Facial Fat

[Nathanologist]

“I’d

Are you sure about that?

People have rapidly lost weight via gastric bypass (and its variations), extended water fasts, GLP1-RAs, as well as the newer multi-agonist injections. My suspicion is that there's something specific to single-agonist GLP1 drugs that biases people towards losing a higher protein:fat ratio on very-low calorie diets and being a major driver of "Ozempic face."

For example, if someone goes on a water fast their body will up the release of growth hormone, as a means of preserving lean mass. I'm not sure if this has been studied, but I wouldn't be surprised if a perpetual 24/7 "I just ate" signal being faked from the gut to the brain along the afferent pathway of the vagus nerve could interfere with growth hormone release and cause the body to catabolize more lean mass than is ideal (vs breaking down fat). You could try to counter that effect by upping your protein (which is consistent with your advice). Or it's conceivable that moving to a multi-agonist treatment might mitigate that effect too.

Nothing in life or scientific practice is sure… But the science so far contradicts your suspicions. Let me show you my receipts

Frank, P. J., & Rueda, A. E. (2024). Natural Weight Loss or "Ozempic Face": Demystifying A Social Media Phenomenon. Journal of Drugs in Dermatology, 23(1), 1367-1372.

Dedhia, R. et al. (2025). Are the Next GLP-1 Drugs Finally Going to Outrun “Ozempic Face”? Los Angeles Times.

Rueda, A. E., & Frank, P. J. (2025). GLP-1RA and the possible skin aging. International Journal of Dermatology

Wade, C. (2025). “Ozempic Face”: An Emerging Drug-Related Aesthetic Concern and Its Treatment with Endotissutal Bipolar Radiofrequency (RF)—Our Experience. Journal of Clinical Medicine, 14(15), 5269

Patel, P., & Ali, M. (2024). Ozempic Face: What Is It and Why Does It Happen? HealthCentral

Papoian V et al. (2015). Effects of Bariatric Surgery on Facial Features. Aesthetic Surgery Journal, 35(8), 918–924

De Luca, B., et al. (2024). Soft Tissue Facial Changes Following Massive Weight Loss Secondary to Medical and Surgical Bariatric Interventions: A Systematic Review. Aesthetic Plastic Surgery

While I do use Gemini restricted peer reviewed and scholarly sources to find the articles I cite and read, I do read them all to understand the specifics to the best of my ability. Muscle loss and facial changes have been two areas I’ve been concerned about and intensely researched before embarking on my encretin mimetic fueled body recomp journey.

 

[tubby]

“I’d


Nothing in life or scientific practice is sure… But the science so far contradicts your suspicions. Let me show you my receipts

Frank, P. J., & Rueda, A. E. (2024). Natural Weight Loss or "Ozempic Face": Demystifying A Social Media Phenomenon. Journal of Drugs in Dermatology, 23(1), 1367-1372.

Dedhia, R. et al. (2025). Are the Next GLP-1 Drugs Finally Going to Outrun “Ozempic Face”? Los Angeles Times.

Rueda, A. E., & Frank, P. J. (2025). GLP-1RA and the possible skin aging. International Journal of Dermatology

Wade, C. (2025). “Ozempic Face”: An Emerging Drug-Related Aesthetic Concern and Its Treatment with Endotissutal Bipolar Radiofrequency (RF)—Our Experience. Journal of Clinical Medicine, 14(15), 5269

Patel, P., & Ali, M. (2024). Ozempic Face: What Is It and Why Does It Happen? HealthCentral

Papoian V et al. (2015). Effects of Bariatric Surgery on Facial Features. Aesthetic Surgery Journal, 35(8), 918–924

De Luca, B., et al. (2024). Soft Tissue Facial Changes Following Massive Weight Loss Secondary to Medical and Surgical Bariatric Interventions: A Systematic Review. Aesthetic Plastic Surgery

While I do use Gemini restricted peer reviewed and scholarly sources to find the articles I cite and read, I do read them all to understand the specifics to the best of my ability. Muscle loss and facial changes have been two areas I’ve been concerned about and intensely researched before embarking on my encretin mimetic fueled body recomp journey.

Are you just copy/pasting an LLM output for an answer?

