Ozempic pelvic floor – here’s how to avoid it

Thinking about fat jabs? Read this first. Weight-loss drugs  – Mounjaro, Ozempic, Wegovy – are increasingly hailed as a panacea for all ills (seriously – recent headlines proclaimed they ‘hold the key to longer life’ and  ‘cut heart disease deaths by 20%’ and could even help treat depression and anxiety). This is enough to make any of us start considering trying them, even if we don’t have weight to lose.

The benefits look overwhelming, but… there are a few ‘buts’, and here are the two key ones you should know about. Everyone has heard of ‘Ozempic face’ – the gaunt look that sets in after rapid weight loss, but then there’s ‘Ozempic bum’ and ‘Ozempic pelvic floor’ which refer to the way that medication-driven rapid weight loss can strip away muscle all over the body, as well as fat.

Forewarned is forearmed; here’s how to avoid these particular pitfalls.

Don’t go gaunt

We all know what it looks like when someone’s face goes thin and gaunt. One thing I hadn’t realised until hosting a press panel for Galderma* at the IMCAS conference this year with aesthetic luminaries like Dr Steve Dayan and Professor Alan Wigerow was the way that having very low levels of facial fat leads to poor skin health, and a deterioration of collagen and elastin.

What to do:

Go slowly with the weight loss. Galderma’s research showed that the effects of rapid weight loss, as can happen with Ozempic, begins to show up in the face after 10% of bodyweight had been lost –  though this varies from person to person – but you don’t have to wait to see the effects before taking action. Have a chat with an aesthetic practitioner at the start of your journey with these drugs, because then you can make a plan to boost your skin’s collagen production with treatments and skincare.

Boost your facial volume with skincare?

You might very well think that no skincare product has the power to restore volume to the face but one new skincare product, Volulift from Image skincare, has been formulated specifically to counteract the effects of facial volume loss from GLP-1 medications. I hear you scoffing, but they have clinical proof that this ‘GLP Skin Rebound Complex’ does the job. I had instantly imagined that it was regrowing fat in the face, but it turns out it is boosting volume by increasing collagen density and hydration, which is not quite as exciting as a topical fat-booster, but big news nonetheless.  It costs £105 from volulift.co.uk and no-one here at The Tweakments Guide has tried it, but we’re fascinated.

Boost your facial volume with injectables?

Tweakment-wise, the sure-fire way to enhance the amount of fat in your face is by fat-transfer from your tummy or thighs, but that’s a major procedure involving liposuction to harvest the fat.

In terms of injectables, a collagen-stimulating biostimulator treatment such as Sculptra, Harmonica or Radiesse will help to firm and support the skin – perhaps in conjunction with fillers, if your face is really going hollow. The same Galderma research mentioned above also showed that Sculptra had a regenerative effect on facial fat, increasing skin thickness in the hypodermis (the lowest layer of the skin) by 26 per cent, as well as remodelling the collagen and elastin in the dermis (the middle layer of the skin), which IS big news.

Lots of you have asked whether Profhilo Structura can’t help replace fat in the face. Well, what it can do is thicken the superficial fat pads at the sides of the eyes near the hairline, or up towards the temple, which is great but you need to understand that this treatment is only for those areas, and only for the superficial fat, not the deep fat that adds volume in your cheeks.  Also, it gives what we’d politely call a subtle result – ie, there’s a change but it’s not huge – and you can’t have this type of Profhilo used across the lower face and cheeks which is where you’re more likely to be seeing volume loss.

Mind your pelvic muscles 

If you’re looking at Ozempic et al for weight loss, you’ll probably have heard that as well as losing fat, you’re likely to lose muscle. Which, if you’re moving through mid-life, you can ill-afford to do, given how vital muscle is for health and longevity the older we get, so – start working out with weights to preserve and enhance your muscles. Your future self with thank you for it. And eating plenty of protein – at least 1g per kilo of bodyweight to support those needy muscles, and taking creatine supplements.

But you may not have heard that weight-loss on these drugs can lead to muscle loss in the pelvic floor too, which you really don’t want, because that can result in urinary incontinence.

“As well as skin laxity and muscle loss, some people find they develop stress incontinence,” says Dr Tanja Phillips, who has developed a full protocol to advise and treat patients who are embarking on weight loss with GLP and GLP-1 based drugs. “It’s not to say that the medication is a bad thing, because it helps so very much with weight management, but awareness of the risks and how to mitigate them is very important.”

This protocol might involve blood tests, nutrition and exercise advice and lifestyle coaching alongside more direct approaches to build waning muscles. Dr Phillips likes EmFace to build up facial muscles, and the Fotona Pelvic Floor Chair to rebuild muscle in the pelvic area. Why this particular device? Because, explains Dr Phillips, this one has a back plate as well as a base plate. ‘A lot of people don’t realise that it’s important to stimulate muscle in the lumbar area because it joins with the back of the pelvic floor, and the device also gives the muscle stimulation from the sides. My husband is a professor of uro-gynaecology and has one of these chairs in his NHS practice to treat patients with symptoms of stress incontinence, and we both find it is very effective.”

*Disclosure – I was paid to host the Galderma panel at IMCAS but not to write about it – I’m adding this mention because I was as fascinated as anyone else to hear the research!