Side Effects of Ozempic: What You Need to Know

What is ‘Ozempic face’? Doctors warn about facial ageing side effect of diabetes medications

Doctors are warning individuals who have turned to diabetes medications to lose weight that the drugs may result in unwanted side effects such as facial ageing.

In recent months, injectable prescription medications such as Ozempic, Mounjaro and Wegovy, which were created for those with type 2 diabetes, have seen a rise in popularity among individuals who view the drugs as a quick-fix weight-loss method.

Social media, and reports of widespread use of the drugs among celebrities, have contributed to the phenomenon, which since has resulted in shortages of the prescription medications.

However, doctors have now issued a warning about “Ozempic face,” a possible side effect of using the drugs both as a weight-loss method and without the proper medical supervision, as users have shared their experiences with accelerated ageing.

Jennifer Berger, 41, told The New York Times that she began injecting Mounjaro, a brand name for tirzepatide, to lose weight after her pregnancy. Although the medication helped Berger lose 20 pounds over three months, she said it also left her almost unable to recognise her face in the mirror.

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“I remember looking in the mirror, and it was almost like I didn’t even recognise myself,” she told the outlet. “My body looked great, but my face looked exhausted and old.”

The side effect is one that Dr Paul Jarrod Frank, a dermatologist in New York who spoke to The Times, has coined “Ozempic face,” and he claims he’s begun seeing it in his office “every day”.

“A 50-year-old patient will come in, and suddenly, she’s super-skinny and needs filler, which she never needed before. I look at her and say: ‘How long have you been on Ozempic?’ And I’m right 100 per cent of the time,” he said, adding: “It’s the drug of choice these days for the one per cent.”

Dr Frank, who likened the popularity of the drugs to erectile dysfunction treatment Viagra, is not the only one who has witnessed the influx in patients seeking treatment for the side effect. Dr Dhaval Bhanusali, a dermatologist in New York, also told The Times that he’s seen an increase in patients on the medications who are “concerned about facial ageing and sagging”.

“We are seeing more and more patients on the medications coming in,” he said. “Generally, it’s people in their 40s and 50s who are losing significant amounts of weight and are concerned about facial ageing and sagging that occurs as a result.”

New York-based plastic surgeon Dr Oren Tepper, who also spoke to The Times, said the increase in “Ozempic face” is not surprising and noted that weight loss often leads to a more aged appearance as “key areas of the face” deflate.

“When it comes to facial ageing, fat is typically more friend than foe,” he explained. “Weight loss may turn back your biological age, but it tends to turn your facial clock forward.”

As for whether the side effect can be reversed, the dermatologists said the only way to do so in a noninvasive way is through the injection of fillers, which can cost thousands of dollars.

Though, Dr Tepper says, when a significant amount of weight is lost rapidly, fillers may not be enough to restore lost volume in the face. At that point, he said plastic surgery becomes “the only way to restore the volume loss”.

He said individuals using the drugs to lose weight often do not realise the impact it will have on their face, and that, for many, the sudden weight loss is like “winning a lottery Mega Millions”.

“But then they realise there’s a tax that comes with it – the loss of fat in the face – so it may not be quite the windfall they imagined,” he said.

The plastic surgeon told the Times that he treats “Ozempic face” with a deep plane face-lift, which costs $75,000, and a procedure that transfers fat from other parts of the body to the face, which can cost an additional $12,000.

As interest in the diabetes medications for weight loss continues to grow on social media, doctors have taken to platforms such as TikTok to share advice on combating the ageing effects.

In one TikTok posted by Dr Rocio Salas-Whalen, who also spoke to The Times, the endocrinologist in New York says users can prevent “loose and sagging skin” during weight loss by losing weight gradually, staying hydrated, avoiding smoking, and increasing protein intake, which she noted is “basic for the production of elastin and collagen.”

Facial ageing is not the only concern individuals using the medications have to be aware of either. The prescription drugs can also lead to other, potentially dangerous side effects.

In a press release from the US Food and Drug Administration (FDA) announcing the approval of Wegovy, a brand name for semaglutide and treatment for chronic weight management, it notes that the most common side effects include nausea, diarrhoea, vomiting, constipation, abdominal pain, headache, fatigue, indigestion, dizziness, and digestive disorders.

The FDA also warns about more serious complications that can arise from use of the medication, such as the “potential risk of thyroid C-cell tumours,” pancreatitis, gallbladder problems, acute kidney injury, increased heart rate and suicidal behaviour or thinking.

