People suffering from obesity have few therapeutic options. That is why some of them have chosen to take Ozempic, the star drug of the family of medicines that mimics the action of the GLP-1 hormone and which has been shown to be very effective in losing weight. This commercial presentation is not indicated in Spain for the treatment of obesity, but for type 2 diabetes. That is why it is not financed by the National Health System (SNS) for the first pathology and yes for the second. However, those who want to access this medicine to lose weight opt ??to go to private healthcare and get a prescription for Ozempic, the treatment of which costs about 130 euros per month.
In the case of patients suffering from obesity, the use of Ozempic seeks to obtain benefits for their health, recalls Dr. Núria Vilarrasa, specialist in endocrinology and nutrition at the Bellvitge hospital. People who are overweight seek a different goal, who consume it to a great extent for aesthetic reasons. They want to lose pounds quickly and effectively, and this has consequences for the body. Among which, the flaccidity of the skin. A popular name has even been coined to describe this effect when it occurs on the face: the Ozempic face. The face droops due, among other things, to excess skin, so there are those who end up going through the hands of plastic surgeons to solve it.
Doctor Isabel de Benito, president of the Spanish Society of Reconstructive and Aesthetic Plastic Surgery (Secpre) and director of the Porcuna clinic
Sudden weight loss has two main consequences, he says. On the one hand, the loss of volume in fat compartments that should be filled and need to be that way, “especially in the face to have a youthful appearance”. In fact – he clarifies – the loss of this fat on the face is a common fact in aging. “In the case of a significant loss, logically the face ages”. Just look at Elon Musk’s or other famous people who consume it.
On the other hand, there is the effect on the skin. “When the skin has volume at the back, a process called expansion takes place: it stretches to a limit and there comes a time, if the stimulus is repeated, when more skin is produced”, he points out. And, obviously, when the volume decreases, “that skin can adapt to a certain extent, but there’s 30% that won’t, so there will be some left over. And we already know what happens to the face when this phenomenon occurs: it tends to happen”.
María Jesús (53 years old) did not get to go to the plastic surgeon’s consultation. Your problem is different. She took Ozempic for a few months without this sequela on her face, but she did suffer side effects that caused her to stop injecting it, so she quickly gained back the pounds she had lost (which known as the rebound effect). Years ago, María Jesús had tried to lose weight (she weighed 139 kg) with a stomach reduction, which allowed her to lose 70 kilos. He went up to 90 and then decided on Ozempic. He checked his endocrine. He told her that she could take it, although he warned her that she would have to go to private healthcare to get the prescription. And so he did.
In their case, side effects such as headache, nausea or fatigue appeared. During the three months of treatment, María Jesús lost around five kilos, weight that she regained in a very short time after abandoning the medicine. “When I was taking it, I felt high, but the moment you stop, that feeling disappears and you go back to bad habits.”
Regarding this, Dr. Ana de Hollanda, coordinator of the obesity area of ??the Spanish Society of Endocrinology and Nutrition (SEEN) and endocrinologist at the Clínic Hospital in Barcelona, ??warns that the effect of the drug works while it is being used, just as other drugs for different diseases do: “If you take a drug for hypertension or for pain, for example, we don’t expect it to continue working after you stop it,” he points out.
He also adds that the medication to treat obesity “decreases the appetite while it is taken”, so “it is normal and expected that if it is suspended, the appetite will return and the lost weight can be regained”.
María Jesús now weighs a little over 85 kilos. He explains that he continues to exercise daily and that, moreover, his mentality has changed. “Before I wanted to lose weight quickly. Now I understand that it must be a gradual thing, which is the healthiest”.
Jesus Javier Díaz, president of the Spanish Association for Obese Persons and the Treatment of Obesity (Asepo), is calling for this change in mentality. “What people want is to look for something miraculous. Continue to have a wrong habit, eating and drinking as they have always done and being sedentary, and let the drug make up for their lack of physical exercise”. Remember that obesity is a multifactorial disease and must be treated accordingly from various medical disciplines. “The drug does not cure the psychosomatic part of the patient, nor does it act as a substitute for physical exercise, so it is not the definitive solution or the Holy Grail. It is simply a help”.
Dr. De Hollanda also emphasizes the change in lifestyle. He remembers that in obesity the regulation of appetite and satiety does not work properly – “it is a biological problem and not a behavioral one”, he emphasizes – and that the most common strategy to combat the pathology is diet, although ” it has very modest results because in general doing it causes hunger and that is why it is difficult to maintain it over time and weight regain is very frequent”. Despite this, he affirms that “it is very important to acquire these habits because they will help the other treatments to be more effective”.
According to the president of Asepo, the cost of the drug is another reason why people who take it may end up abandoning the treatment. He does not understand that he is funded by the NHS for diabetes and not for his pathology, when both diseases are treated by the same professional, an endocrinologist. “It’s discrimination”, he says.
To the cost of the medicine must be added, in cases where the affected person so wishes, the price to reverse the effect of the face of Ozempic. According to Dr. De Benito, surgery is a solution, although there are treatments that avoid the operating room and can also be effective, such as hyaluronic acid injections to fill in the spaces that have run out of fat.
The price, however, is not suitable for all pockets. According to the doctor, a bottle of a good brand can reach 400 euros. In addition, “in a single session they usually put a few, 4 or 5” – he points out -, so the cost can go up to 2,000 euros. And the volume effect can last between a year and a year and a half in areas with little mobility (cheekbones or nose) and between six and eight months in those with more mobility (such as the lips).
If you choose to go through the operating room, the figure increases even more. To solve, for example, this loss of facial volume, one of the possible treatments is to use your own fat to fill the gaps. The price of this method, called lipofilling, can be between 3,000 and 6,000 euros.
If the aim is to solve the excess skin on the face, a surgical solution would be a face lifting technique, a procedure that costs from 9,000 euros. “What is done there is to readjust the skin to the volume we have and try to tighten the muscles to rejuvenate the face”, explains De Benito.
This doctor also warns that the boom in cases has not yet arrived. “Most patients who lose weight with Ozempic wait until they have a stable weight to start looking for formulas that can improve their face. Especially if they need surgery. There we always advise them to have a stable weight, it is very important”, he concludes.