Ozempic for weight loss makes you skinny-fat

Woman eating pizza is worried about getting skinny fat with Ozempic.

The new wonder drug for weight loss might have a dark side: Ozempic could make you skinny fat.

Ozempic has been credited with the body transformations of celebs like Elon Musk, Kim Kardashian, and Jonah Hill. But, this new miracle drug could also result in making you the dreaded skinny fat.

Some experts now caution that Ozempic (the brand name of Semaglutide) carves off more muscle than fat.

Prominent longevity guru Dr. Peter Attia is seeing this troubling trend in his clinic.

Attia says a healthy weight loss ratio is roughly 75% fat and 25% muscle. However, when he began doing body scans of his Ozempic patients, he discovered something shocking.

“We’re seeing two-thirds of the weight loss is lean mass,” Attia told Megyn Kelly, via her podcast. “Only one-third is fat mass.”

Attia goes on to explain that Ozempic (also called Wegovy) is making people skinny AND fat.

They’re getting lighter, but they’re getting fatter.”

Dr. Peter Attia

Why Ozempic makes you skinny-fat

Intermittent fasting may offer a clue as to why Ozempic patients are losing muscle.

Fasting was all the rage in the weight loss world for years. Interestingly, Dr. Attia was once a big proponent of this trend too.

However, in 2020, Attia abruptly changed his tune. He stopped doing extended fasts of three or more days.

While Dr. Attia doesn’t dispute the potential longevity benefits of extended fasting, he noticed his muscles were wasting away.

“Over a period of three years, I probably lost about 10 pounds of lean mass. So today I just don’t feel like that tradeoff is worthwhile,” Attia told fitness Youtuber Thomas DeLauer in 2023.

Sounds a bit like the problem with Ozempic, no?

How Ozempic could make your body worse

The exact mechanism by which Ozempic induces weight loss isn’t totally clear. However, appetite suppression is certainly a big part.

The drug is taken as a weekly injection. It slows digestion and mimics hormones that make you feel full. By curbing hunger, patients can easily fast for long stretches. Many say they just, “forget to eat.”

Like regular (natural) fasting, the extreme calorie deficit that can happen on an Ozempic-induced fast may explain the attendant loss of muscle mass.

However, it gets worse.

Let’s say you’ve lost a lot of weight with Ozempic. So far, so good. But eventually, since the drug is often not covered by insurance, you might feel it’s too expensive.

Many patients also lose the love for their favorite foods — another prominently reported side effect. If suddenly pizza tastes actively bad, you might not want to live like that forever.

So, obviously, at some point, you might want to quit Ozempic — even if it’s just because you hit your goal weight and don’t want your face sunken like a skeleton.

The big catch with Ozempic for weight loss

Not so fast. Without Ozempic, your hunger will return with a vengeance. And if most of the weight you lost was muscle mass, your metabolism is going to be decimated.

Without lean tissue to burn calories naturally, and Ozempic to curb cravings, you could be in for the worst dirty-bulk of your life.

In this case, it’s not hard to imagine ending up both skinnier, and fatter, than when you started.

Given this catch, it might be best to think of Ozempic as a last resort.

If obesity and diabetes are threatening your life, yeah, ask your doctor for help. But you just need to put down the ice cream and get to the gym, probably do that.