Diabetes medication is not often a hot topic — but there’s a fair chance that one drug has crossed your social media or news feed in recent weeks.
That’s because Ozempic is rumored to be a popular weight loss strategy in Hollywood and among the wealthy. This has led to online speculation — perhaps more aptly termed a “witch hunt” — about which celebrities are using the medication.
Sometimes the supposed proof is simply a picture of the celebrity in question. And there’s been discussion about so-called “Ozempic face” — a phrase to describe various effects of losing weight in the face, including extra facial skin, a hollow appearance to the face or the appearance of aging.
Aoife Egan, M.B., B.Ch., Ph.D., an endocrinologist and specialist in diabetes and weight management, has prescribed Ozempic and medications like it to her patients. Her take: Throw the term away.
“It’s certainly not a medical term,” Dr. Egan says. “And I would profoundly disagree with the use of the term in general.”
Ozempic and similar drugs don’t specifically target weight in the face, and concern about facial weight loss hasn’t touched Dr. Egan’s practice.
And just as importantly, the phrase is just the latest example of weight bias to crop up in the appearance-focused social media landscape.
“Firstly, I think it very much makes light of the underlying conditions that we are treating — important conditions such as diabetes and obesity,” Dr. Egan says. “And secondly, I really feel that it just adds to the stigma and discrimination that have been associated with a diagnosis of obesity.”
“We’ve seen this down through the years and different ways: People with obesity have been referred to in various derogatory terms. This is just another way that has potential to cause harm to a vulnerable group of people.”
What is Ozempic?
Ozempic is the brand name of a drug known as semaglutide. Semaglutide lowers blood sugar and was originally approved by the Food and Drug Administration (FDA) to treat type 2 diabetes.
But it also tends to help people lose weight, because it slows the emptying of the stomach, increasing feelings of fullness. It also seems to work on the appetite center in the brain to reduce appetite. In 2021, semaglutide was approved by the FDA as a weight loss medication under the brand name Wegovy.
Wegovy is given as a weekly home injection. When FDA-approved weight-loss drugs are used in tandem with lifestyle changes, it’s possible to see weight loss of about 5% to 15% of body weight. That can make a big difference, with potential benefits like lowering blood pressure and blood sugar and improving joint discomfort.
It’s not the only diabetes drug that was rebranded for weight loss: Liraglutide (with the original brand name Victoza) was later FDA-approved for weight loss as Saxenda. And a recent large study showed promising weight-loss results for tirzepatide (Mounjaro). Tirzepatide is not yet approved as a weight-loss drug, but it was granted a fast-track review process.
“These are very effective medications when used for diabetes,” Dr. Egan says. “They’re very effective at treating high blood sugars. They also have lots of other beneficial effects for metabolic health and can reduce the risk of diabetes-related complications.”
What should Ozempic be used for?
Ozempic is FDA-approved only for use in those with type 2 diabetes.
Wegovy is a weight management drug. When used in adults, it’s specifically approved for:
- People with a body mass index (BMI) of at least 30.
- People with a BMI of at least 27 and a medical condition related to weight, like diabetes, high blood pressure or cholesterol concerns.
If someone doesn’t meet these criteria, a prescription for one of these medications should only be given after careful consideration, Dr. Egan says.
Unfortunately, that’s not always the case. These medications may be prescribed irresponsibly or possibly obtained online — which could be contributing to shortages of these drugs for people who really need them.
What are the side effects of Ozempic?
There are common gastrointestinal side effects with Ozempic and Wegovy like nausea, vomiting, diarrhea and constipation.
There are ways to potentially mitigate these side effects — like slowly increasing the dose of medication, staying well hydrated, avoiding high-fat foods and appropriately spacing out meals — which is all “information you would get if it’s been prescribed in an appropriate manner,” Dr. Egan says.
There have also been concerns raised about potential risks of pancreatitis and a rare thyroid cancer known as medullary thyroid carcinoma. For these reasons, these medications aren’t typically prescribed to those with a personal history of pancreatitis or a personal or family history of medullary thyroid carcinoma.
What is “Ozempic face” and why does it happen?
The term “Ozempic face” is misleading. When it comes to Ozempic — as well as Wegovy — “there is nothing specific in the medications that’s targeting fat loss in the facial area,” Dr. Egan says. Instead, they appear to lead to an overall reduction in body weight because of their effect on appetite and calorie intake.
But when you maintain a higher weight for an extended period of time and then lose a large amount of that weight, the decrease in under-the-skin (subcutaneous) fat can lead to excess skin accumulation — especially in areas like the face, arms and abdomen, Dr. Egan says.
It’s possible that you may see less excess skin if weight is lost in a controlled, gradual way, Dr. Egan says. But some of it may just be inevitable.
“Particularly as we get older, our skin and subcutaneous tissue is less able to adjust well to large changes in subcutaneous fat,” she says.
There are potential ways to address this through cosmetic treatments to the body or face, Dr. Egan says, but these can be costly procedures and aren’t without risk.
But Dr. Egan hasn’t actually ever had a patient express concern about facial fat loss.
“We’ve been using this medication for years for the treatment of type 2 diabetes, and (this concern) has never been raised,” she says.
And she hopes that all the recent discussion about “Ozempic face” won’t scare people off from taking a very helpful diabetes drug.
“It could actually lead to people not seeking the treatment that they may very desperately need for their short- and long-term health,” Dr. Egan says.
Is Ozempic safe?
Dr. Egan says that when prescribed and used correctly as part of a multidisciplinary approach to chronic disease management, Ozempic and Wegovy are safe drugs.
In fact, beyond diabetes treatment and weight control, they have a few other potential benefits: Both medications may cut down on cardiovascular events such as heart attacks and strokes in certain populations.
And unlike other weight-loss drugs such as phentermine (Adipex-P, Lomaira) and phentermine-topiramate (Qsymia) — which both contain a drug that’s similar to an amphetamine — these drugs don’t carry a risk of misuse.
However, weight-loss medications are far from magic, and it’s important to understand their limits. They don’t work for everyone and can be expensive. They may have to be taken indefinitely to maintain the weight loss. And though some have been approved for long-term use, the risks of taking these drugs for indefinite periods are not well understood.
And it’s definitely not safe to take these drugs — or any prescription drug — without a prescription.
“We really carefully consider what medications we prescribe, particularly here at Mayo Clinic, when it comes to individuals with diabetes or obesity,” she says. “If we recommend the medication, it’s because we feel that the potential benefit outweighs any associated risks.”
