[HN Gopher] Ozempic is changing people's skin, say plastic surgeons
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Ozempic is changing people's skin, say plastic surgeons
Author : bookofjoe
Score : 57 points
Date : 2024-08-13 21:52 UTC (1 hours ago)
(HTM) web link (www.allure.com)
(TXT) w3m dump (www.allure.com)
| cbanek wrote:
| I wonder if using something like Retinol, which is proven to
| improve skin and make it look tighter, younger, and get rid of
| blemishes, marks, and sun damage, could be paired with Ozempic to
| keep skin more healthy along with a good skin routine?
| Loughla wrote:
| What are the side effects from that medicine?
| goodJobWalrus wrote:
| For me it's uncomfortably dry skin on my cheeks.
| sctb wrote:
| They're minimal; retinol is usually mixed with a carrier oil
| or cream in various concentrations and applied topically. I
| would be surprised if it has an impact on the superficial
| musculoaponeurotic system (SMAS) referred to in the article,
| however.
| cbanek wrote:
| There's a few, but they are all pretty minor. It doesn't mix
| well with water (rash), so make sure to put it on right
| before you go to sleep. It can increase sun sensitivity of
| your skin, making it easier to have sun burn or additional
| sun damage, so again, put it on before bed. It can sometimes
| cause breakouts especially when you start using it, including
| a red bumpy rash. But after a few weeks, your skin typically
| adapts to it and the rash goes away.
|
| The tricky part is there's all sorts of people that sell
| Retinol products but the amount of retinol is OTC. This isn't
| typically good enough, but you can go to your dermatologist
| to get a prescription strength that really works, and it's
| cheap.
| pnw wrote:
| FWIW, Adapalene (sold OTC as Differin) is a third
| generation retinoid that is less irritating than the
| original formulations.
| jordanb wrote:
| I'm sometimes reminded of a parable of an old lady who
| swallowed a fly...
| cbanek wrote:
| I don't know why she'd swallow a fly? Perhaps she'll die?
| jonplackett wrote:
| Kinda already on that train with the boat load of sugar to
| get overweight in the first place.
| arcticbull wrote:
| The problem is she swallowed everything else too. The obesity
| is a massive problem that needs to be remedied and yes there
| may be side effects along the way but literally nothing else
| works for obesity except roux-en-Y gastric bypass. Palid skin
| is nothing compared to losing your foot to diabetes.
| andy_ppp wrote:
| I know someone who lost an eye to diabetes, so your comment
| is certainly not hyperbole.
| __MatrixMan__ wrote:
| I don't know much about skin care, but given that Ozempic has
| side effects that affect the retina, it wouldn't be crazy to
| get plenty of vitamin A if you're taking it.
| brians wrote:
| The consensus is clear from the article but doesn't support the
| headline: rapid weight loss changes the skin, which recovers over
| more time.
| r00fus wrote:
| Not unlike the "massive muscle tone reduction" scare about GLP1
| meds - you lose that muscle because you're also losing the fat
| you needed the extra muscle for...
| nordsieck wrote:
| > you lose that muscle because you're also losing the fat you
| needed the extra muscle for
|
| That may be part of the cause, but it's also true that
| whenever you lose weight, you always lose some muscle. Even
| bodybuilders who are following the most aggressive protocol
| to minimize muscle loss (extremely high protein intake
| compared to other macros, along with intense strength
| training) will experience some amount of muscle loss along
| with fat loss when slimming down for competition.
| mjamesaustin wrote:
| The relevant quote I saw was this:
|
| "These are changes he hasn't noticed in patients who have lost
| significant weight in other ways--like through diet or gastric
| bypass surgery--which makes him think it's unique to GLP-1
| usage."
|
| Are you suggesting sections elsewhere in the article suggest
| otherwise?
| remram wrote:
| It's not that clear. The article is specifically about this, is
| it just the speed or something else.
|
| > "We're still waiting to find out," says Dr. Few. "I don't
| think anybody can tell you definitively that there's not an
| inherent change to the skin."
| bamboozled wrote:
| It's strange how there is almost never a shortcut to anything.
| Like a universal law.
|
| So now you might get free weight loss without making any effort
| at all, but you'll also look older in the process?
|
| I have to say, my father has been taking it, and I noticed that
| he does look older all of a sudden...and his weight loss also
| plateaued. I thought it was just my imagination, but maybe not.
| mym1990 wrote:
| I have _heard_ that people who lose weight quickly will
| typically look older due to the development of wrinkles and the
| development of harder features. Skin simply doesn 't have time
| to keep up with the weight loss. I don't know if this is true
| but the theory could have some merit as far as our perception
| of people. The real question is: does something like ozempic
| change the biological age of someone?
