Ever since Ozempic flooded the mainstream consciousness, the controversial weight loss drug of choice has come with some well-documented downsides. Many have dealt with the infamous Ozempic face, which experts describe as rapid weight loss to the face and loss of elasticity in the skin, causing one to look much older. “Ozempic face can look gaunt, deflated, and saggy,” New York-based facial plastic surgeon Dr. 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 Zepound, to name a few) are affecting their hairline 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 see medications like Wegovy and Zepbound are causing the same—and sometimes more—amount of muscle loss as one might experience through more traditional weight loss methods. 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 5 to 6 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 says that it is normal to shed about 50 to 100 hairs a day, so you should only be concerned if you notice significantly more hair falling out or if your hair loss persists longer than three to six months. If that is the case, she recommends seeing a board-certified dermatologist to be properly evaluated. “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 six to 12 months, providing reassurance that it can get better on its own is often sufficient.”
She says getting bloodwork 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 Wellbell. 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.