People suffering from obesity have few therapeutic options. Hence, some of them have chosen to consume Ozempic, the star drug in the family of medications that mimic the action of the GLP-1 hormone and have 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. Hence, it is not financed by the National Health System (SNS) for the first pathology and is for the second. However, those who want to access this medication to lose weight choose to go to private healthcare and get a prescription for Ozempic, whose treatment costs about 130 euros per month. In the case of patients who suffer 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 largely for aesthetic reasons. They want to lose kilos quickly and effectively, and that has consequences for the body. Among these, sagging 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, which is why some people end up going through the hands of plastic surgeons to solve it.
Dr. Isabel de Benito, president of the Spanish Society of Reconstructive and Aesthetic Plastic Surgery (Secpre) and director of the Porcuna clinic
Sudden weight loss mainly has two consequences, he says. On the one hand, the loss of volume itself in fatty compartments that should be filled and need to be, “especially in the face to have a young-looking face.” In fact – he clarifies – the loss of this fat in the face is a common occurrence during aging. “In the case of a major loss, logically the face ages.” You just have to look at the face of Elon Musk or other celebrities who consume this type of medication.
In parallel, there is the effect on the skin. “When it has volume behind it, a process called expansion occurs: it stretches to a limit and there comes a moment, if the stimulus is repeated, when more skin is produced,” he points out. And of course, when the volume decreases, “that skin can adapt to a certain point, but there is 30% that will not, so there will be leftovers. And we already know what happens to the face when this phenomenon occurs: it tends to fall.” Hence, some go to plastic surgeons to remedy it.
This is not the case of María Jesús (53 years old). Her problem is different. She took Ozempic for a few months without suffering this effect on her face, but she did suffer side effects that caused her to stop injecting it, quickly gaining the kilos that she had lost (what is known as the rebound effect).
A few years ago, he reached 139 kilos. “When I reached that figure I wanted to lose weight on my own, but it was impossible.” In 2018 she underwent a stomach reduction. They reduced it by 80%. She lost 70 kilos.
However, as the years went by he began to gain weight again. “Over time the stomach dilates. Furthermore, the operation does not influence the metabolic system at all.” When he reached 90 kilos, all his alarms went off. He had heard about Ozempic and consulted his endocrinologist. He told her that he could take it, although he warned her that he would have to go to private healthcare to get the prescription. And so she did it.
The problem? Side effects appeared immediately. “From the first day I suffered from headaches, which I had never had before, nausea all the time and marked fatigue.” She thought that maybe her body had to get used to the medication and that’s why she continued taking it. However, three months passed and not only did the symptoms persist, they got worse. In the end he spoke to his doctor and they reduced the dose until he stopped permanently.
In relation to these effects, Dr. Vilarrasa explains that, indeed, there are people who do not tolerate the drug, even in low doses, due to the gastrointestinal symptoms it can produce. She also remembers (like Dr. De Benito) that all sudden weight loss leads to flaccidity, whether that decrease has been caused by a drug like Ozempic or bariatric surgery.
During the three months of treatment, María Jesús lost about five kilos, a weight that she regained in a very short time after abandoning the medication. “When I took it I felt satiated, but the moment you give it up that feeling disappears and you return to bad habits.”
In this regard, 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 used, just as They make other medications for different diseases: “If you take a drug for hypertension or pain, for example, we don’t expect it to continue working after you stop,” he points out.
He also adds that medication to treat obesity “reduces hunger while it is used,” so “it is normal and expected that if it is suspended, appetite will return and the lost weight can be recovered.”
María Jesús is now over 85 kilos. She explains that she continues to do sports daily and that, in addition, her mentality has changed. “Before I wanted to lose weight quickly. Now I understand that it has to be a gradual thing, which is the healthiest thing.”
This change in mentality is what Jesús Javier Díaz, president of the Spanish Association for Obese People and the Treatment of Obesity (Asepo), demands. “What people want is to look for something miraculous. “Continuing to have an erroneous habit, eating and drinking as they have always done and being sedentary, and having 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’s just a help.”
Dr. De Hollanda also places emphasis on the change in lifestyle. Remember that in obesity the regulation of hunger and satiety do not work correctly – “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, she states that “it is very important to acquire these habits because they will help make other treatments more effective.”
According to the president of Asepo, the cost of the drug is another reason why people who take it end up abandoning it. He does not understand that it is funded by the SNS for diabetes and not for its pathology when both ailments are treated by the same professional, an endocrinologist. “It’s discrimination,” he says.
To the cost of the medication we must add, in cases where the affected person so wishes, the price to reverse the effect of Ozempic on the face. According to Dr. De Benito, surgery is a solution, although there are treatments that avoid the operating room and that can also be effective, such as hyaluronic acid injections. The price, however, is not suitable for all budgets. According to the doctor, a vial of a good brand can cost up to 400 euros. Furthermore, “in a single session, several, 4 or 5, are usually performed,” he points out, which can increase the cost to up to 2,000 euros. And the volume effect can last between a year and a year and a half in areas of little mobility (cheekbones or nose) and between six and eight months in those with more mobility (such as the lips).
If you choose to undergo surgery, the number skyrockets even more. To solve, for example, this loss of facial volume, one of the possible treatments is to use your own fat to fill in 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 facial lifting technique, a procedure that costs from 9,000 euros. “There what is done is readjust the skin to the volume we have and try to tighten the muscles to rejuvenate the face,” says De Benito.
This doctor also warns that the boom in cases has not arrived yet. “The majority of 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 are going to need surgery. There we advise that they have a stable weight, it is very important,” she concludes.
