A comprehensive new study has revealed that widely used weight loss drugs trigger significant muscle loss, including noticeable changes in facial appearance. The research, which will be presented at the American College of Physicians' Internal Medicine Meeting in San Francisco, reviewed health data from thousands of patients taking medications like Mounjaro and Wegovy.
Muscle Loss and Facial Changes
The study found that two-thirds of users experienced crucial muscle mass reduction while taking these injections. This muscle loss is believed to be responsible for the phenomenon dubbed 'Ozempic face', where users' faces appear hollowed out with prominent cheekbones. The researchers examined 36 weight loss drug studies and discovered that patients consistently lost more muscle than anticipated.
Celebrity Experiences and Public Awareness
Reality TV star Sharon Osbourne publicly discussed her experience in 2024, stating that after using weight loss drugs she felt 'too gaunt' and 'too skinny', while also struggling to regain weight. Similarly, singer Meghan Trainor admitted to using Mounjaro to help with substantial weight loss, though she emphasized making 'huge lifestyle changes' including working with a dietician and personal trainer.
Health Risks and Expert Warnings
Medical experts are now warning users to take preventive measures against muscle loss, which can lead to serious complications including life-threatening falls. Dr Charlotte Suetta, a geriatric consultant at Copenhagen University Hospital, emphasized that 'treatment should be paired with strategies likely to preserve muscle health, especially resistance exercise and adequate protein intake.'
Dr Ruby Aktar, a neuroscientist and weight-loss expert at Queen Mary University of London, explained: 'The aesthetic change often referred to as 'Ozempic face' is typically linked to the pace and composition of weight loss, rather than the medication itself. When weight is lost quickly, the body doesn't just draw from fat stores, it can also break down lean muscle and the structural fat that supports areas like the face.'
Particular Concerns for Older Adults
Dr Suetta highlighted special concerns for older adults, stating: 'In older adults, preservation of muscle may be decisive for whether weight loss leads to better health or greater vulnerability. For older adults especially, this is not just about body composition. It is about mobility, falls, frailty, and the ability to maintain an independent life.'
Weight Regain and Heart Benefits
The research follows a landmark Oxford study published in January that found most users regain weight within two years of stopping treatment, much faster than traditional dieters. Experts warned that discontinuing the drugs not only reverses weight loss but also diminishes key heart benefits previously gained.
How GLP-1 Drugs Work
These injections, collectively known as GLP-1 drugs, function by mimicking hormones released after eating. While they have transformed obesity treatment by offering dramatic weight loss previously difficult to achieve through diet and exercise alone, concerns have emerged about what happens when users stop taking them.
Exercise Recommendations and National Guidelines
Experts have long recommended strength training to help maintain muscle mass while using these medications and after discontinuing them. In the absence of specific research on optimal training protocols for muscle preservation during weight loss, the study authors suggest users follow national guidelines recommending 150 minutes of moderate to vigorous exercise weekly.
NHS Expansion and Wider Implications
The National Institute for Health and Care Excellence (NICE) announced this month that more than a million people with heart disease will be offered these injections through the NHS. This marks the first UK approval of these drugs specifically for heart problem prevention rather than just weight loss.
Currently, two in three Britons are classified as overweight or obese, with NHS figures showing adults weigh approximately a stone more than they did thirty years ago. This trend is estimated to cost the economy £100 billion annually.
Balancing Benefits and Risks
While these medications can cause side effects including nausea, vomiting, diarrhea, and in rare cases pancreatitis, experts maintain that benefits generally outweigh risks for most patients. However, they emphasize that those prescribed these medications should receive comprehensive advice about diet, nutrition, and increased physical activity alongside the injections to help preserve muscle mass and overall health.
