You’ve undoubtedly seen the run on diabetes drugs like Ozempic and Mounjaro and weight loss drugs like Wegovy to the degree that there is a well-publicized shortage of these injections. The reason behind this is the effectiveness in providing weight loss. While the diabetes drugs mentioned above are not FDA-approved for weight loss, medical doctors can prescribe them “off-label” if they believe there is a clinical benefit. For example, while Wegovy (weight loss) and Ozempic (diabetes) are approved for different uses, these injections contain the same essential active ingredient – semaglutide.
There are several concerns associated with this new trend. First, we see patients with legitimate options outside of pills to lose weight, taking these medications to drop an extra 10, 20, or even 30 pounds. Secondly, this shortage of medicine is creating a severe concern for diabetic patients who must take these drugs to control their blood sugar. Finally, there are some potential side effects that patients must consider, especially if the injection is primarily being used for cosmetic purposes.
Of all the side effects of these drugs, one that is not labeled, but needs to be discussed is the effect of weight loss medication and rapid weight loss on facial fullness. Fat is our friend when it comes to our face, at least. Facial fullness comes from strategically placed fat pads that give us the good youthful look we want. When we lose that facial fullness, typically through age, it’s because the fat starts to recede. We combat this by using facial fillers, whether bovine-based or hyaluronic acid.
So, is the loss of facial fullness worth losing 20 pounds over? Dr. Boger weighed in on this trend by saying: “It’s not a zero-sum game. Weight loss and facial fullness can coexist. But whatever you do has to be thoughtful and deliberate. Unfortunately, today, we are looking for easy ways to lose weight, and the use of these drugs by some, especially those that would derive greater benefit from a proper diet and exercise program, is a testament to that. When we see patients with gaunt facial features who have lost a considerable amount of weight in a short period, we know that something’s up, and these days, it’s usually drug therapy.”
Dr. Boger continued with some practical advice for all our patients, which includes optimizing your lifestyle through diet and exercise whether or not you are taking weight loss medication: “In the end, if you have fewer than 20 pounds to lose and you’re in good general health with no metabolic disease markers, we need to talk about diet and exercise as the primary form of weight loss. A proper diet can boost collagen production while allowing you to lose weight and minimize the facial aging process. Building muscle through exercise burns more calories and provides for a toned body, better skin, and, once again, improved collagen production. If you are experiencing metabolic disorders because of your weight and have not had success with diet and exercise alone, you can talk to your medical provider about any of these drug options. However, seeing the pounds melt away and not feeling hungry is not a substitute for the diet and exercise program I just mentioned. I would say that getting on a diet and exercise program while on any of these medications is even more critical. If you ever stop taking these drugs, you will most likely regain weight unless you have changed your lifestyle significantly. I can’t stress this enough: You need to have a candid conversation with your medical team – Primary Care Physician, Weight Loss Expert, and/or Endocrinologist about these medications and their side effects because there’s so much more to it than just appetite suppression.”
Here’s the kicker. While weight loss will undoubtedly reduce facial fullness, weight regain does not necessarily put fat back in the same places. Each of us carries fat differently, and while some facial fullness will return if you gain weight, it may not be exactly the way it was. Hormonal and lifestyle changes since you last gained weight make a difference. For example, you may find that your neck or jowls collect more fat than your cheeks. This could ultimately lead to needing more cosmetic procedures.
If you know Dr. Boger, you know that he prioritizes physical and mental wellness. As a medical doctor in the cosmetic world, he takes a whole-body perspective. We can discuss a comprehensive weight loss program that minimizes the loss of facial fullness and fat during a consultation. Ultimately, patients need to be aware of their options and understand that no matter how enticing, the only way to get the best of both worlds is to work hard at it.
We look forward to seeing you in our office for a free consultation to discuss this further.