According to the website for Ozempic, which is not FDA-approved for weight loss, the potential serious side effects are similar to Wegovy’s. The website warns patients about possible thyroid tumours, including cancer, pancreatitis, changes in vision, and kidney and gallbladder problems.

The most common side effects experienced by individuals using Mounjaro include nausea, diarrhoea, vomiting, constipation, indigestion and stomach pain, while the website also warns Mounjaro “may cause tumours in the thyroid, including thyroid cancer,” gallbladder or kidney problems, changes in vision and pancreatitis.

In addition to countless posts praising the drugs as a magic weight-loss method, users have also taken to social media to share their experiences with the various side effects.

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One TikTok user says they have experienced nausea after taking Mounjaro, while another user said they suffered from acid reflux while taking Ozempic.

Dr Salas-Whale, who described Mounjaro as the “Apple 14” of the diabetes drugs, says the side effects are “extremely rare if the medication is being prescribed at the right dose and with careful medical supervision”.

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Side Effects of Ozempic: What You Need to Know

If you have type 2 diabetes, Ozempic (semaglutide) may be a treatment option for you.

Ozempic is used to:

• help lower blood sugar levels in adults with type 2 diabetes (when used with diet and exercise)
• help reduce the risk for certain cardiovascular problems (related to the heart or blood vessels) in adults with type 2 diabetes and cardiovascular disease

Ozempic is given by subcutaneous injection (an injection under your skin). You’ll use it once a week as part of your diabetes treatment plan to help meet your daily and long-term blood sugar goals.

For more details on Ozempic, see this in-depth article.

Ozempic may cause mild or serious side effects in some people. Keep reading to learn more.

Note: Ozempic isn’t used to treat type 1 diabetes or diabetic ketoacidosis, a serious diabetes complication. Talk with your doctor to learn more.

Like all drugs, Ozempic may cause side effects in some people. The more commonly reported side effects of Ozempic include:

• abdominal (belly) pain
• constipation
• diarrhea
• nausea or vomiting

Ozempic may cause other side effects, too. Talk with your doctor about your specific risk for side effects from this drug.

Learn more about Ozempic’s side effects in the next sections.

Ozempic can cause mild side effects in some people. These may include:

• change in the way things taste
• abdominal (belly) pain
• burping*
• constipation or diarrhea
• dizziness
• headache
• flatulence (gas)*
• fatigue (lack of energy)
• indigestion (upset stomach) or acid reflux
• injection-site reactions, such as skin redness, discoloration, or discomfort
• nausea or vomiting
• minor increase in heart rate

In most cases, these side effects should be temporary. Some may be easily managed, too. But if you have any symptoms that are ongoing or that bother you, talk with your doctor or pharmacist. And don’t stop using Ozempic unless your doctor recommends it.

Ozempic may cause other mild side effects, too. To learn more, see the Ozempic prescribing information.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Ozempic, visit MedWatch.

* For more information on this side effect, see the “Side effects explained” section below.

In rare cases, Ozempic may cause serious side effects. Before starting treatment, talk with your doctor about your risk for serious side effects from this drug.

Serious side effects of Ozempic can include:

• diabetic retinopathy (damaged blood vessels in the eye)
• gallbladder disease, including gallstones or cholecystitis (gallbladder pain and swelling)
• kidney problems
• pancreatitis* (swelling of the pancreas)
• increased risk of thyroid cancer*†
• allergic reaction*
• hypoglycemia* (low blood sugar)

* To learn more about this side effect, see the “Side effects explained” section below.
† Ozempic has a boxed warning for an increased risk of thyroid cancer. This is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “Side effects explained” section below.

Get answers to some frequently asked questions about Ozempic’s side effects.

Can Ozempic cause weight loss?

Yes, Ozempic can cause weight loss in some people. Although the drug isn’t approved for weight loss, some people using Ozempic in studies lost weight. In these studies, Ozempic was either used alone or with other treatments for type 2 diabetes.

Another diabetes drug, Saxenda (liraglutide), is approved for weight loss in people with type 2 diabetes. Saxenda is in the same drug class as Ozempic. (A drug class is a group of medications that work in a similar way.)

Saxenda can’t be used with Ozempic. If you’re interested in learning more about Saxenda or other weight-management treatments, talk with your doctor.

