Don't these plastic surgeons have a conflict of interest if they perform liposuction? Liposuction is probably wildly more profitable than prescribing a GLP-1 inhibitor.
People are coming to them with sagging skin from Ozempic. Since 6% of Americans are on it now (according to that article), how is that competition for the plastic surgeons?
> These are changes he hasn’t noticed in patients who have lost significant weight in other ways—like through diet or gastric bypass surgery—which makes him think it’s unique to GLP-1 usage.
I wonder if using something like Retinol, which is proven to improve skin and make it look tighter, younger, and get rid of blemishes, marks, and sun damage, could be paired with Ozempic to keep skin more healthy along with a good skin routine?
I don't know much about skin care, but given that Ozempic has side effects that affect the retina, it wouldn't be crazy to get plenty of vitamin A if you're taking it.
There are more options. Many medications are usually prescribed together with other meds, to help with the side effects. We may adjust the formulations, or learn what to compliment it with.
1. If other weight loss methods also have significant impacts on the skin, it seems plausible that a shared mechanism could be the most parsimonious explanation. Therefore, if this effect exists, it might be due to weight loss itself rather than specifically due to Ozempic. The article cites a study supporting the fact that dramatic weight loss has negative impacts on skin health.
2. GLP-1 agonists modify appetite, which could lead people to consume less satiating foods (e.g., protein). This might negatively affect both lean muscle and skin health. There is data supporting collagen supplementation for skin health, as collagen likely raises serum amino acids. This would have the opposite effect on skin health compared to a lower intake of protein.
3. The observations made by plastic surgeons might be influenced by healthy user bias. Ozempic is an expensive medication, and insurance coverage is generally granted to those who are already quite unhealthy. To make a fair comparison, these patients should be compared to individuals with similar health characteristics.
It's also worth adopting an engineering mindset and considering the trade-offs involved. For someone who is extremely metabolically unhealthy, the benefits of weight loss might outweigh potential negative effects on the skin in terms of long-term health.
I've been using tirzepatide since the end of february, since then I've lost 52lbs in about 25 weeks, if my fat skin was stretched and it's since relaxed at a rate of 2lbs per week then maybe right now it is like an old rubber band that's been unstretched, but in a few months time once the rate of loss reduces it will be ok. I'm almost 50 so tbh I expected it to be much worse, I've virtually no loose skin compared to the 6 inches I've lost around my waist.
> “Fifteen years ago, I would never have done a lower body lift on a patient unless they had gastric bypass, a lap band, or a gastric sleeve,” he says.
Right, because 15 years ago nobody else lost any weight. GLP-1s and roux-en-Y are literally the only two treatments shown in clinical studies that cause people to lose weight and keep it off indefinitely.
Maybe the skin is saggy because there’s nothing under it, maybe not? But at least they won’t have a stroke, heart attack, cancer or type 2.
Chemo is going to make you look much worse.
The new category of patient is “person who successfully lost weight and kept it off without gastric bypass.”
[edit] if you think I’m exaggerating there’s a great study from 2023 that tracked how many people lost more than 5% body weight in a given year.
Answer: 1 in 10, skewing mostly to people who had more to lose.
If you were morbidly obese your probability of achieving a healthy weight is 1 in 1667 in a year.
And if you manage to thread that needle your average weight regain over 5 years is 80%.
Wow. 10% success rate for diet is really lower than I thought. I'd have guessed 25% based on my experience (34 BMI to 25 over 6 years). Not that surprising though, loosing weight is the hardest, most painful thing I ever done.
It's strange how there is almost never a shortcut to anything. Like a universal law.
So now you might get free weight loss without making any effort at all, but you'll also look older in the process?
I have to say, my father has been taking it, and I noticed that he does look older all of a sudden...and his weight loss also plateaued. I thought it was just my imagination, but maybe not.