| swozey wrote:
| You're going to need to include a weight percentage drop or
| something. I've wrestled/jiujitsued my entire life and we go
| up and down weight constantly, 2-30lb swings. We'll water +
| electrolyte fast for a week or two if we have to and drop
| 10-20lbs.
|
| We all look 10-15 years younger than we are (35-45s).
|
| But we're also not dropping 150-200lbs or whatever number
| you're potentially referring to to where skin would stretch.
| But prolonged, constant rapid dropping hasn't bothered our
| skin. I'm complimented all the time on mine.
|
| https://old.reddit.com/r/wrestling/comments/2r9nwy/whats_the.
| ..
| mym1990 wrote:
| Yeah totally, there would be umpteen different factors that
| would influence the "age perception" so to say. I also
| wonder how losing different types of weight(water fast vs
| longer timeframe fat/muscle loss) could impact this.
| JumpCrisscross wrote:
| > _strange how there is almost never a shortcut to anything.
| Like a universal law_
|
| There _are_ win-win tradeoffs. Vitamins, for instance. If you
| 're running a vitamin deficiency, there isn't a downside to
| increasing your intake of that vitamin. (Curing acute
| dehydration via IV is another shortcut that just works.)
|
| The Ozempic story, for me, has been more about how we almost
| seem to be reflexively against the idea of a win-win. A lot of
| people _want_ there to be a tragic downside to the drug for
| reasons that aren 't entirely clear to me.
| xlbuttplug2 wrote:
| But gluttony is a sin!
| mbrumlow wrote:
| I thought everybody was saying Gluten was bad...
| ethbr1 wrote:
| Fat soluable vitamin toxicity?
| https://www.ncbi.nlm.nih.gov/books/NBK234920/
|
| Because apparently a surprising number of people can't
| calculate bodyweight doses.
| silverquiet wrote:
| My perception is that we judge fat people as weak and
| contemptible and therefore a drug is allowing them to cheat
| their way out of their sin instead of paying the proper
| penance (diet and exercise).
|
| It's well known that people treat fat people worse; I
| constantly wonder how aware people are of their own biases?
|
| For what it's worth I've been fat before and I've been in
| shape before. I have my own biases that are beyond the scope
| of this comment. Never taken one of these drugs but only
| because of cost/access; I'm actually curious to experience
| them. If they work for people, I say they should take them.
| PhasmaFelis wrote:
| I think it's pretty simple, unfortunately. A lot of folks
| have this visceral, instinctive horror of fat people, and
| instead of examining that, they convince themselves that what
| they _actually_ despise is laziness and gluttony: inner vices
| expressed outwardly, like a medieval morality play.
|
| But if there's a way to lose weight without major lifestyle
| change, it threatens that tidy moral barometer. Someone might
| _look_ virtuous without actually being so. Cognitive
| dissonance ensues. So they hope and wish for anything to
| catch out and punish these "cheaters."
| armchairhacker wrote:
| What about people who are naturally thin?
| wiseowise wrote:
| Harder to gain weight. Getting called skinny, etc.
| goodJobWalrus wrote:
| I see older very skinny women who look old and frail due to
| being very skinny. You need some fat under that skin to plump
| it up to look youthful. Catherine Deneuve I believe was the
| one that said that after the age of 40 you have to chose
| between your face and your ass. I say all of this as a 40
| something woman.
| digbybk wrote:
| Coffee being the only exception.
| lagichikool wrote:
| Even coffee is without its downsides and risks. There are
| cardiovascular risks, acid reflux, sleep issues, and probably
| more.
| Faaak wrote:
| I though GERD was not caused by coffee [1]: "Drinking
| coffee or tea and adding milk or sugar was not associated
| with reflux symptoms or EE"
|
| [1]: https://journals.lww.com/tcmj/_layouts/15/oaks.journal
| s/down...
| maximus-decimus wrote:
| coffee definitely ruins my sleep no matter what time I drink
| it, so there's that.
|
| My father also had headache his whole working life on
| Sundays, not realizing that drinking coffee all week days but
| not on the weekend, that was probably coffee withdrawal that
| was giving him a headache by day 2.
| rexer wrote:
| I don't know, I think that might be a bias of some kind. The
| free shortcuts are obvious and so the alternative sounds
| ridiculous. No one claims to be a genius when they save time by
| driving instead of walking. But at the margin, of course
| everything has a trade off.
| bananapub wrote:
| seems pretty unsurprising to me that when you shift the
| equilibrium of some extremely complicated system that evolved
| over an extremely long time to improve some metric, that the
| side effects are mostly moving down some other metric you
| liked.
|
| or even more boringly: almost only bad things get called side
| effects rather than being redefined into the benefits
| cm2187 wrote:
| What kind of effort are you talking about? Weight loss has very
| little to do with exercise and mostly to do with how much you
| eat. Those drugs allow you to combat the carving when you
| restrict food. Is fighting the carving the "effort" you think
| people ought to make?
