The discussion surrounding medical weight loss has rapidly expanded, often leading to misconceptions. Concerns about facial changes, muscle loss, and long-term effects are prevalent, but the reality is not as alarming as portrayed on social media. To offer insight, we consulted with Dr. Spencer Nadolsky, a lipid and obesity specialist in Portage, MI, who assists patients undergoing these treatments. Below, Dr. Nadolsky dispels common myths and provides a realistic outlook for patients.
What is the most common misconception among patients regarding GLP-1s and aesthetic changes?
“The ‘Ozempic butt’ myth is a significant one. These medications aid in calorie reduction, leading to weight loss, not muscle loss specifically. However, without weight training and adequate protein intake, some muscle loss may occur, including in the glutes. Weight loss typically results in fat reduction from areas where fat is naturally stored, such as the buttocks. Concerns about facial gauntness are also unfounded, as there is no evidence suggesting that GLP-1s have a negative impact on skin or facial appearance beyond what a calorie-restrictive diet would cause.”
Are there any recent myths exacerbated by social media?
“The prevalent myth of muscle loss is magnified by social media. GLP-1s are highly effective in weight loss, and muscle loss is expected without weight training and adequate protein intake. Emphasizing body composition and strength training is crucial. However, attributing excessive muscle loss solely to the medication is inaccurate.”
What unexpected changes do patients typically experience?
“The most significant change is a newfound sense of hope. Patients often realize they can achieve long-term weight loss. Improved mental health, including reduced anxiety, is also commonly reported. Patients note a decreased inclination towards other addictive behaviors, such as excessive alcohol consumption.”
What myth would you like patients to be aware of early on?
“The misconception surrounding gastroparesis, often dubbed ‘stomach paralysis,’ is concerning. These medications do not induce permanent gastroparesis but may delay gastric emptying. Nausea experienced by some patients is more related to the brain than gastric emptying and tends to diminish over time with proper management.”
What advice do you offer to patients to prevent undesired facial changes during weight loss?
“I recommend a gradual weight loss approach, aiming for about one percent of total body weight per week. Adequate protein, vitamins, and minerals are essential. Regular self-assessment of appearance and well-being, rather than focusing solely on weight, is crucial. Some individuals may choose to halt weight loss once they are content with their appearance and well-being.”

