The debate surrounding medical weight loss has grown rapidly—and it’s not always accurate. Concerns about facial changes, muscle loss and long-term effects are common, but the truth is not always as shocking as social media makes it seem. To add perspective, we turned to Portage, MI lipid and obesity expert Dr. Spencer Nadolsky, who works closely with patients navigating these therapies. Below, he breaks down the myths we still hear often and explains what patients can realistically expect.
What is the biggest misconception you hear from patients about GLP-1 and beauty changes?
“Definitely ‘Ozempic butts.’ These drugs help people eat fewer calories, which leads to weight loss. They don’t directly make you lose muscle. However, if someone doesn’t lift weights and doesn’t eat enough protein, muscle loss is almost inevitable, including the glutes. Most people naturally store a lot of fat in their hips, so when they lose weight, they will lose fat in that area. That’s not specific to GLP-1s— that’s how weight loss works in general. I am also worried that this medicine will make the face look wrinkled. There is no data to suggest that GLP-1 worsens skin or causes facial changes more than any other calorie-reducing diet.”
Are there any myths that social media has made worse recently?
“The main thing is muscle loss. GLP-1 is the most effective weight loss treatment we have without bariatric surgery, and muscle loss is inevitable if one does not lift weights and eat enough protein. Body composition and strength training should be absolutely emphasized. But we should not be afraid and make it seem that the drugs themselves cause accurate muscle loss than exercise without exercise.
What unexpected changes do patients experience?
“The biggest change is hope. Many patients realize, often for the first time, that they can lose weight and keep it off for a long time. I also see improvements in mental health, including anxiety. People who have spent years worrying about food often report that they feel calmer and have more mental energy to focus on other areas of their lives. Another change that patients often mention is a decrease in the attraction to other addictive habits. The most common example is not alcohol, but only them.”
What’s one myth you wish patients knew right away?
“Maybe it’s a myth about gastroparesis, which people call “stomach paralysis.” These drugs do not cause chronic gastroparesis. They abort slowly, which is part of the way they work. The nausea that some patients experience is more related to the brain than to abortion. Both nausea and decreased bowel movements tend to improve over time. When patients work with an experienced physician and dietitian to manage dosage and food choices, they can often deal with side effects and stay on medication for a long time instead of stopping early and thinking it’s not for them.”
What is your best advice for patients who want to prevent unwanted facial changes while losing weight?
“I recommend losing weight slowly – no more than one percent of body weight per week. For someone who weighs 200 pounds, that’s about two pounds per week. It’s also important to get enough protein, vitamins and minerals. Patients should always want to check how they look and feel, not just how much they weigh. At some point, some people decide how they feel and feel great and how good they feel. It makes sense.”
