'Ozempic Butt' Isn't *Directly* Caused By The Type 2 Diabetes Drug

midsection of woman working out in the park, using weights
What Is 'Ozempic Butt?' Experts Weigh InKathrin Ziegler - Getty Images


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Whether it’s “Ozempic face” or “nature’s Ozempic,” the buzzy weight loss drug and its various side effects have taken social media by storm. Today’s lesson is on “Ozempic butt,” another phrased used to describe a potential physical impact of using the medication.

First things first: Ozempic butt is an entirely subjective term with no actual medical definition, says Michael Glickman, MD, a board-certified family medicine and obesity medicine physician and founder of Revolution Medicine, Health and Fitness. If you turn to TikTok, though, the term is apparently associated with having loose or saggy skin on your bum after losing significant amounts of weight from being on the drug.

As a quick refresher, Ozempic is an FDA-approved prescription injectable medication originally created to help people with type 2 diabetes, says Rekha Kumar, MD, a board-certified endocrinologist and obesity medicine specialist and chief medical officer at Found Health.

Ozempic itself is *not* approved for weight loss. But the active ingredient in the drug, semaglutide, is available at a higher dose in a different medication, known as Wegovy, which is FDA-approved to treat obesity and type 2 diabetes. However, because the two medications both contain semaglutide, Ozempic is often prescribed and used off-label to treat obesity.

Meet the experts: Rekha Kumar, MD, is a board-certified endocrinologist and obesity medicine specialist and chief medical officer at Found Health. Michael Glickman, MD, is a board-certified family medicine and obesity medicine physician and founder of Revolution Medicine, Health and Fitness.

To break it down further, semaglutide belongs to a class of medications called GLP-1 (glucagon-like peptide 1) receptor agonists that work by increasing how much insulin your body releases after a meal, mimicking a gastrointestinal hormone which signals digestion and satiety, says Dr. Kumar. From there, the medication alerts your pancreas to make insulin which regulates blood sugar and reduces appetite, ultimately triggering weight loss when paired with exercise and a balanced diet, she explains.

Now, some people do report adverse side effects and cosmetic downsides from the medication, and you should definitely chat with your doctor if you want to know more about whether a medication like this could make sense for you.

Here’s what you need to know about so-called Ozempic butt in particular.

What 'Ozempic Butt' Means

Again, Ozempic butt is not a real medical term but has been described on social media as loose skin around the butt due to significant weight loss from the drug, says Dr. Glickman. The subjective term usually refers to a flat, amorphous backside, adds Dr. Kumar.

Ozempic butt is also not a direct side effect of taking Ozempic. “A side effect means it's an adverse impact of the medicine, but this is just a consequence of weight loss, and it can happen with Wegovy, Ozempic, restricted calories, or even running,” says Dr. Kumar. “It can happen anytime we lose body fat.”

That said, because the drug regulates blood sugar and appetite, Ozempic can cause rapid weight loss which may contribute to a saggier and/or flatter tush, says Dr. Kumar. Because the drug suppresses appetite, you lose weight fast, and it can be tough for your skin to keep up and maintain its elasticity, adds Dr. Glickman. “When you are overweight, the protein fibers in your skin will be stretched to adapt to your body’s size so when the weight is gone, it is hard for those fibers to retract to their original size.”

Risk Factors For Ozempic Butt

Anyone losing large amounts of weight can develop so-called Ozempic butt, says Dr. Glickman. “A patient is no more likely to experience 'Ozempic butt' as they are to experience ‘Weight Watchers butt’ if they were to lose a comparable amount of weight,” he explains. In short: The quicker you shed pounds, the more likely you are to develop a saggier bum.

On top of that, anyone misusing the medication to achieve an unrealistic or unhealthy body weight may be at an increased risk of Ozempic butt, adds Dr. Kumar. “When the medicine is used as indicated, the fat that people lose is healthy for them, and it's fat that we want them to lose," she says. "But we're seeing a lot of inappropriate use of these meds or abuse of these medicines, and those are the people often fixated on Ozempic butt or Ozempic face, which are cosmetic focus areas.”

How To Prevent Ozempic Butt

The most natural way to avoid sagging skin or a "flat" backside—due to weight loss of any kind—is to increase resistance-based exercise, which promotes lean muscle mass directly beneath the skin and can create a better tone, says Dr. Glickman.

“When exercise is neglected during weight loss, there can be a tendency for the metabolism to slow down further because the body will sacrifice lean muscle and fat simultaneously," he explains. "So if we remain active, we can prevent this from happening to a degree, and preferentially burn off fat.”

That advice tracks with the findings of a 2019 review of GLP-1s. The authors note that the loss of lean body mass and skeletal muscle due to these drugs, while similar to what one might expect after weight loss through surgery or a low-calorie diet, "warrants attention," and they recommend structured exercise to preserve skeletal muscle and improve physical function. (FYI: Two of the authors disclosed potential conflicts of interest within the study, which doesn't necessarily mean the findings aren't legit, but can mean positive results are likely in the authors' best interests.)



Start with three days a week of strength training when your focus is weight loss, WH previously reported. And while you'll want to train from head to toe, throwing in some glute-focused training can also help define the shape and tone of your body, limiting sagging skin, adds Dr. Kumar.

“People don't realize that glutes are one of the biggest sets of muscles in the body and if you do exercises to develop them, you’ll burn more calories at rest,” she explains. “You get a lot of bang for your buck for working on your glutes.” (Note that focusing on strengthening a particular muscle group is legit, unlike trying to "spot-treat"an area by attempting to lose fat in one spot in particular.)

How To Fix Ozempic Butt

Again, if you're looking to shore up your back side, for any reason, resistance training is your new best friend, says Dr. Kumar.

Another pro tip? Up your protein intake. “The only way to build muscle is to fuel [your body] so not only do you need the exercise, but you need protein,” says Dr. Kumar. Your exact protein needs may vary depending on your age, sex, and activity level, but regular exercisers likely need around 1.2 to 1.5 grams per kilogram.

If strength training and a healthy diet aren’t cutting it, talk with your doctor. “Genetic skin elasticity factors are likely at play here, which also explains why some women may experience stretch marks or loose skin after pregnancy, and others may not,” says Dr. Glickman. From there, a doc can refer you to a plastic surgeon who specializes in cosmetic procedures and loose skin, he says.

Other Ozempic Side Effects To Know About

Although saggy skin is not a direct side effect of Ozempic, Dr. Kumar says you may experience the following undesirable symptoms when using the medication:

  • Nausea

  • Vomiting

  • Stomach pain

  • Constipation

  • Diarrhea

  • Decreased appetite

Most mild to moderate side effects fade over time, says Dr. Glickman. If you’re taking Wegovy you can also expect similar effects since the two medications contain the same active ingredient (semaglutide), he adds.

Bottom line? Rapid weight loss in general, rather than specifically because of Ozempic, is what can lead to a flat- or saggy-looking butt. That's why it's key to work with a doctor, who can monitor your weight loss and guide your individual needs, if you're looking to lose a significant amount of weight.

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