This post was originally published on the BBC Arabic Website
Many people dream of losing weight and achieving a slim figure. But this dream often seems out of reach due to the perseverance and discipline it requires. In an era marked by speed and the prevalence of instant and easy solutions, traditional dieting and exercise may seem exhausting—especially in the face of temptations like fast food and spending long hours in front of computer and smartphone screens.
With scientific and technological advancements, new methods have emerged promising magical results: medications that offer rapid outcomes and strict diets that promise to shortcut the journey. Amid this obsession with being thin, terms like “Ozempic Mouth”, have started to trend in the media and on social media platforms, revealing another side of the story: the side effects of rapid weight loss.
So, what is “Ozempic Mouth”?Are the side effects of rapid weight loss purely cosmetic, or do they also pose potential health risks?
“Ozempic Mouth” and “Ozempic Face”
Ozempic is the brand name for a medication containing the active ingredient semaglutide. It’s an injectable or oral drug primarily prescribed for people with type 2 diabetes and sometimes for those with obesity. It belongs to a class of medications known as GLP-1 (glucagon-like peptide-1) drugs, which mimic the action of the GLP-1 hormone that regulates blood sugar, controls appetite, and slows digestion.
These medications have gained immense popularity in recent years, especially after celebrities admitted to using them to lose weight—even some who weren’t obese.
“Ozempic Mouth” (or previously “Ozempic Face”) is a term used primarily by the media to describe facial changes—especially around the mouth—resulting from the rapid weight loss caused by GLP-1 drugs like Ozempic, Mounjaro, or Wegovy. These changes may include wrinkles, fine lines, sagging skin, and a hollowed appearance in the cheeks or eyes.
According to Dr. Andrew Kernohan, an endocrinologist and director of The Weight Loss Medics clinic, this could be a real source of concern for some people, and is “caused by subcutaneous fat loss around the face.”
What Is a Safe and Sustainable Rate of Weight Loss?
Dr. Kernohan states that losing 0.5 to 1.0 kilogramper week is considered safe and sustainable. For individuals just beginning their weight-loss journey, slightly faster rates may be acceptable in the early weeks.
He adds that exceeding this rate beyond the first two months is generally considered too rapid. “An individual approach looking at total energy expenditure, calorie deficit, micro and macronutrient diet composition can better inform any therapeutic decisions and prevent too rapid weight loss and the risks associated.”
Health Risks of Rapid Weight Loss
Sure, rapid weight loss might initially seem like a cause for celebration for those taking such drugs or following ultra-low-calorie diets. But the problem is that this speed can come with several negative side effects, beyond just the facial changes labeled as “Ozempic Face.” According to Dr. Kernohan, these include:
- Increased risk of gallstones and biliary problems. This may be particularly an issue for people taking GLP-1 agonists where the risk of biliary problems and gallstones is doubled.
- Possible Increased risk of pancreatitis
- Accelerated loss of bone mineral density
- Increased risk of Hair loss
- Dehydration is a major problem in people who lose weight too rapidly. Much of what we drink is associated with food and in extreme calorie restriction dehydration and acute kidney injury can occur.
- Fatigue and weakness, which can be signs of unsafe weight loss speed
- Micronutrient deficiencies
While Dr. Kernohan confirms having seen these side effects in patients using GLP-1 drugs, he emphasizes that it’s very difficult to say to what extent the problems were caused by rapid weight loss per se or the GLP-1 agonist.”
There are also common side effects directly linked to weight-loss injections, including dizziness, vomiting, bloating, constipation, and diarrhea. These usually subside over time for many users, but others stop the medication due to these symptoms.
Experts warn that the complications can worsen if these drugs are misused—such as being taken without medical consultation or bought online from unlicensed, unregulated sources.
Fat Loss vs. Muscle Loss
Weight loss, whether through dieting or medication, typically involves a combination of fat, muscle mass, and water, among other components.
Dr. Kernohan explains that “in most studies, muscle loss represents about 25% of total weight losswhether this with diets or with GLP-1 agonists. In the early weeks of weight loss (either by diet or GLP-1/GIP agonists) water represents a higher proportion of the weight lost. This is likely related to depletion of glycogen stores.”
Glycogen, a carbohydrate storage form sometimes called “animal starch,” consists of many glucose units. It’s mainly stored in the liver and muscles and is released into the bloodstream when the body urgently needs energy—such as during exercise or between meals.
Loss of muscle mass poses significant health concerns. It weakens physical strength, reduces functional ability, slows metabolism, and increases the risk of falls, injuries, and fractures.
Dr. Kernohan emphasizes that “by focussing on hydration and a protein rich diet with plenty of fresh fruit and veg combined with exercise, the risks of muscle loss can be attenuated. This is the same with any successful weight loss strategy but the risks may be higher with GLP-1 agonists simply because they are more effective at switching off appetite”.
Regarding subcutaneous fat loss, nutritionist Bridget Benelam notes that “some issues like wrinkles or sagging skin may be unavoidable when a large amount of weight is lost, especially rapidly.”
Some people turn to collagen supplements to improve skin appearance and reduce wrinkles. While some studies suggest potential skin benefits, many health experts—including the European Food Safety Authority—believe more research is needed before drawing definitive conclusions. Current scientific evidence is not sufficient to confirm these benefits.
How Can We Protect Our Health During Weight Loss?
Dr. Kernohan emphasizes the importance of safe and sustainable weight loss and avoiding rapid shedding of pounds. For those using GLP-1 drugs, he recommends making lasting dietary and exercise changes, “emphasising and agreeing safe individual targets with patients, and outlining some of the risks associated with too rapid weight loss”.
If weight loss is progressing too rapidly, I often advise lowering the medication dosage and providing additional dietary and lifestyle guidance”. He adds that “If weight loss was too rapid, I would usually advice dose reduction of any weight loss mediation and diet/lifestyle advice above”.
“Very low-calorie diets should always be supported by qualified nutrition professionals to ensure that nutrient needs are met”, says Benelam, who adds that “this could include guidance on selecting nutrient rich foods and potentially also advice on supplements or fortified foods to cover nutrient requirements”.
In the race to lose weight, it’s easy to focus on what the mirror reflects—especially with the media and social platforms highlighting terms like “Ozempic Mouth” or “Ozempic Face.” But visible changes aren’t the only indicators of health. Rapid weight loss can come at a cost to the body’s long-term well-being.
Though weight loss can bring many health benefits—such as reducing the risk of type 2 diabetes, heart disease, high blood pressure, and improving joint health—it is not a one-size-fits-all journey. Everybody responds differently. That’s why consulting with doctors and qualified specialists remains a crucial step to ensure the path to weight loss is both safe and sustainable.