Are there foods to avoid while taking Ozempic?

No, you don’t have to avoid any specific foods during your Ozempic treatment. Also, the drug can be taken with or without food.

However, Ozempic is used to improve blood sugar levels in adults with type 2 diabetes, and it’s used along with diet and exercise. To reach your blood sugar goals while using Ozempic, you should follow the nutrition guidelines that your doctor recommends.

If you have changes to your diet, activity level, or weight, your diabetes treatment plan may need to be adjusted. Talk with your doctor if you have any of these changes.

How long do Ozempic side effects last?

In general, mild side effects of Ozempic should be temporary or manageable while you’re using the drug.

However, after stopping Ozempic, it could take your body about 5 weeks after your last dose to fully clear the drug from your system. So you could have side effects during this period.

And you could experience some serious side effects, such as worsening diabetic retinopathy, even after Ozempic has been fully cleared from your system.

If you have questions or concerns about how long side effects from Ozempic could last, talk with your doctor.

Does Ozempic cause hair loss?

No, Ozempic shouldn’t cause hair loss. Hair loss wasn’t seen in studies of Ozempic.

However, hair loss has been linked with both type 1 and type 2 diabetes. Diabetes-related hair loss isn’t fully understood, but it may be caused by various factors. These may include:

• damaged hair follicles from long periods of high blood sugar or poor circulation
• stress from managing a chronic (long-term) condition
• having hypothyroidism (low thyroid hormone levels) along with diabetes

Also, many people with diabetes take medications to treat other chronic conditions such as cardiovascular disease (CVD). In rare cases, certain drugs used to treat CVD, such as statins or angiotensin-converting enzyme (ACE) inhibitors, may cause hair loss.

If you’re experiencing hair loss, contact your doctor right away. If it’s related to blood sugar management, they may change your diabetes treatment plan. If it’s not, your doctor will check for other causes and discuss treatment options with you.

Learn more about some of the side effects Ozempic may cause.

Thyroid cancer risk

Ozempic has a boxed warning about the possible risk of thyroid cancer. Ozempic has caused thyroid cancer in animals. It’s unclear if this drug also increases thyroid cancer risk in humans.

However, to lower the possible risk of thyroid cancer, don’t use Ozempic if:

• you have a rare genetic condition called multiple endocrine neoplasia type 2
• you or a family member has had medullary thyroid cancer

What might help

While using Ozempic, tell your doctor right away if you have symptoms of thyroid cancer, such as:

• a lump or pain in your neck
• trouble swallowing
• shortness of breath or wheezing
• hoarse voice that doesn’t get better

If you’re diagnosed with thyroid cancer, your doctor will stop your Ozempic and adjust your diabetes treatment plan.

Gas and burping

Flatulence (gas) and burping can occur with Ozempic, but they aren’t the most common digestive system side effects. Some more common digestive system side effects include constipation, diarrhea, nausea, and vomiting.

Burping is also a symptom of acid reflux or indigestion (upset stomach). These are both digestive system side effects that can occur with Ozempic, too.

What might help

In most cases, gas and burping are considered mild side effects. But if they bother you or don’t go away during your Ozempic treatment, talk with your doctor. They may suggest diet changes or an over-the-counter (OTC) medication, such as Gas-X (simethicone), to help relieve gas and burping.

If your burping is related to acid reflux or indigestion, your doctor may suggest an OTC antacid, such as Pepcid (famotidine) or Tums (calcium carbonate tablets).

Contact your doctor right away if you have gas or burping along with vomiting or severe pain in your back or abdomen (belly). These could be symptoms of pancreatitis (swelling of the pancreas), which is a serious side effect of Ozempic. (See “Pancreatitis” below to learn more.)

Dizziness

Some people may experience dizziness while using Ozempic. However, this isn’t a common symptom of Ozempic.

Dizziness could also be a symptom of hypoglycemia (low blood sugar). Hypoglycemia is a serious side effect of Ozempic that can cause severe health problems if it’s not treated.

What might help

Talk with your doctor right away if you feel dizzy while using Ozempic.

Before starting Ozempic, ask your doctor how often you should check your blood sugar. Also, ask your doctor or pharmacist to explain the symptoms of low blood sugar and how to manage these episodes.

Your doctor or pharmacist may suggest that you carry OTC glucose products so you’re ready to treat low blood sugar quickly before it becomes severe. (See “Hypoglycemia” below to learn more.)