> strange how there is almost never a shortcut to anything. Like a universal law
There are win-win tradeoffs. Vitamins, for instance. If you're running a vitamin deficiency, there isn't a downside to increasing your intake of that vitamin. (Curing acute dehydration via IV is another shortcut that just works.)
The Ozempic story, for me, has been more about how we almost seem to be reflexively against the idea of a win-win. A lot of people want there to be a tragic downside to the drug for reasons that aren't entirely clear to me.
I have heard that people who lose weight quickly will typically look older due to the development of wrinkles and the development of harder features. Skin simply doesn't have time to keep up with the weight loss. I don't know if this is true but the theory could have some merit as far as our perception of people. The real question is: does something like ozempic change the biological age of someone?
What kind of effort are you talking about? Weight loss has very little to do with exercise and mostly to do with how much you eat. Those drugs allow you to combat the carving when you restrict food. Is fighting the carving the "effort" you think people ought to make?
IMO GLP-1 agonists are obviously not free, from first principles. They might be for diabetics who carefully manage their diet, but many (most?) people using them for weight loss usually already have shitty diets with poor macronutrient balance and micronutrient deficiencies. Eating less of the crappy food they were eating before just makes the true situation worse.
This is just the latest [1][2] evidence for the obvious muscle wasting that will happen to a human body that is starved of protein and micronutrients. The muscles under the skin are being cannibalized for protein that’s missing in the diet and other biochemical processes that restore them are starved of the nutrients they need to function.
It's worth noting that people, in this forum especially, would defend weight loss drugs at any cost. Because for them they mean being not-obese without any trace of effort. Controlling caloric input, maybe even leaving the house and moving... puff. Gone. Just take a pill daily for the rest of your life.
There's no shot that the cure everything pill will have any negative health consequences, it's been working so well for me that I just spoke to my pharmacist and we're doubling my dose.
A quick explanation about what Ozempic is would be helpful in this case. Not every country uses the same name for their drugs and the brand names are often very different
That's an interesting remark, considering this is most famous drug on the face of the Earth, and only has one brand name worldwide (in a different dosage it's called Wegovy, and when it's released as a pill it will be called Rybelsus). Its generic name is Semaglutide.
Was this article written by an LLM? I had to scroll so far to get to the core content it kept promising, it's like it wasn't written for human consumption.
Ultimately this article is kind of a FUD nothing-burger. People's skin behaves the same anytime there is rapid weight loss.
> These are changes he hasn’t noticed in patients who have lost significant weight in other ways—like through diet or gastric bypass surgery—which makes him think it’s unique to GLP-1 usage.
here’s my casual armchair analysis about some thing I know nothing about: Is this correlation instead of causation? I mean, if you’re dumping pounds rapidly and then your skin is all been stretched out…
> These are changes he hasn’t noticed in patients who have lost significant weight in other ways—like through diet or gastric bypass surgery—which makes him think it’s unique to GLP-1 usage.
If you're using ozempic or any other form of semiglutide , you'll want to keep and prioritize a high protein diet to reduce or eliminate the muscle wasting that the drug causes.
Nothing worse than losing weight but most of the weight loss was muscle mass.
My impression from watching various people debating studies on the topic, is that even more important than protein is physical activity, when it comes to stopping muscle loss. Someone sitting in a box eating nothing for a month will come away from it with all sorts of health issues compared to someone who walks for half an hour and otherwise lives normally, despite the second person supposedly having higher energy and nutritional needs. Physical activity is a powerful signal to the body to maintain itself. This is why the health of bedridden people looks like a horrible feedback loop that destroys them.
Another issue that makes me wary is that normally when fasting, there’s an initial period of being hungry, followed by adaption and minimal/no hunger. After a few weeks (or longer if there are special circumstances), hunger should eventually return, and this is your signal to start eating again regardless of plans. What concerns me is that Ozempic may prevent the return of hunger signal. I could see this leading to malnutrition, which another post already mentioned in a different way.
