Ever since Ozempic flooded the mainstream consciousness, the controversial weight-loss drug of choice has come with some well-documented downsides. Many have experienced the infamous Ozempic face, which experts describe as rapid weight loss in the face and loss of skin elasticity, resulting in a significantly older appearance. “Ozempic face can look gaunt, deflated, and saggy,” New York facial plastic surgeon Jennifer Levine once told Vogue. “Think raisin as opposed to grape!”
Now people are noticing that Ozempic and similar GLP-1 drugs (Mounjaro, Wegovy, Rybelsus, and Zepbound, to name a few) are affecting their hairlines and possibly weakening their muscle strength. So what gives?
Why is this happening?
Though some studies link these drugs to hair loss, experts still say it is not a direct side effect of GLP-1s like Ozempic or other medications like Mounjaro. Marisa Garshick, MD, board-certified dermatologist at MDCS Dermatology, explains that it’s actually more of an indirect result of rapid weight loss, nutritional deficiencies, or stress on the body. “Telogen effluvium is a type of hair shedding that may be noticed a few months after the body experiences some type of change or stress,” says Dr. Garshick. (It’s akin to the dramatic hair shedding some saw in the months post-COVID-19.) “People on GLP-1s may not actually notice hair shedding or thinning for several months after they are on it.”
As for muscle loss, that’s just a general side effect of losing weight, regardless of whether the impetus is diet, exercise, surgery, or a medication like Ozempic. Holly Lofton, MD, director of the medical weight-management program at NYU Langone Health, tells Vogue that experts are seeing medications like Wegovy and Zepbound causing the same amount of muscle loss as one might experience through more traditional weight-loss methods—and sometimes more. Studies show that 25 to 30% of the total weight loss caused by calorie restriction and exercise comes from lean body mass, which includes muscles. So if someone were to lose 20 pounds, she says, around five to six pounds of that might be muscle that is lost. Studies on medications like Wegovy and Zepbound show patients can lose roughly 15 to 22% of their total weight, with about 25% of that weight loss being lean muscle mass. “These drugs are not necessarily muscle sparing,” she says. “However, because people tend to lose more total weight on these medications, the absolute amount of muscle loss can be greater, unless we intervene with resistance training and adequate protein intake.”
What can you do about it?
There are a few things you can do to treat hair and muscle loss that you might experience when on these medications. Dr. Garshick notes that it is normal to shed approximately 50 to 100 hairs per day, so you should only be concerned if you notice significantly more hair falling out or if your hair loss persists for longer than three to six months. If that is the case, she recommends consulting a board-certified dermatologist for a proper evaluation. “Since telogen effluvium is considered a temporary process, once the weight stabilizes, it is possible the hair loss will slow down and hair regrowth will resume and normalize even without doing any specific intervention,” she says. “While this process can take 6 to 12 months, providing reassurance that it can get better on its own is often sufficient.”
She advises getting blood work done to see if there are hormonal changes or nutritional deficiencies that can be addressed through diet (making sure you are consuming enough protein is key) or the use of oral supplements like Nutrafol or Wellbel. You can also turn to thickening and volumizing shampoos, like the Nioxin Hair Fall Defense Shampoo or the Vegamour Gro Revitalizing Shampoo, and leave-in products like the Virtue Flourish Density Booster to help increase hair density. For more intense treatments, you can inquire about platelet-rich plasma (PRP) therapy to stimulate hair growth.