Pancreatitis

In rare cases, Ozempic may cause pancreatitis (swelling of the pancreas). This can be either acute (short-term) pancreatitis or chronic pancreatitis.

Your pancreas is a gland that releases enzymes (proteins) and substances, such as insulin, needed to digest foods and use energy. When the pancreas becomes inflamed, the swelling can damage your pancreas and cause symptoms.

Acute pancreatitis usually lasts for a short period of time and goes away after treatment. Chronic pancreatitis may develop with continued damage to the pancreas over time.

What might help

Before starting Ozempic, tell your doctor if you’ve had pancreatitis or other pancreatic problems before. It may be unsafe for you to use Ozempic. If so, your doctor will prescribe another diabetes treatment.

While using Ozempic, watch for pancreatitis symptoms, such as:

• abdomen (belly) pain that may radiate to your back
• nausea or vomiting
• bloating
• fever

Contact your doctor right away if you experience any of these symptoms. If your doctor confirms you have pancreatitis, they’ll stop your Ozempic treatment and manage your condition.

Hypoglycemia

Ozempic may cause hypoglycemia (low blood sugar). This side effect is more common if you use Ozempic along with insulin or other diabetes drugs. Making certain lifestyle changes, such as fasting or suddenly changing your diet, can cause low blood sugar, too.

If your blood sugar gets too low, it can cause symptoms or serious health problems. Examples of these problems include dizziness, blurred vision, or seizures.

What might help

Before starting Ozempic, tell your doctor if you take insulin or any other medications. They may adjust your insulin regimen or your dosage of other diabetes drugs to help prevent low blood sugar with Ozempic.

Follow your prescribed diabetes treatment plan, including your meal plan, to keep your blood sugar in a healthy range. If you change your diet or physical activity level, tell your doctor. And tell them if you gain or lose a lot of weight. These factors can affect your blood sugar and may make you more likely to have episodes of hypoglycemia.

Symptoms of hypoglycemia can vary, but common symptoms to watch for include:

• dizziness
• shakiness
• chills or sweating
• confusion or clumsiness
• skin that is paler than usual
• blurry vision
• intense hunger

You should keep foods on hand that can raise your blood sugar quickly if you have an episode of hypoglycemia. Or you can try OTC glucose gels or chewable glucose tablets.

If you have severe hypoglycemia, call 911 or your local emergency phone number, or have someone drive you to the emergency room. (You shouldn’t drive yourself during an episode of severe hypoglycemia.)

Allergic reaction

Like most drugs, Ozempic can cause an allergic reaction in some people. Symptoms can be mild, such as:

• rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

But in rare cases, Ozempic may cause a serious allergic reaction with severe symptoms, such as:

• swelling under your skin, typically in your eyelids, lips, hands, or feet
• swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest an OTC treatment to manage your symptoms. Examples of these treatments include an antihistamine such as Benadryl (diphenhydramine) or a hydrocortisone cream.

If your doctor confirms you had a mild allergic reaction to Ozempic, they’ll decide if you should continue using the drug.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you had a serious allergic reaction to Ozempic, they’ll have you stop using the drug and switch you to a different treatment.

• what dose of drug you were taking when you had the side effect
• how soon after starting that dose you had the side effect
• what your symptoms were from the side effect
• how it affected your daily activities
• what other medications you were also taking
• any other information you feel is important

Ozempic has some warnings that may affect whether or not you can safely use this drug.

Boxed warning: Thyroid cancer risk

Ozempic has a boxed warning about the possible risk of thyroid cancer. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

Ozempic has caused thyroid cancer in animals. It’s unclear if the drug also increases thyroid cancer risk in humans. To lower the potential risk of thyroid cancer, don’t use Ozempic if:

• you have a rare genetic condition called multiple endocrine neoplasia type 2
• you or a family member has had medullary thyroid cancer

For more details, see the “Side effects explained” section above.

Other warnings

Ozempic may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Ozempic. Factors to consider include those in the list below.

Kidney problems. Before starting Ozempic, tell your doctor if you’ve had any kidney problems. Drugs such as Ozempic have caused new or worsening kidney disease, including kidney failure, in some people. If you become dehydrated from other side effects of Ozempic, such as vomiting or diarrhea, this could also cause kidney problems. Your doctor may monitor your kidney health closely during your Ozempic treatment. If you develop new or worsening kidney problems, they may stop your treatment.

