Survey of 1,226 patients finds skin, hair and muscle concerns more common among GLP-1 users

In a survey of 1,226 people receiving medical weight management, 61.9% reported at least one skin, hair, facial or muscle concern, and the share reporting concerns was higher among those taking GLP-1 receptor agonists and among those who lost the most weight ^[1].

The study appears in the International Journal of Women's Dermatology and was written by dermatologists and weight management physicians ^[1]. It used an anonymous, voluntary survey offered in April and May 2025 through a national telemedicine platform, and combined the results with a review of published medical literature ^[1].

What patients reported

The most common concern was skin sagging, reported by 37.7%, followed by facial volume loss at 29.2%, hair loss at 28.9%, worsened skin quality such as more dryness, fine lines or wrinkles at 24.1%, and decreased muscle strength at 17.9% ^[1]. Most participants who reported a concern reported more than one ^[1]. For sagging, the arms were the most frequently named site (71%, n = 390) ^[1]. The paper opens by noting that the term 'Ozempic face' has become shorthand for facial volume changes linked to this drug class ^[1].

Concerns rose with more weight lost

Participants were grouped by how much total body weight they had lost. Among those who lost more than 20% of their body weight, 90.9% reported at least one concern, compared with 50.5% of those who lost less than 10% ^[1]. The authors describe this pattern as suggesting a dose-response relationship ^[1].

Participants were also grouped by treatment. Six in ten (60.0%) were taking only a GLP-1 receptor agonist, a group the study lists as dulaglutide, liraglutide, semaglutide and tirzepatide; 16.2% took a GLP-1 plus another weight management drug; 19.4% took only non-GLP-1 drugs, listed as bupropion, metformin, naltrexone, orlistat, phentermine or topiramate; and 4.4% did not specify ^[1]. For most concerns, a higher share of GLP-1 users reported problems than non-users ^[1]. The largest gap appeared among people who had lost 10% to 20% of body weight: 76.6% of GLP-1 users reported at least one concern, versus 52.1% of those not taking a GLP-1 ^[1]. The authors note that GLP-1 users generally lost more weight than other participants ^[1].

Limits of the survey

The respondents were mostly women (80.3%) and mostly White (85.1%), with 84.7% between ages 40 and 69 ^[1]. The authors list several limitations: the survey was voluntary, it may reflect selection and recall bias, and the largely White, female telemedicine population may limit how far the results apply to others ^[1]. They also note that the rate of weight loss was not recorded, leaving its impact on these outcomes uncertain ^[1]. The survey reports what patients said they experienced; it cannot show that a medication caused any specific change.

Why it matters for patients

Appearance and muscle changes are common enough in this group to be worth knowing about before or during treatment, according to the authors, who argue that unwanted effects of this kind can undermine treatment adherence and therefore affect weight and health outcomes ^[1]. Because concerns increased with the amount of weight lost in both GLP-1 and non-GLP-1 groups, the size of the loss, not only the drug, appears relevant, and the survey could not separate faster from slower loss ^[1].

Several practical questions remain unanswered in the paper. Whether these changes fade after weight stabilizes, persist, or respond to treatment has not been reported for GLP-1 users specifically, and the authors write that data on hair shedding in GLP-1 users are lacking ^[1]. Costs, insurance coverage and access to dermatologic or aesthetic care are not addressed ^[1].

The authors' proposed first response is nutrition and preserving strength, with aesthetic and regenerative treatments when appropriate ^[1]. That is a framework proposed by the authors, not a tested protocol; the paper does not describe a trial of it ^[1].

What happens next

No follow-up studies or dates are announced in the paper ^[1]. The authors call for early dermatologic evaluation and preventive strategies to be built into weight management care ^[1]. Whether clinics, telemedicine platforms or insurers change practice based on these findings has not been disclosed ^[1].