As GLP-1 medications surge in popularity, longer-term concerns are beginning to surface. “Ozempic face”, loss of butt muscles, sagging tissues, loss of strength, and constipation are just some of the effects being reported. While weight loss can be beneficial, these widely used drugs come with side effects that aren’t always discussed and can be difficult to reverse. Are you aware?
What is GLP-1?
GLP-1 (glucagon-like peptide1) is a hormone secreted by endocrine cells in the brain and small intestine upon eating food. It communicates with the gut-brain axis and numerous other internal organs. Research shows that it affects neurotransmitter levels, nerve vitality, and inflammatory mechanisms. It allows the pancreas to secrete insulin, moderates insulin sensitivity and leptin, slows gastric emptying, improves satiety, and suppresses food intake.
GLP-1 that is naturally produced in your body has a half-life of 1-2 minutes, staying in your system for about 5 minutes. Synthetic GLP-1 injections/drugs like semaglutide/Ozempic, Wegovy, etc. stay in your system for about 5 weeks!
GLP-1 FDA Warnings and Precautions
GLP-1 agonist drugs include exenatide (Byetta), lixisenatide (Adlyxin), liraglutide (Victoza), dulaglutide (Trulicity), and semaglutide (Ozempic, Wegovy). FDA warnings and precautions for these medications include pancreas inflammation, vision/retina changes, kidney problems, severe hypoglycemia, gallbladder problems, stomach paralysis and intestinal blockages, thyroid cancer, and other concerns.
GLP-1 medications were first approved for type 2 diabetes in 2005. Ozempic/Semaglutide has been on the market since 2017. In the last few years, other medications with higher doses have been approved for use in adults with type 2 diabetes, chronic kidney disease, cardiovascular disease, and with a great surge in use for weight loss.
GLP-1 Linked with Loss of Muscle Mass
As millions of individuals with low quality health and metabolic functions use these medications, additional health concerns have come to light and into question, such as loss of muscle mass.
Animal research shows Ozempic use caused loss of skeletal and heart muscle mass and a reduction in heart muscle cells in both lean and obese mice. Other animal studies showed that semaglutide caused loss of muscle strength as well as skeletal muscle mass.
The Lancet Diabetes and Endocrinology journal reports that use of GLP-1 medications in humans can cause a decrease in 25-39% muscle mass in 36-72 weeks as part of the total weight loss. In comparison, individuals on calorie restricted diets without GLP-1 medications commonly experience a loss of 10-30% of their muscle mass.
GLP-1, Muscles, Mitochondria, and Glucose
Research on GLP-1/Semaglutide medications on mitochondrial function and muscle is still in its infancy. Some of these early cellular studies suggest mitochondrial function is improved with the use of GLP-1 medications due to the benefits of weight loss.
However, there is much to be evaluated as one study reveals the impact of high levels of natural GLP-1 in the body and how it leads to muscle loss. This should be cause for concern in using GLP-1 medications that artificially force very high levels of GLP-1 in the body.
The Journal of Cachexia Sarcopenia Muscle focuses on muscle loss research. In the October 2024 publication, a group of adults who went to the Emergency Room of Taipei Veterans General Hospital for care were evaluated for sarcopenia or muscle loss. GLP-1 levels naturally made in the body were measured.
Results showed that individuals who had the highest levels of GLP-1 levels (non-medicated), had the greatest muscle loss. Upon further investigation with cell samples from these individuals, the higher the amounts of GLP-1 in their cells, the greater the suppression for muscle cell growth and formation. Furthermore, there were marked adverse changes in glucose movement into cells for use resulting in reduction of mitochondrial energy production. These study results showed that elevated GLP-1 levels are associated with loss of muscle mass and strength, impaired glucose uptake, and loss of physical energy.
The results of a different study published July 2025 looked at the effects of Semaglutide use on muscle mass and strength in older adults with type 2 diabetes. In this 2-year study, muscle loss to the degree of sarcopenia definition was found in 27.7% of the drug recipients. Overall, grip strength and gait speed were significantly reduced in both men and women especially with higher Semaglutide dosages.