| anakaine wrote:
| This, and there's seems to be a number of people with a
| misconception that getting medical assistance is either
| cheating, or you're not trying hard enough.
|
| As someone who is quite strong and fit, but has a family
| history of obesity, and who has been packing on the kilos
| into their 40s - I've recently started with ozempic and it's
| a breakthrough drug. The incessant never ending demand to
| eat, that voice which never goes away and pervades every part
| of the day and task, the call which is almost impossible to
| ignore ore even after months of dieting and managing macros -
| it got moderated down from a 10/10 volume to about a 2/10
| volume. I've started dropping the gut fat, and 6 weeks in my
| energy is coming back up to levels it was at 10 years ago.
|
| I'm hoping that this isnt a permanent solution, but that it
| permits me to reset my bodies relationship with food,
| insulin, fat accumulation and hunger signals in the long term
| as the signalling cells senesce, the fat is reduced and
| demands less maintenance, etc.
| Aperocky wrote:
| > Weight loss has very little to do with exercise and mostly
| to do with how much you eat.
|
| That's not an accurate statement. Over the past year I have
| averaged 2 hours of aerobics per day (~1500 active CAL). And
| I've simply buffeted my way eating multiple portions per day
| and haven't gained any weight.
|
| It have a lot to do with a lot of exercises - it has little
| to do if you just had little exercise. It's all about the
| caloric balance, and it takes a lot of exercise to skew that
| balance while it's a lot easier to eat more.
| Loveaway wrote:
| Dude, it definitely is a universal law of sorts. Like it's a
| zero sum game. Ever wondered how there's no antidepressant or
| drug, legal or illegal, that just makes you happy? Or anything
| of that matter? Free bliss doesn't exists. You always have to
| pay for it. Literally. That's why drugs are bad, you get the
| high first, but now you're in debt. Exercise is good, because
| it's the other way around! I actually think that's the whole
| point of "time", so we can charge our energies one way or
| another and then experience happiness as a reward!
| throwup238 wrote:
| IMO GLP-1 agonists are obviously not free, from first
| principles. They might be for diabetics who carefully manage
| their diet, but many (most?) people using them for weight loss
| usually already have shitty diets with poor macronutrient
| balance and micronutrient deficiencies. Eating less of the
| crappy food they were eating before just makes the true
| situation worse.
|
| This is just the latest [1][2] evidence for the obvious muscle
| wasting that will happen to a human body that is starved of
| protein and micronutrients. The muscles under the skin are
| being cannibalized for protein that's missing in the diet and
| other biochemical processes that restore them are starved of
| the nutrients they need to function.
|
| [1] https://news.ycombinator.com/item?id=37558780
|
| [2] https://news.ycombinator.com/item?id=39326333
| cameronh90 wrote:
| Why do you think they just eat less of the same crappy food?
|
| In my experience, it turned down the reward feedback for
| calorie dense food, and I would usually now prefer something
| like a lentil daal over a Dominos.
| exabrial wrote:
| here's my casual armchair analysis about some thing I know
| nothing about: Is this correlation instead of causation? I mean,
| if you're dumping pounds rapidly and then your skin is all been
| stretched out...
| throwup238 wrote:
| From TFA:
|
| _> These are changes he hasn't noticed in patients who have
| lost significant weight in other ways--like through diet or
| gastric bypass surgery--which makes him think it's unique to
| GLP-1 usage._
| hypercube33 wrote:
| They aren't seeing it with other rapid weight loss so seems
| like no however this isn't a scientific study so it's just an
| observation.
| dark-star wrote:
| A quick explanation about what Ozempic is would be helpful in
| this case. Not every country uses the same name for their drugs
| and the brand names are often very different
| istultus wrote:
| That's an interesting remark, considering this is most famous
| drug on the face of the Earth, and only has one brand name
| worldwide (in a different dosage it's called Wegovy, and when
| it's released as a pill it will be called Rybelsus). Its
| generic name is Semaglutide.
| vintagedave wrote:
| Wouldn't the most famous drug be: aspirin, heroin, cocaine,
| paracetamol, or maybe viagra?
|
| I don't know from your comment what it is, and it was
| unhelpful. Not really in the HN spirit. For future readers,
| it seems to be an anti-diabetic drug or artificial hormone
| originating in the 70s. More educated comments than mine are
| very welcome.
| bgnn wrote:
| This is the first time I'm hearing about it. It seems here
| it's only prescribed to type 2 diabetes partients and doctors
| are strictly prohibited from prescribing it for weight loss.
| Arubis wrote:
| I had never heard of this drug before today.
| azinman2 wrote:
| It literally says this in the article.
| metadat wrote:
| Was this article written by an LLM? I had to scroll so far to get
| to the core content it kept promising, it's like it wasn't
| written for human consumption.
