Ozempic Face and Ozempic Butt
“Ozempic face” may have been the first Ozempic side effect to go viral. Soon after, the pattern repeated itself when claims of “Ozempic butt” hit headlines. In each case, users complained that the drug had given some part of their bodies a surprising and unfortunate flabby appearance.
There’s nothing to worry about. There is no evidence that Ozempic or any other similar drug directly affects your appearance. Experts seem to agree that Ozempic face and Ozempic butt are purely caused by weight loss. The same flabby results can and will occur when you lose weight the old-fashioned way, or through other medical methods such as bariatric surgery.
It turns out that not all weight loss enhances your appearance. When you lose a lot of weight, you might also lose some healthy-looking fat that you’d prefer to keep in places like your face or butt. Rapid weight loss can also lead to saggy skin: The skin is an adaptable and elastic organ, but it cannot snap instantly back into a taut shape. Successful dieters have struggled with these issues since long before Ozempic came on the scene.
Ozempic Breath and Dry Mouth
Bad breath is typically a matter of oral hygiene. Food particles and bacteria in the mouth can create foul odors. Though in some cases bad breath (halitosis) can signal a more substantial medical condition, experts seem unworried that Ozempic breath is a serious sign.
How does Ozempic cause bad breath? One possible explanation is Ozempic’s tendency to cause dry mouth (xerostomia). Saliva helps to cleanse the mouth, and a lack of saliva can allow bacteria to fester, grow, and get stinky. Though dry mouth was not initially reported among semaglutide’s known side effects, it has been widely discussed in social media and clinicians have published reports of extreme cases.
“Keto breath” may also explain some cases of Ozempic breath. This side effect is common when people switch to a keto diet, which strictly limits the number of carbohydrates you are allowed to eat. Keto breath, which tends to have a fruity aroma, is caused by acetone, a by-product of ketosis. It is probable that some Ozempic users have unintentionally adopted a ketogenic eating pattern as a result of their diminished appetites — eating 50 grams or less of carbohydrates per day can trigger ketosis.
Hair Loss
Ozempic can cause hair loss. While it isn’t listed as a side effect on Ozempic’s FDA label, hair loss is listed on the FDA's label for Wegovy, essentially the same medication. Three percent of participants in the drug’s pivotal trial reported hair loss (3 times as many as those who used a placebo).
Like Ozempic face and Ozempic butt, however, this is merely a common consequence of rapid weight loss. Dramatic weight loss, no matter how it’s caused, often causes hair loss. This science is well-established. For example, a study of crash dieters published in 1974 found multiple cases of “profuse hair loss.” And more than half of people who receive bariatric surgery experience hair loss, too.
The good news: One study found that “hair loss stopped and new hair gradually grew out in all patients.” Hopefully, the minority of Ozempic users who lose some hair on the drug will have the same good luck.
Ozempic Side Effects in Females
As far as research goes, most of semaglutide’s side effects are common to both males and females, and there is no special interaction between GLP-1 drugs and female hormones. But there are certain Ozempic side effects that specifically affect women.
Ozempic Babies
We may be experiencing an Ozempic baby boom. Across social media, women are crediting surprise pregnancies to their GLP-1 medication.
Though there’s no solid data on the phenomenon, experts agree that Ozempic has a number of different features that could account for increased fertility. Obesity itself has long been known to cause subfertility and infertility, so the dramatic weight loss associated with Ozempic could easily increase a woman’s chances of conceiving. The effect may be even stronger when weight loss and metabolic improvements help improve or alleviate a condition like polycystic ovary syndrome (PCOS).
There is also a chance, however, that Ozempic could interfere with the birth control pill. Today, there is no scientific evidence that this happens, but a related drug in the class, tirzepatide (Mounjaro, Zepbound), carries warnings on its FDA labels that it “may reduce the efficacy of oral hormonal contraceptives due to delayed gastric emptying.” Patients are advised to switch to a non-oral form of contraception or to add a barrier method, such as condoms.
Ozempic Breasts
First, there was Ozempic face, then, there was Ozempic butt. Finally, complaints of “Ozempic breasts” hit headlines in the spring of 2024.
Women who have lost weight with Ozempic and other GLP-1 medications are complaining that their breasts have a saggy or deflated appearance. But there is no evidence that Ozempic has a particular effect on breast tissue. Rather, any change in breast shape is almost certainly due to the rapid and substantial weight loss that these drugs so frequently cause. Women who have lost weight with other methods have noticed the same issue.
Tiredness and Fatigue
There are reports that Ozempic can cause fatigue — basically, tiredness or exhaustion that isn’t improved by sleep. The FDA label for semaglutide (Wegovy) reports that 11 percent of trial participants experienced fatigue, a little bit more than twice as often as those who used a placebo.
It’s unclear why Ozempic would cause fatigue, although one very plausible explanation is the fact that it causes people to eat so much less food. Ozempic causes extreme weight loss by encouraging users to eat at an extreme calorie deficit. You’re putting less fuel into your body, essentially crash dieting. Is it any wonder that Ozempic might sap your energy?
Dizziness
Dizziness has also been reported in a slim minority of Ozempic users. It is possible that Ozempic dizziness stems from the glucose-lowering effects of the drug — dizziness is a common symptom of hypoglycemia. Even patients who are not at risk of severe hypoglycemia (typically those who do not use insulin or sulfonylureas) may feel dizzy while experiencing transient low blood sugar episodes.
Excessive Muscle Loss
It is inevitable that weight loss will involve some muscle loss. This is considered healthy and natural.
Some experts, however, believe that Ozempic and related drugs are causing a surprising and worrying amount of muscle loss.
We only have a modicum of good data on this question. Body composition analyses of volunteers in two trials found that semaglutide users lost about 40 percent lean mass and 60 percent fat. This is more muscle loss than researchers expect to see. A review published in 2017 stated that people using other methods to lose weight tend to lose only 20 to 30 percent lean mass.
In February 2024, The New York Times reported that the manufacturers of GLP-1 drugs are taking the problem seriously, and have begun to develop combination drug treatments that could help users of Ozempic and related drugs preserve lean mass.
In the meantime, experts agree that it would be wise for users to engage in strength-building exercises to help preserve muscle mass during weight loss. Eating enough protein may also help.
This potential side effect may also be a good reminder that Ozempic is inappropriate for people who do not have a good medical reason to lose weight.
