"I Succeeded at Dieting, So Why Do I Look Like This?"... "This Area" Shrunk by 7% After Losing 10 kg

Facial changes linked more to weight loss than to obesity treatment side effects
Expert warns: "Don't stop medication on your own"

“Ozempic face” refers to a face that appears older after weight loss with obesity treatments such as Wegovy and Ozempic, as the cheeks become hollow and the skin sags. A new analysis suggests that these changes are not so much a side effect unique to the medications themselves as a result of losing facial fat along with body fat during weight loss.

Image for illustrative purposes only; unrelated to the article's content. Getty Images

According to Chung-Ang University Gwangmyeong Hospital on Nov. 9, Professor Yoo Gwang-ho of the Department of Dermatology published a review analyzing the causes and risk factors of facial changes after using obesity treatments, along with ways to prevent and manage them. The paper appeared online in Aesthetic Surgery Journal, the official journal of the American Society for Aesthetic Plastic Surgery.

Professor Yoo reviewed 46 papers that met the selection criteria from among 958 relevant publications issued between January 2014 and August 2026. The analysis found that facial changes were closely associated with fat loss during weight reduction, rather than with any specific obesity treatment itself. Facial fat helps maintain volume like a cushion beneath the skin and supports the underlying tissue.

When this layer of fat also diminishes as weight drops, the cheeks and temples can become sunken, while sagging skin and wrinkles may appear more pronounced than before. Similar changes have also been observed in patients who lost weight through bariatric surgery without using obesity treatments. An analysis of photographs of patients who underwent bariatric surgery in an overseas study found that their apparent facial age was, on average, about 3 years higher one year after surgery.

Imaging analyses of patients receiving GLP-1 treatments also confirmed a loss of facial volume. A review of computed tomography (CT) and magnetic resonance imaging (MRI) scans of 20 patients who lost an average of about 11 kg found that the volume of the midface, the central part of the face, decreased by about 9% based on the median.

In particular, the superficial fat layer close to the skin’s surface decreased by 11%, while the deep fat layer decreased by 7%. The midface volume was estimated to decrease by about 7% for every 10 kg of weight lost. However, the extent of facial changes can vary from person to person, even when the same amount of weight is lost. This is because facial fat varies in distribution and function across different areas, leading to differences in which areas show the most noticeable loss of volume and in the degree of skin sagging.

To date, the amount of weight lost is the risk factor that has been identified most consistently. The more weight a person loses, the more likely facial volume changes are to become pronounced. Changes may also be more noticeable in older people and those who had little facial fat to begin with.

Facial changes that may occur during weight loss. Chung-Ang University Medical Center

By contrast, the often-cited figure that “20% to 50% of users of obesity treatments experience facial changes” is not a confirmed incidence rate. It is an estimate based on medical staff surveys and small-scale reports, and the actual frequency has yet to be accurately determined.

It has also not been proven whether the speed of weight loss independently affects facial changes. Nor has a reliable method been established to prevent or reverse them. Nutritional intake and strength training can help maintain muscle mass during weight loss, but there is insufficient evidence that they can prevent facial fat loss itself.

Those considering cosmetic procedures such as fillers are advised to have their facial condition assessed comprehensively once their weight has stabilized to some extent. This is because procedures that further reduce fat could worsen hollowing if facial volume has already decreased. “Given the significant medical benefits of obesity treatments, facial changes that may occur during weight loss should also be taken into account,” Professor Yoo said. He emphasized, “Patients should not adjust their medication dosage or stop treatment based solely on changes in their appearance without consulting their medical team.”

This content was produced with the assistance of AI translation services.