In the UK those products are only available to people with a BMI > 30. If you have 20 or 30 kg to lose it is simply not true that most of the weight loss is muscle mass. The fat is visible and the fat loss is also visible. You might lose a bit of muscle mass, and doing exercise at the same time is good. But between the loss of a bit of muscle mass during the diet vs remaining obese, it is an easy trade off from a health point of view.
"These are changes he hasn’t noticed in patients who have lost significant weight in other ways—like through diet or gastric bypass surgery—which makes him think it’s unique to GLP-1 usage."
Are you suggesting sections elsewhere in the article suggest otherwise?
Not unlike the "massive muscle tone reduction" scare about GLP1 meds - you lose that muscle because you're also losing the fat you needed the extra muscle for...
[+] [-] cosmicvarion|1 year ago|reply
[+] [-] Saline9515|1 year ago|reply
Plastic surgeons are like the bank in casino: they always win in the end.
[+] [-] comice|1 year ago|reply
[+] [-] fyrepuffs|1 year ago|reply
[+] [-] brigadier132|1 year ago|reply
- it's just stretched skin
- people get on ozempic but are not eating nutritious diets, so now they are malnourished
[+] [-] ceejayoz|1 year ago|reply
> These are changes he hasn’t noticed in patients who have lost significant weight in other ways—like through diet or gastric bypass surgery—which makes him think it’s unique to GLP-1 usage.
[+] [-] cbanek|1 year ago|reply
[+] [-] jordanb|1 year ago|reply
[+] [-] thefz|1 year ago|reply
[+] [-] __MatrixMan__|1 year ago|reply
[+] [-] Loughla|1 year ago|reply
[+] [-] cm2187|1 year ago|reply
[+] [-] Saline9515|1 year ago|reply
It's an important side effect that ought to be researched.
[+] [-] irusensei|1 year ago|reply
[+] [-] unknown|1 year ago|reply
[deleted]
[+] [-] ikurei|1 year ago|reply
[+] [-] readthenotes1|1 year ago|reply
She had the unwrinkled face of a woman who had never been calorically challenged.
[+] [-] prbl2|1 year ago|reply
1. If other weight loss methods also have significant impacts on the skin, it seems plausible that a shared mechanism could be the most parsimonious explanation. Therefore, if this effect exists, it might be due to weight loss itself rather than specifically due to Ozempic. The article cites a study supporting the fact that dramatic weight loss has negative impacts on skin health.
2. GLP-1 agonists modify appetite, which could lead people to consume less satiating foods (e.g., protein). This might negatively affect both lean muscle and skin health. There is data supporting collagen supplementation for skin health, as collagen likely raises serum amino acids. This would have the opposite effect on skin health compared to a lower intake of protein.
3. The observations made by plastic surgeons might be influenced by healthy user bias. Ozempic is an expensive medication, and insurance coverage is generally granted to those who are already quite unhealthy. To make a fair comparison, these patients should be compared to individuals with similar health characteristics.
It's also worth adopting an engineering mindset and considering the trade-offs involved. For someone who is extremely metabolically unhealthy, the benefits of weight loss might outweigh potential negative effects on the skin in terms of long-term health.
[+] [-] ddmf|1 year ago|reply
[+] [-] arcticbull|1 year ago|reply
Right, because 15 years ago nobody else lost any weight. GLP-1s and roux-en-Y are literally the only two treatments shown in clinical studies that cause people to lose weight and keep it off indefinitely.
Maybe the skin is saggy because there’s nothing under it, maybe not? But at least they won’t have a stroke, heart attack, cancer or type 2.
Chemo is going to make you look much worse.
The new category of patient is “person who successfully lost weight and kept it off without gastric bypass.”
[edit] if you think I’m exaggerating there’s a great study from 2023 that tracked how many people lost more than 5% body weight in a given year.
Answer: 1 in 10, skewing mostly to people who had more to lose.
If you were morbidly obese your probability of achieving a healthy weight is 1 in 1667 in a year.