Allergic reaction to GLP-1 agonists. If you’ve had an allergic reaction to Ozempic or any of its ingredients, you shouldn’t take Ozempic. Also tell your doctor if you’ve had an allergic reaction to another GLP-1 agonist (the drug class Ozempic belongs to). If you have, you could have an allergic reaction to Ozempic, which could be severe. Your doctor can prescribe a safer treatment option for you.

Diabetic retinopathy. If you have diabetic retinopathy, using Ozempic may make it worse. Tell your doctor if you have this condition before starting Ozempic. While using this drug, keep all your eye appointments and tell your doctor right away if you have any vision changes.

Insulin or other diabetes drug use. Using Ozempic with insulin or other diabetes drugs may raise your risk for severe hypoglycemia. If untreated, this condition can cause serious health problems. Before starting Ozempic, tell your doctor about all medications you take. They may adjust your insulin regimen or your dosage of other diabetes drugs to help prevent hypoglycemia with Ozempic. But don’t make changes to your diabetes treatment plan unless your doctor recommends it.

Alcohol and Ozempic

Ozempic isn’t known to interact with alcohol. However, Ozempic lowers your blood sugar. Alcohol may make your blood sugar drop, too. So, drinking alcohol during your Ozempic treatment may cause severe hypoglycemia (low blood sugar).

Also, chronic (long-term) alcohol consumption is a common cause of pancreatitis (swelling of the pancreas). Using Ozempic may raise your risk for pancreatitis, too. To help prevent these health problems, avoid excessive alcohol use during your Ozempic treatment.

If you drink alcohol, talk with your doctor about how much may be safe for you to drink with your condition and treatment plan.

Pregnancy and breastfeeding while taking Ozempic

It’s unknown if Ozempic is safe to use during pregnancy or while breastfeeding.

If you’re planning to become pregnant, you’ll need to stop Ozempic at least 2 months before trying to conceive. This waiting period ensures your body has fully cleared the drug from your system. If you become pregnant while using Ozempic, talk with your doctor right away.

If you’re breastfeeding or planning to breastfeed, talk with your doctor about the risks and benefits of using Ozempic.

If you have type 2 diabetes, Ozempic may help improve your blood sugar levels. If you also have cardiovascular disease (CVD), it can lower your risk for heart attack, stroke, or death from CVD.

Ozempic can cause side effects in some people. In general, Ozempic’s common side effects are mild. But in rare cases, the drug could cause serious side effects.

If you have questions about possible side effects with Ozempic, talk with your doctor or pharmacist. They can provide answers to help you feel confident about your diabetes treatment plan. Examples of questions you may want to ask include:

• What’s my risk for serious side effects?
• Is there anything I can do to prevent diabetic retinopathy while using Ozempic?
• If I have kidney disease and have diarrhea with Ozempic, is it safe to drink electrolyte replacement solutions such as Pedialyte to stay hydrated?
• How should I manage injection-site reactions with Ozempic?
• I have gallstones that I manage through my diet. Should I avoid using Ozempic?

To learn more about Ozempic, see these articles:

• All About Ozempic’s Dosage
• Ozempic and Cost: What You Need to Know
• Ozempic Interactions: Alcohol, Medications, and Others
• Ozempic vs. Victoza: Which Is Better for Me?

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Q:

I’ve read that I may need Baqsimi, which contains glucagon, to treat severe episodes of hypoglycemia. What is glucagon and how is it used?

A:

Baqsimi is a prescription drug your doctor may prescribe to treat severe hypoglycemia (low blood sugar), which diabetes medications such as Ozempic may cause. Baqsimi contains glucagon, a hormone that your body normally makes. It tells your liver to make glucose (sugar) when your blood sugar level is too low.

Baqsimi works with your liver to make glucose quickly available to your body. This raises your blood sugar level.

Baqsimi is a nasal (nose) spray. It’s given as one spray into one nostril during an episode of severe hypoglycemia. With severe hypoglycemia, your blood sugar level can get so low that you may need someone else’s help to treat it. For this reason, make sure your family members, friends, caregivers, and coworkers know how to recognize the symptoms of severe hypoglycemia and how to use Baqsimi.

If you have questions about whether you need a prescription for Baqsimi, talk with your doctor.

The Healthline Pharmacist Team Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Last medically reviewed on November 6, 2022