GLP-1 Weight Loss and Body Contouring: What To Expect and When To Consider Laser Fat Reduction
By April Khan, PhD, DHlc
No matter which channel you switch to, there seems to be a commercial about GLP-1 medications like Ozempic and Wegovy promising quick, easy weight loss. While these medications were originally developed as treatments for diabetes alone, more and more people are turning to them to shed those stubborn extra pounds.
However, losing weight with a GLP-1 is not the same as body contouring. Weight loss occurs throughout the body, so these medications cannot help users target fat in specific areas. They also do not allow people to lose weight without risking undesirable cosmetic effects, such as loose skin or fat pockets. For these issues, laser fat reduction is a more appropriate treatment.
In this guide, you’ll learn more about GLP-1s and how they assist in weight loss, when to consider laser fat reduction, and whether or not you can use both simultaneously. You’ll also discover why fat pockets remain after using a GLP-1 and how to reduce and address this risk.
How GLP-1 Medications Work
To date, nearly 12% of American adults have taken a GLP-1 for the treatment of type 2 diabetes or obesity. However, many people still don’t understand what this medication is or how it works.
GLP-1 is a hormone naturally produced in the gut. This hormone regulates blood sugar, slows gastric emptying, and sends signals to the brain when you have eaten enough. Pharmaceutical GLP-1 medications work by:
- Activating the GLP-1 receptor, improving its function, and providing more sustained effects.
- Assisting the pancreas in releasing insulin when serum glucose (blood sugar) levels are elevated.
- Suppressing glucose release from the liver when it’s not needed.
- Slowing digestion so you feel fuller for longer.
- Activating GLP-1 receptors in appetite-regulating areas of the brain to reduce cravings and signal less hunger overall.
People with reduced satiety signals, insulin resistance, and short-lived GLP-1 activity can take prescription-grade GLP-1s to improve these functions. This makes them especially helpful for people with type 2 diabetes or obesity since they are more likely to suffer from these issues.
Some studies support the use of GLP-1s for their metabolic health effects, including reducing inflammation and improving heart and kidney health.
With all of the things GLP-1s can do, it’s important to note their limitations.
GLP-1s cannot:
- Cure obesity or diabetes: Both conditions can be improved with GLP-1s and lifestyle changes, such as following a healthier diet and engaging in regular exercise.
- Override biology: Although they mimic your body’s own GLP-1, they cannot replace it or make it work better. Even while taking a GLP-1, factors like your hormones, environment, genetics, and sleep still play big roles in hunger and insulin resistance.
- Replace a healthy diet: GLP-1 medications are not an adequate replacement for good nutrition or a reduced-calorie diet.
- Guarantee long-term weight maintenance: Some people regain weight after stopping a GLP-1. This is usually due to poor lifestyle habits, such as eating overly processed foods or consuming a caloric surplus without exercising.
What Happens to Stubborn Fat After GLP-1 Weight Loss?
Have you found yourself wondering, ” Why do I still have fat after GLP-1 use?” If so, you’re not alone.
After using a GLP-1 to lose weight, many people find themselves asking their prescribing physician, “Why do I still have belly fat on Ozempic?” Overall, GLP-1s are excellent at helping people with a high body mass index (BMI) lose weight. While BMI will fall, pockets of fat and loose skin remain.
Weight loss involves reducing muscle, fat, and water. It isn’t possible to spot-reduce fat, even if you follow a low-fat diet, exercise regularly, eat in a caloric deficit, and use a GLP-1. This is why you may have residual pockets of fat in areas such as the upper arms, thighs, hips, and abs. Where you deposit or retain fat depends on several factors, including your genetics, fat cell distribution, and skin elasticity. These are the main reasons people take Ozempic but still have love handles.
Spot reducing fat requires surgical or non-surgical cosmetic treatments.
Loose Skin vs. Stubborn Fat After GLP-1
After weight loss with GLP-1, you may notice protruding or sagging pockets on your body. These effects are often due to skin laxity (a.k.a. loose skin) or residual fat pockets. While they may look similar, they are very different.
Here’s how to tell them apart:
- Skin laxity: Lax skin is papery or crepe-like and very thin. You can easily pull it away from your body, and it wrinkles when you move. Lastly, if you’re able to flatten it out with compressed garments or clothing, it is most definitely loose skin.
- Stubborn fat: These pockets feel thicker than loose skin and are significantly harder to flatten. They are soft, but firm to the touch. Many people describe them as “hanging bulges.”
When it comes to weight loss, GLP-1s reduce volume overall. This includes fat, water, and muscle. The medication circulates throughout the body, mimicking the signals your natural GLP-1 would send. For this reason, it cannot override genetics. Where you store fat is largely determined by your DNA and sex hormones. This is why you’ll lose weight overall, but still find pockets of fat.
