to remember the purpose of weight loss programs.

“People taking medication for weight loss or even undergoing surgery should realize the goal is to achieve a healthy weight to minimize obesity-related health conditions and achieve a normal lifespan,” he said.

What to know about GLP-1 drugs drugs

Losing weight is inherently a difficult task.

First, the body may need to store fat for various physiological reasons, including organ protection, hormone regulation, and nutrient absorption.

Azagury noted that the human body is also programmed to retain some fat in case of food shortages. “Your body is designed to avoid weight loss,” he said. “You’re fighting tens of thousands of years of evolution when you try to lose weight.”

He added that modern techniques, such as bariatric surgery and new weight loss medications, can make weight reduction a little easier.

“There is no hierarchy in how we lose weight,” Azagury said. “There is no better or worse way.”

Ozempic and Wegovy are injectable medications containing the active ingredient semaglutide. Ozempic is approved by the Food and Drug Administration (FDA) for treating type 2 diabetes, while Wegovy is approved for weight loss and management.

Mounjaro and Zepbound are injectable drugs that contain the active ingredient trizepatide. The FDA approves Mounjaro for type 2 diabetes, while Zepbound is used for weight management.

All these drugs work in the same basic way by suppressing a person’s appetite. They do have some potential side effects. Some of the more common are:

• nausea
• diarrhea
• constipation
• abdominal pain

These medications have been shown in clinical trials to help people with obesity and other weight management issues lose weight effectively. People who are prescribed these drugs are advised to maintain a healthy lifestyle.

The medications have also been credited with other beneficial health effects such as:

• blood sugar control
• improving cardiovascular health
• lowering kidney disease risk
• improving cognitive abilities

Experts say lifestyle changes are important. So is developing a weight loss program under the supervision of a medical professional.

Kirkpatrick advised developing a strategy to eventually stop using the weight loss drugs.

“You should begin thinking about the off ramp when jumping onto the on ramp,” she said. “This means — begin planning how you get off the drugs (if this is the plan) once you meet your weight and metabolic goals.”

“Ozempic and Zepbound are appropriate for select individuals, but everyone can engage their body’s innate metabolic wisdom by adopting evidence-based lifestyle interventions, resulting in more durable, holistic health,” added Pandya.