And if you manage to thread that needle your average weight regain over 5 years is 80%.
https://jamanetwork.com/journals/jamanetworkopen/fullarticle...
[+] [-] orwin|1 year ago|reply
[+] [-] Andaith|1 year ago|reply
Total Diet Replacement (TDP) is apparently also quite effective. This isn't the article I read, but it's talking about the same trial(Direct) so here you go: https://tdmr-europe.com/2024/01/17/experts-demonstrate-total...
[+] [-] unknown|1 year ago|reply
[deleted]
[+] [-] bamboozled|1 year ago|reply
So now you might get free weight loss without making any effort at all, but you'll also look older in the process?
I have to say, my father has been taking it, and I noticed that he does look older all of a sudden...and his weight loss also plateaued. I thought it was just my imagination, but maybe not.
[+] [-] JumpCrisscross|1 year ago|reply
There are win-win tradeoffs. Vitamins, for instance. If you're running a vitamin deficiency, there isn't a downside to increasing your intake of that vitamin. (Curing acute dehydration via IV is another shortcut that just works.)
The Ozempic story, for me, has been more about how we almost seem to be reflexively against the idea of a win-win. A lot of people want there to be a tragic downside to the drug for reasons that aren't entirely clear to me.
[+] [-] mym1990|1 year ago|reply
[+] [-] cm2187|1 year ago|reply
[+] [-] throwup238|1 year ago|reply
This is just the latest [1][2] evidence for the obvious muscle wasting that will happen to a human body that is starved of protein and micronutrients. The muscles under the skin are being cannibalized for protein that’s missing in the diet and other biochemical processes that restore them are starved of the nutrients they need to function.
[1] https://news.ycombinator.com/item?id=37558780
[2] https://news.ycombinator.com/item?id=39326333
[+] [-] thefz|1 year ago|reply
[+] [-] mistercheph|1 year ago|reply
[+] [-] czard0mn|1 year ago|reply
[+] [-] dark-star|1 year ago|reply
[+] [-] istultus|1 year ago|reply
[+] [-] azinman2|1 year ago|reply
[+] [-] metadat|1 year ago|reply
Ultimately this article is kind of a FUD nothing-burger. People's skin behaves the same anytime there is rapid weight loss.
[+] [-] PhasmaFelis|1 year ago|reply
[+] [-] throwup238|1 year ago|reply
[+] [-] fnord77|1 year ago|reply
[+] [-] exabrial|1 year ago|reply
[+] [-] throwup238|1 year ago|reply
> These are changes he hasn’t noticed in patients who have lost significant weight in other ways—like through diet or gastric bypass surgery—which makes him think it’s unique to GLP-1 usage.
[+] [-] hypercube33|1 year ago|reply
[+] [-] freitzkriesler2|1 year ago|reply
Nothing worse than losing weight but most of the weight loss was muscle mass.
[+] [-] Modified3019|1 year ago|reply
Another issue that makes me wary is that normally when fasting, there’s an initial period of being hungry, followed by adaption and minimal/no hunger. After a few weeks (or longer if there are special circumstances), hunger should eventually return, and this is your signal to start eating again regardless of plans. What concerns me is that Ozempic may prevent the return of hunger signal. I could see this leading to malnutrition, which another post already mentioned in a different way.
[+] [-] cm2187|1 year ago|reply
[+] [-] pavlovsgods|1 year ago|reply
[deleted]
[+] [-] brians|1 year ago|reply
[+] [-] mjamesaustin|1 year ago|reply
"These are changes he hasn’t noticed in patients who have lost significant weight in other ways—like through diet or gastric bypass surgery—which makes him think it’s unique to GLP-1 usage."
Are you suggesting sections elsewhere in the article suggest otherwise?
[+] [-] r00fus|1 year ago|reply
[+] [-] remram|1 year ago|reply
> "We’re still waiting to find out," says Dr. Few. "I don't think anybody can tell you definitively that there's not an inherent change to the skin."
[+] [-] unknown|1 year ago|reply
[deleted]