CMHC Pulse Blog

Experts in both obesity medicine and dermatology have a lot to say about Ozempic, the latest glucose-control drug being used for weight loss. According to the online rhetoric, it’s too expensive for the average American, easy for celebrities to access but in short supply to the public, and can cause a gaunt-like appearance dubbed “Ozempic Face.”

And, it’s not even approved for weight loss.

An Overview of Semaglutide for Weight Loss

Novo Nordisk produces both Ozempic and Wegovy, two formulations of semaglutide approved for two different purposes. Ozempic is a once-weekly injection to help adults with type 2 diabetes manage their blood sugar. Although research suggests that people who take Ozempic may lose modest amounts of weight while on the medication, it is not officially labeled for weight loss. Semaglutide, the active ingredient in Ozempic is approved by the U.S. Food and Drug Administration (FDA) at higher doses for treating individuals living with obesity and other weight-related medical problems under the name Wegovy.

“Semaglutide 1 mg (Ozempic) is a once-weekly injection FDA-approved to treat diabetes since 2017. A higher 2 mg dose was approved in early 2022,” says W. Scott Butsch, MD, MSc, director of obesity medicine in the Bariatric and Metabolic Institute at Cleveland Clinic. “Wegovy is a higher dose of weekly semaglutide (2.4 mg) that was approved for the treatment of obesity in July 2021.” But, because Wegovy is hard to get and even harder to afford, people without type 2 diabetes have begun using Ozempic off-label for weight loss purposes.

Genetics, Environment and Lifestyle in Obesity

For most, obesity is the result of a complex interaction between both their genes and their environment or lifestyle. Lauded as the father of obesity science, George A. Bray, MD, showed how genetic information can be used to develop personalized dietary advice. He was one of the investigators behind the DASH diet and was actively involved in the Diabetes Prevention Program. But, some experts ask why the rates of overweight and obesity keep rising even though genetics haven’t changed much in theory over the past few generations. The bottom line seems to be that any method of weight loss, whether it is lifestyle modification or medical intervention, needs to be sustainable.


"Genes load the gun and the environment pulls the trigger.”

Because obesity is a chronic disease, using semaglutide formulations like Ozempic use to manage it must be a lifelong strategy. But, what if cost or availability results in a person being unable to continue their course of treatment? Just as a person will regain weight if they stop exercising or dieting, they’ll also regain the pounds once they cease taking a drug like Ozempic.

The Effects of Rapid Weight Loss on the Face

Significant weight loss, especially when it occurs quickly, changes the size of the body as well as the way the skin looks. But, according to Dr. Caroline Apovian, co-director of the Weight Management and Wellness Center at Brigham and Women’s Hospital in Boston, and a professor at Harvard Medical School, there is no medical reason Ozempic and other semaglutide formulations should cause a person’s face to hollow if taken as prescribed. “We start these drugs in very low doses and titrate up while watching patients very carefully for nausea, for vomiting, for weight loss which is too rapid, which is over one to two pounds of weight on average per week,” She noted that the phenomenon of “Ozempic Face” is a clear sign patients are losing weight too rapidly or in an unhealthy way, possibly by administering too high of a dose or titrating up more quickly than prescribed.

For more on the specific dermatologic concerns patients taking semaglutide or other drugs for weight may experience, read LiVDerm’s blog on the topic:

Ozempic Face: Patients Turn to Dermatologists Amid Concerns Over Sagging Facial Features

"While any form of weight loss can cause a corresponding loss of volume in the face, the rate at which this is seen with Ozempic (semaglutide) is accelerated. Significant weight loss over a short period of time depletes the skin of essential nutrients, therefore thinning the skin and making it lose its elasticity. This results in more prominent hanging skin and accentuating hollowed-out cheekbones."

The Impact of Hollywood and the Media

The combination of notoriety and means can result in celebrities gaining access to many things nonfamous people can’t. Usually, these things aren’t of much consequence – a last-minute reservation at an exclusive restaurant? – but when it comes to health care this preferential access is concerning, ethically speaking.

National Public Radio, NBC’s The Today Show, The Wall Street Journal, New York Times, Vogue, People Magazine, and countless other media outlets have reported on the Ozempic phenomenon, most focusing on how people with diabetes and prediabetes are struggling to afford the drug amid its recreational popularity with celebrities. On Feb. 23, 2023, the streaming service Hulu aired an episode of its documentary series Impact x Nightline titled “The Skinny Shot.”


Scroll through the celebrity and media buzz on Ozempic, below.


“Other than Viagra and Botox, I’ve seen no other medication so quickly become part of modern culture’s social vernacular.”

Joint Webinar from CMHC and LiVDerm

A new webinar addresses the new weight loss drugs, issues of public access, how celebrities and experts influence the debate, and the effect of rapid weight loss on not the body’s appearance, but how the face looks as well. Join Drs. Fatima Cody Stanford from CMHC and Shasa Hu from LiVDerm as they tackle this complicated issue and field questions from a live audience of curious providers in The Buzz With Newer Weight Loss Treatments: Complications for Cardiometabolic Health, Facial Aging, and Quality of Life.

Shasa Hu, MD
Shasa Hu, MD
Fatima Cody Stanford
Fatima Cody Stanford, MD, MPH

Join Us

The Buzz With Newer Weight Loss Treatments: Implications for Cardiometabolic Health, Facial Aging, and Quality of Life


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