Ozempic
08 April 2023
If plump lips and other signs of an overfilled face are the looks de rigeur of Hollywood celebrities- then what would be the anti-thesis to this aesthetic? Enter Ozempic Face, a description of a new look that’s been making its rounds on the internet.
Although popularised by celebrities and TikTokers as a medication for drastic weight loss, Ozempic is originally a brand name of a medication for type 2 diabetes called semaglutide Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist, which means that it works by mimicking the effects of a hormone called GLP-1 in the body.
Ozempic is one of the brand names of semaglutide (Glucagon-like peptide-1), which has received US FDA approval for treatment of type 2 diabetes in adults in 2022. Glucagon-like peptide-1 (GLP-1) is a hormone that is produced by the gut and released into the bloodstream in response to food intake. It promotes insulin secretion to regulate blood sugar levels in people with type 2 diabetics. GLP-1 agonists also mimic the body’s intrinsic satiation pathway, which helps reduce hunger and decrease energy intake1. This feeling of fullness is one of the factors behind semaglutide’s weight loss effects1.
Besides reducing blood sugar levels in people with type 2 diabetes mellitus, semaglutide has been shown to reduce the risk of major cardiovascular events in adults with type 2 diabetes and known heart problems1.
Fuelled by the fast results of weight loss, Ozempic’s use (and misuse) has skyrocketed in popularity; resulting in a temporary shortage for diabetics who have a therapeutic indication for this medication. Take a look at #Ozempic on TikTok, and you’ll find countless videos crediting Ozempic for their evident weight loss and the instant gratification that comes with it. Some celebrities that have openly discussed their use of Ozempic are comedian Chelsea Handler and Elon Musk.
Coined by Dr. Paul Jarrod Frank, a New York City-based dermatologist in an interview with the New York Times in January 2023. The term Ozempic Face is used to describe the skinny, gaunt looking and sagging skin faces of users of Ozempic often sport.
According to Dr Frank, “I see it every day in my office. A 50-year-old patient will come in, and suddenly, she’s super-skinny and needs filler, which she never needed before. I look at her and say, ‘How long have you been on Ozempic?’ And I’m right 100 percent of the time.”
Ozempic face is caused by the rapid weight loss brought upon by the medication. The rapid and drastic weight loss causes a global fat loss in the face. Where the anatomical fat pads gave a youthful appearance, the disappearance of these facial fats caused a gaunt, hollow looking face.
The sudden deflation of facial volume also results in loose, sagging skin due to the stretch of the initial volume in the face. Loss of facial volume and stretch in the face also accentuates wrinkles and lines.
Some of these signs of volume loss in the face and sagging are hollow temples, sunken cheeks, tear trough deformities, nasolabial folds and jowls. In short, while Ozempic may reverse the clock for one’s metabolism; it definitely accelerates the ageing process on the face.
Another look that started trending in end December 2022 was the hollow cheek look from surgical removal of buccal fats. Celebrities spotting caved in, sunken cheeks, inviting speculation of whether they’ve had this plastic surgery done include Bella Hadid and Lea Michele. Ozempic face is a more drastic and global deflation of the face and neck; as opposed to localised sunken cheeks from buccal fat removal.
Related blogpost:
Why Is Everyone Talking About Buccal Fat Removal?
The most common side effects of Ozempic are stomach discomfort, nausea and vomiting1. The rarer side effects of Ozempic include possible risk of medullary thyroid cancer in people with a condition called multiple endocrine neoplasia 2 (MEN-2) syndrome; pancreatitis and kidney failure1.
A recent study has shown that users stopping GLP-1 agonists regained weight.In a randomised controlled trial of almost 2000 subjects, obese participants treated with semaglutide plus lifestyle intervention had most of the weight loss being regained within 1 year, and a similar change in some cardiometabolic variables back to baseline after cessation of semaglutide2. This finding underscores the importance of reinforcing sustainable, long term interventions for metabolic disorders.
Ozempic is available in Singapore. Ozempic received Singapore’s Health Science Authority’s approval as a treatment for adults with type 2 diabetes. The use of Ozempic for weight loss in patients who do not have diabetes is considered off-label use.