|
| Ultimately this article is kind of a FUD nothing-burger. People's
| skin behaves the same anytime there is rapid weight loss.
| throwup238 wrote:
| _> These are changes he hasn't noticed in patients who have
| lost significant weight in other ways--like through diet or
| gastric bypass surgery--which makes him think it's unique to
| GLP-1 usage._
| metadat wrote:
| TFA contains mixed messaging. The part you quoted is
| discussing face skin, then later, also talking about face
| skin:
|
| _> ("We see a similar pattern in other causes of rapid
| weight loss, including gastric bypass surgery, he says.) In
| some cases, the loss of subcutaneous fat is significant
| enough that it impacts a patients' ability to get injectables
| .._
|
| So which is it?
|
| My takeaway was that losing weight fast == problematic.
|
| The article dials up the FUD factor to the max, which makes
| me question the quality of reporting and any intent to
| accurately inform vs. just get clicks.
| ineedaj0b wrote:
| I had an internship with a researcher who swore skin had
| different properties between races (not including color).
| Black populations had a different feel to adipose tissue. I
| think I could tell but he had examined thousands, he didn't
| want to be the guy publishing a paper on that.
| PhasmaFelis wrote:
| I've got no dog in this fight, but the article explicitly says
| this is different from the normal effects of rapid weight loss
| on skin.
| cm2187 wrote:
| And if that's true, what is the conclusion? Stay obese to have a
| beautiful skin (and deal with the associated health effects)?
| ikurei wrote:
| There are more options. Many medications are usually prescribed
| together with other meds, to help with the side effects. We may
| adjust the formulations, or learn what to compliment it with.
| readthenotes1 wrote:
| You remind me of a quote from a book whose name I can't
| remember:
|
| She had the unwrinkled face of a woman who had never been
| calorically challenged.
| Saline9515 wrote:
| The article explains that this happens also with patients who
| aren't obese but are using ozempic to lose 20 pounds.
|
| It's an important side effect that ought to be researched.
| rtsil wrote:
| I'd say a more important side effect that ought to be
| researched is possible thyroid tumors, including cancer.
|
| > In studies with rodents, Ozempic(r) and medicines that work
| like Ozempic(r) caused thyroid tumors, including thyroid
| cancer. It is not known if Ozempic(r) will cause thyroid
| tumors or a type of thyroid cancer called medullary thyroid
| carcinoma (MTC) in people.
|
| https://www.ozempic.com/how-to-take/side-effects.html
| irusensei wrote:
| Hit the gym eat healthy and get fit while retaining your
| beautiful skin?
| cm2187 wrote:
| Let them eat cake
| mistercheph wrote:
| There's no shot that the cure everything pill will have any
| negative health consequences, it's been working so well for me
| that I just spoke to my pharmacist and we're doubling my dose.
| brigadier132 wrote:
| Two guesses:
|
| - it's just stretched skin
|
| - people get on ozempic but are not eating nutritious diets, so
| now they are malnourished
| ceejayoz wrote:
| This is a challenge for the first hypothesis:
|
| > These are changes he hasn't noticed in patients who have lost
| significant weight in other ways--like through diet or gastric
| bypass surgery--which makes him think it's unique to GLP-1
| usage.
| comice wrote:
| Worth keeping in mind that many plastic surgeons are in
| competition with drugs like Ozempic.
| cosmicvarion wrote:
| Don't these plastic surgeons have a conflict of interest if they
| perform liposuction? Liposuction is probably wildly more
| profitable than prescribing a GLP-1 inhibitor.
| Saline9515 wrote:
| As the article says, they have patients come anyway to reduce
| the side effects of GLP-1.
|
| Plastic surgeons are like the bank in casino: they always win
| in the end.
| arcticbull wrote:
| > "Fifteen years ago, I would never have done a lower body lift
| on a patient unless they had gastric bypass, a lap band, or a
| gastric sleeve," he says.
|
| Right, because 15 years ago nobody else lost any weight. GLP-1s
| and roux-en-Y are literally the only two treatments shown in
| clinical studies that cause people to lose weight and keep it off
| indefinitely.
|
| Maybe the skin is saggy because there's nothing under it, maybe
| not? But at least they won't have a stroke, heart attack, cancer
| or type 2.
|
| Chemo is going to make you look much worse.
|
| The new category of patient is "person who successfully lost
| weight and kept it off without gastric bypass."
|
| [edit] if you think I'm exaggerating there's a great study from
| 2023 that tracked how many people lost more than 5% body weight
| in a given year.
|
| Answer: 1 in 10, skewing mostly to people who had more to lose.
|
| If you were morbidly obese your probability of achieving a
| healthy weight is 1 in 1667.
|
| And if you manage to thread that needle your average weight
| regain over 5 years is 80%.
|
| https://jamanetwork.com/journals/jamanetworkopen/fullarticle...
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