I ask because I went to the very first reference you listed (I assumed you'd lead with the best evidence), which I was able to find a full text copy of here:

https://jddonline.com/articles/natural-weight-loss-or-ozempic-face-demystifying-a-social-media-phenomenon-S1545961624P1367X

It discusses Ozempic and weight loss, but seems to be focused on telling physicians how they should counsel patients about facial appearance changes. There is one sentence in the conclusion that reads:

Currently, there is no evidence to suggest GLP-1 agonists directly catabolize adipocytes within the face. As the usage of semaglutide increases, it is critical that a dermatologist obtains an accurate history from a patient and counsels them on the compounded effect of facial filler and GLP-1 agonist cessation.

But otherwise, the paper doesn't seem to be trying to get to the bottom of whether or not GLP1s are more or less likely to give "Ozempic face" vs other rapid weight loss methods.

Not trying to be a jerk here. Just genuinely interested in the topic and curious if you had a specific reference or rationale that you found compelling in reaching your conclusion.

 

[desinr-gal]

After some research I've came to a possible solution:

After reaching my lean goal, if my face is still rather cherubic I will use HCTZ diuretic to try and debloat. Also, I'm currently eating like twice a day and dry scoop 3 times (75 g protien), and if that doesn't work my buddy I'm going to Agartha!

You could try lymph drainage massage, gua sha, and face yoga. If the fullness is due to blocked fluids, those will help. I am tempted by those face brushes I keep seeing. The massage and yoga can probably be found for free on you tube.

 

[Retazempic]

I know that I'm going to look a little older in the face when I get my weight all the way down (Started at BMI 30, currently 24, aiming for 20), and I'm at peace with that. I'd rather look 45, a little weathered, and gloriously happy with a gorgeous, lean body than looking a little less weathered but doughy and round and also deeply worried about my cholesterol. I'll moisturize and call it good; I'm never going to win any beauty contests, but I'm also never gonna ENTER any.

Exactly the same here

 

[Nathanologist]

Are you just copy/pasting an LLM output for an answer?

I ask because I went to the very first reference you listed (I assumed you'd lead with the best evidence), which I was able to find a full text copy of here:

https://jddonline.com/articles/natural-weight-loss-or-ozempic-face-demystifying-a-social-media-phenomenon-S1545961624P1367X

It discusses Ozempic and weight loss, but seems to be focused on telling physicians how they should counsel patients about facial appearance changes. There is one sentence in the conclusion that reads:

But otherwise, the paper doesn't seem to be trying to get to the bottom of whether or not GLP1s are more or less likely to give "Ozempic face" vs other rapid weight loss methods.

Not trying to be a jerk here. Just genuinely interested in the topic and curious if you had a specific reference or rationale that you found compelling in reaching your conclusion.

No, I am not simply copy/pasting from AI- I am maintaining a library of articles as I research- this is a sampling of the more recent articles I was reviewing in no particular order. I also am not trying to be a jerk, but… Here are the statements throughout the article that present the current scientific position regarding causation of facial changes while on GLP-1, backed by citations. It is good to not just skim, but to read and understand as well as find the citations (if possible) and confirm the position.

“Although known to cause weight loss, the relationship between the GLP-1 agonist mechanism of action and facial weight loss is not characterized and may be unrelated.”

“Evidence of GLP-1 agonists favoring adipose catabolism of the face, as opposed to other body regions, is lacking.”

“There is no evidence that subcutaneous adipose tissue is more likely to be catabolized compared to other adipose stores.”

“Despite this phenomenon, this adverse effect is explained by any variation of rapid weight loss in combination with slow elastin turnover and is not solely medication derived.”

“Currently, there is no evidence to suggest GLP-1 agonists directly catabolize adipocytes within the face.” (the one sentence in the article you picked up)

That is exactly the point of the paper you read- the facial changes are not the result of the medication, rather the weight loss. It draws on other scholarly sources to back up that foundation. This makes it necessary of dermatologists to take accurate history and use appropriate tools and counsel patients about THE MISINFORMATION surrounding “Ozempic face”

You may be better served reviewing the citations. I find that sharing them can be difficult because often they are behind paywalls, but some of these specialty field articles are not, but are scholarly sources we may trust the statements are accurate to current standards and conclusions.