In Singapore, a similar medication, called Saxenda is available for weight loss treatment. Saxendra contains Liraglutide, also a Glucagon-like peptide-1 agonists. Saxenda has received Singapore Health science Authority’s approval for weight management in patients who are obese and have a body weight above 60kg.
Both Ozempic and Saxenda consist of Glucagon-like peptide-1 agonists- Semaglutide and Liraglutide respectively. Saxenda requires daily injections; Ozempic requires weekly injections. This is because Semaglutide has a longer duration of action in the body.
The million dollar question on everyone’s mind is- which is more effective; Saxenda vs Ozempic? Research shows that Semaglutide is more effective in improving blood glucose control and weight loss compared to Liraglutide3,4.
The phenomenon of deflated, hollow faces from Saxenda has not been reported- yet. As the weight loss effects from Saxenda is lesser than Ozempic’s, the risk of developing loss of fats from the face from Saxenda is also expected to be lower.
In treating Ozempic face or results of changes to the face from weight loss, multi-modality treatments are required to undo the volume loss, downward projection of the face, sagging and wrinkles.
Reversing the signs of fat loss in the face such as sunken cheeks and hollow temples can be achieved with dermal fillers. Dermal fillers are traditionally used to replenish volume loss in the face. In treating Ozempic face, the key is to restore balance in the areas that have been deflated without causing overfilled faces.
Related blogposts:
Getting Cheeky: A Guide to Cheek Filler Injections
Temple Fillers for Hollow Temples
Fillers Gone Wrong: Telltale Signs of Too Much Filler Injections
Loose, sagging skin can by stretching of the face by fats can be tightened non-surgically with lifting treatments such as face threadlifts. Face threadlifts physically lift loose, sagging skin in the jawline and cheeks using dissolvable surgical sutures to improve facial contours. Another non-surgical option is Profhilo; an injectable moisturiser that builds collagen and elastin in the skin to also lift the jawline and cheeks. You can learn about non-surgical face lift options in this post How to Treat Sagging Skin Without Surgery.
Related blogpost:
Silhouette Soft Face Threadlift
Is Profhilo the Injectable Skincare of the Future?
Wrinkles in the skin caused by the sudden loss of fats in the face are treated by skin resurfacing treatments, such as fractional CO2 laser. Fractional CO2 laser is type of laser that rejuvenates the skin by increasing collagen levels in the skin to smoothen fine lines for younger looking skin. An alternative to resurfacing lasers would be injectable moisturisers such as Skinboosters, Profhilo and Rejuran. These injectables moisturisers hydrate the skin; and also increase collagen level in the skin (albeit to different extents) to plump up fine wrinkles. The hydration brought about by these injectable moisturisers also imparts a brighter and plump feel to the skin.
Related blogposts:
Skinboosters/水光针: All You Need to Know About It
Rejuran Healer: What You Should Know Before Getting It
Rejuran VS Profhilo VS Skinboosters: Injectable Moisturisers Explained
Another day, another TikTok trend that is expensive to correct. Off label use of Ozempic for weight loss might be a popular trend, especially on TikTok; but it is a treatment not without its risks.
With the aesthetic of slim and sharp contoured faces being a trend; and social media’s unhealthy celebration of thin body types, quick fixes for weight loss- through off label and supervised use of weight loss medications such as semaglutide will be a problem that stays.
References:
1. A clinical review of GLP-1 receptor agonists: efficacy and safety in diabetes and beyond. Prasad-Reddy and Issacs. Drugs Context. 2015; 4: 212283.
2. Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Wilding et al. Diabetes Obes Metab. 2022 Aug;24(8):1553-1564.
3. Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight in Adults With Overweight or Obesity Without Diabetes: The STEP 8 Randomized Clinical Trial. Rubino et al. JAMA. 2022 Jan 11;327(2):138-150.
4. Efficacy and Safety of Liraglutide and Semaglutide on Weight Loss in People with Obesity or Overweight: A Systematic Review. Xie et al. Clin Epidemiol. 2022 Dec 6;14:1463-1476.
