The Hidden Side Effects of GLP-1 Injections (Ozempic, Mounjaro, Wegovy & More)

GLP-1s are all over the news, social media, the local gym, the church, anywhere you go… everyone seems to be on them or wants to be on them.

BUT what we are hearing more and more is the “I wish I knew about….”

• I wish I knew about the hair loss… 

• I wish I knew that I was going to look 10 years older… 

• I wish I knew that I was going to have wrinkly, saggy skin …..   

It doesn’t have to be that way!  

So, lets recap… for those of you who are just new to the discussion.  

GLP-1 receptor agonists (like semaglutide and tirzepatide) have reshaped how we approach weight loss and metabolic disease. Drug makers like Eli Lilly and Novo Nordisk list the most common side effects—but what’s often missing is the deeper conversation around aesthetics, muscle health, and long-term vitality. 

This article gives you the full landscape—not just the known side effects, but also the ones that impact your skin, face, hormones, and future health. And most importantly, it outlines how we address each one proactively at Trevi Longevity & Aesthetics. 

Known Side Effects (Reported by Manufacturers) 

According to FDA-approved documentation from Eli Lilly (Zepbound, Mounjaro) and Novo Nordisk (Ozempic, Wegovy): 

• Nausea, vomiting, constipation, or diarrhea 

• Loss of appetite and fatigue 

• Headaches and dizziness 

• Risk of pancreatitis 

• Risk of gallbladder disease (especially gallstones) 

• Injection site reactions 

• Hypoglycemia (when combined with certain diabetic meds) 

• Rare thyroid C-cell tumors in rodents 

These are widely known. But there’s another side to the story—especially when GLP-1s are used without clinical guidance or support. 

Less Reported Side Effects

Rapid weight loss comes with aesthetic and metabolic costs. Here are some of the less reported side effects of GLP-1.

We have seen many of these firsthand with our patients. We’ve also included some less common side effects which we have heard about from other providers, but not seen directly in our patient population.

Few, if any, of these side effects are reported by GLP-1 manufacturers.

1. Facial Volume Loss & “Ozempic Face” 

Common Side Effects:

• Fat loss in the midface and temples leads to sunken cheeks and sagging jowls. 

• Wrinkles deepen and skin appears prematurely aged. 

What We Do:

• Early use of filler in temples and cheeks 

• We make sure that weight loss is controlled appropriate not rapid! 

• Biostimulators like Sculptra or Radiesse 

• Collagen-stimulating devices (RF, ultrasound) 

• Regenerative therapies (PRF/PRP, exosomes) 

“People are telling me that I look fantastic and they just cannot put there finger on it. That is because I proactively had filler just before my weight loss journey. I look like me and completely natural” 
—M.K., TREVI Patient

2. Skin Laxity & Loss of Elasticity 

Common Side Effects:

• Rapid fat loss can outpace the skin’s ability to contract, especially in adults over 40. 

• Neck, arms, abdomen, and thighs are common trouble spots. 

What We Do:

• We make sure that weight loss is controlled appropriate not rapid so the skin elasticity had time to respond.  

• We recommend treatments EARLY 

• RF, ultrasound, and collagen stimulation 

• Topical growth factors + retinoid skin cycling 

• Peptides and bioactive collagen supplements 

• Vitamin C and nutrient support for dermal repair 

3. Hair Shedding 

Common Side Effects:

• Many patients notice increased shedding 2–3 months into GLP-1 use. 

• Causes: rapid weight loss, nutritional deficits, and hormonal shifts. 

What We Do:

• PRF scalp injections + growth stimulators 

• Nutraceuticals targeting hair cycle support 

• Minoxidil (oral/topical) and stem cell topicals 

• Hormone panel review for DHT/testosterone balance 

• Intervene early 

“I am soooo happy with the injection treatments, I have a full head of hair and my hairdresser is happy also! Ha!”
—L.P., TREVI Patient

4. Gallstones and Gallbladder Issues 

Common Side Effects:

• Too-fast weight loss (esp. >1.5 lbs/week) reduces gallbladder stimulation. 

• Low-fat diets can worsen gallbladder stasis which can create or make those  pesky gall stones suddenly a problem.  

What We Do: 

• Encourage moderate healthy fat intake 

• Support bile flow with taurine, ox bile, phosphatidylcholine 

• Ursodiol for higher-risk individuals 

LUCKILY NONE of our patients have had these complications, so they are not saying much!  

5. Muscle Loss

The Most Overlooked Risk: Losing mostly Muscle,  and not as much Fat 

Muscle Loss = The Skinny Fat Trap 

Aesthetic concerns are real—but the bigger problem is when patients lose muscle instead of visceral fat. This leads to the “skinny fat” body type: 

⚠️ A body that’s lighter on the scale but still inflamed, insulin-resistant, and at higher risk for falls, fatigue, and metabolic disease. 

Without adequate resistance training and protein intake: 

• Up to 40% of weight lost can be muscle 

• Basal metabolic rate slows 

• Visceral fat may persist even as limbs and face shrink 

• Patients become weaker, frailer, and biologically older despite “weight loss success” 

What We Do:

• Require strength training from day 1 

• Ensure 1.2–1.6 g protein/kg/day minimum 

• Monitor body composition monthly to confirm that weight loss is mainly fat and NOT muscle  

• Use anabolic peptides (CJC/Ipamorelin, Tesamorelin, 5-Amino-1MQ) 

• Supplement with creatine, HMB, amino acids, and post-workout recovery protocols 

This isn’t just about looking better—it’s about preserving metabolic resilience and healthspan. 

6. Hormonal Shifts: The Invisible Saboteur

GLP-1s impact key hormones involved in energy, sex drive, mood, and skin integrity: 

• Thyroid hormones (especially T3) decline with reduced caloric intake 

• Estrogen and testosterone can dip, worsening fat gain and mood changes 

• Cortisol often rises due to the stress of weight loss or undernourishment 

✅ What We Do: 

• Monitor and optimize free T3, testosterone, estradiol, DHEA-S 

• Support natural hormone production where possible 

• Replace with bioidentical hormones if clinically necessary 

• Use lifestyle and targeted supplementation to buffer cortisol and improve sleep quality 

Remember: Long-Term Success Is Never One-Dimensional 

GLP-1s are a tool, not a magic bullet. 

The best outcomes happen when treatment is: 

• Monitored closely 

• Tailored to hormone status and lifestyle 

• Combined with aesthetics and regenerative medicine 

• Supportive of physical and emotional transformation 

At Trevi Longevity & Aesthetics, our GLP-1 programs include: 

• Full body composition monitoring (not just weight!) 

• Hormone and nutrient testing 

• Hair and skin optimization 

• Muscle-sparing protocols 

• Individualized peptide therapy and energy-based treatments 

GLP-1s Can Transform—But Without Strategy, They Can Age You 

Losing weight rapidly can create aesthetic, hormonal, and metabolic consequences if not managed correctly. Our approach ensures: 

✨ You lose fat, not muscle 
✨ You maintain youthful skin, hair, and confidence 
✨ You gain strength, energy, and hormonal balance  

Want to know if your GLP-1 journey is on track?

Book Your GLP-1 Optimization Review today and let’s ensure your transformation is one of beauty, longevity, and true healthgevity.