Rates and Effects of Muscle Mass Loss
Maintaining muscle mass becomes harder with each passing decade. Normal age-related muscle mass is estimated to be 0.8% per year or 8% muscle mass loss per decade from ages 40-70 years. Other research shows that muscle strength declines 1.5-5% per year after the age of 50 and muscle mass declines 1-2% each year after the age of 50. Inactivity or a sedentary lifestyle is one of the main causes of muscle mass decline. Imagine, however, losing nearly 40% of your muscle mass after 9-18 months of GLP-1 drug use.
Loss of muscle mass has profound implications and effects on health. It ultimately affects your whole body. Muscle mass affects your ability to walk, move, get out of a chair, drive a car, and maintain your balance. Healthy muscle mass helps your blood sugar and insulin management, bone density, lymph and return blood flow in your veins, liver, thyroid, and immune system function, and more. A loss of muscle mass is associated with more adverse outcomes such as falls, functional decline, becoming frailer, and increased mortality.
Ozempic Face or Loss of Butt Muscles?
“Ozempic face” has become a popular term for the sagging facial features that occur with the drug use which is thought to be due to fat loss in the face. The human face has about 30 muscles on each side depending on how they are counted. You must ask is “Ozempic face” also due to loss of facial muscle mass?
Another common sign of general sarcopenia, especially in men, is the loss of the glutes or butt muscles with age. The butt muscles are vital to movement, balance, posture, and more. Have you noticed any of these concerns for yourself or others who may be taking a GLP-1 agonist medication?
Other Hidden Concerns?
There are two additional hidden concerns that you need to be aware of with GLP-1 meds. As noted above, GLP-1 medications slow down gastric motility causing constipation. Changes in gut motility change the gut microbiome leading to SIBO/SIFO, i.e. small intestine bacteria or fungal overgrowth. GLP-1 medications are linked with an increased risk of SIBO.
Secondly, there is a paradox that happens with GLP-1 and fat cells. There is a loss of fat mass with GLP-1, however GLP-1 can actually “induce fat cell formation”. Cellular studies show the GLP-1 drugs activate GLP-1 receptors which promote pre-adipocyte formation and inhibit apoptosis of fat cells and white fat is converted into more metabolically active brown fat.
This raises questions for me. Is this analogous to the bisphosphonate drugs that promote new bone without the breakdown of old bone creating low quality bone over time? Brown fat can revert into white fat with sedentary lifestyles and unhealthy diets.
Astronomical Profits
As these GLP-agonist medications have grown in great popularity for quick weight loss and other purported benefits, the profits have also grown exponentially. The American Medical Association News Wire August 26, 2025, documents the monumental increase in spending on GLP-1s from a study published in JAMA Network Open.
“From 2018 to 2023, they found, spending on GLP-1s rose by more than 500%, from $13.7 billion to $71.7 billion, with the amounts being adjusted to 2023 dollars. Yet not all GLP-1s grew alike.
Of the medications with indications for type 2 diabetes, spending on Ozempic (semaglutide) grew the most, rising from $410 million in 2018 to $26.42 billion by 2023. Mounjaro also saw rapid spending growth after it was first indicated for type 2 diabetes in 2022, when patients and payers shelled out $2.51 billion. By 2023, that rose to $12.42 billion.
Of medications indicated for obesity at the time of the study, Saxenda (liraglutide) rose from $560 million in 2018 to $890 million in 2023. Spending on Wegovy (the form of semaglutide indicated for obesity) grew from $580 million in 2021 to $6.99 billion by 2023.”
GLP-1 drugs are powerful. The fact that the man-made drug forms stay active for 5 weeks in your body compared to your own natural hormone with 5 minutes of activity should make you question things. When pharmaceutical companies make even stronger medications with exponential use and astronomical profits, are these drugs truly the cure-all without costly side effects?
Type 2 diabetes is a disease that can be modified and reversed by a healthy diet, exercise, and lifestyle. Think about it.
Additional Resources
Ozempic Side Effects Include Pancreatitis, Stomach Paralysis, Thyroid Cancer
Next-Generation Gut Support: Introducing the New Super Dophilus