Moreover, not all fat cells are created equal. Some fat cells have beta-2 receptors. These cells release fat when stimulated by specific hormones, such as adrenaline. Alpha-2 receptors, another type of fat cell, hold onto fat stores when stimulated. Research indicates that areas with higher alpha-2 receptor expression promote fat accumulation, especially in gluteal and subcutaneous fat.
Another study, cited in the Journal of Clinical Endocrinology & Metabolism, finds that estradiol increases the number of A2A-adrenergic receptors in subcutaneous fat, which increases fat stores, particularly in the hips and thighs.
After GLP-1 weight loss
Loose skin is another common effect of weight loss on GLP-1, especially if you’ve lost a significant amount of weight. Your skin is a living organ, and its elasticity depends on collagen and elastin, not your GLP-1 receptors or activity. Overall, the medication rapidly shrinks the fat cells but doesn’t signal fibroblasts to produce any more collagen. Therefore, your skin doesn’t have enough time or collagen to contract.
To naturally tighten loose skin or reduce the appearance of fat pockets after significant weight loss, you must build muscle. This gives you a firmer overall look. To build muscle, you must increase your protein intake and strength train. However, even with these methods, you will still have loose skin and fat pockets, albeit less noticeable.
Ozempic Face, Ozempic Body: What GLP-1 Changes — and What It Doesn’t
There are dozens of news stories about a phenomenon called “Ozempic Face,” which many Hollywood actors and actresses are accused of having. The use of Ozempic for quick weight loss has made it desirable amongst individuals battling obesity, and those who want to shed a few pounds for a specific event. Taking a GLP-1 to lose weight for a specific engagement is inadvisable. However, this new Ozempic Face look has become another reason the medication is being sought out.
Ozempic, like all GLP-1s, causes people to lose 25% to 40% of their lean muscle, not just fat. The lean muscle in the face gives it a plump and youthful appearance. When you lose fat, especially fat that isn’t stubborn, and muscle tone in the face, your appearance becomes gaunt. This is why some people taking Ozempic have sunken eyes, deeper lines, and hollow cheeks.
Another concern people have about taking Ozempic and other GLP-1s for weight loss is “Ozempic Body.” This term describes a cluster of unwanted aesthetic changes.
These include, but are not limited to:
- Vertical bands around the neck (turkey neck)
- Overhanging loose skin or fat around the abs (also called an “apron”)
- Loose skin or fat pads on the upper arms (bat wings)
- Crepey skin on the arms
- Lose skin around the jawline
To reduce the appearance of Ozempic Body or Ozempic Face, some physicians slow their patients’ weight loss by prescribing a microdose or a slow titration. “Slow titration” means they’ll gradually increase the dose over time.
A Complementary Treatment Framework
To obtain the benefits of using a GLP-1 while reducing cosmetic concerns that may arise, consider using a three-phase treatment framework like the one below:
Phase 1: Medical weight loss
In the initial phase of weight loss with a GLP-1, the overall goal is to reduce your BMI to a healthy range of 18.5-25.5. This improves your metabolic markers and reduces the risk of future health concerns related to obesity.
In this phase, you’ll transition to a healthy diet, begin regular exercise, and take your prescribed GLP-1 daily at a regular dose. Starting basic strength training under your healthcare provider’s medical guidance can help reduce the loose skin you may have after finishing your GLP-1 treatment.
Phase 2: Body sculpting refinement
During the second phase, your overall goal is to address any cosmetic concerns that arise as you approach your goal weight.
This includes:
- Getting a professional consultation. This will help you determine whether you have residual stubborn fat or loose skin and decide which treatments are appropriate to resolve remaining issues.
- Using a cosmetic treatment method for tightening the skin. This includes popular treatment options such as laser lipo.
You might also be a candidate for volume restoration services using a biosimulator rather than traditional fillers that you would have to use continuously.
Phase 3: Maintenance and lifestyle stabilization
During phase three, you will continue to eat healthily and make lifestyle changes to maintain your new weight. Your physician will work closely with you in this phase to taper you off of your GLP-1. This slow taper helps to reduce the risk of negative effects. You may also have a final consultation with your plastic surgeon about any skin laxity or fat pockets during this stage.
Safety and Treatment Timing
Undergoing a traditional liposuction or some forms of laser liposuction while using a GLP-1 is not advisable. This is due to the risk of aspiration during anesthesia since food remains in the stomach for longer. In fact, most surgeons recommend that GLP-1 patients wait several weeks to several months after stopping their GLP-1 before undergoing any surgical procedure. This ensures your stomach is empty and the body is under less stress.
Unlike other forms of laser liposuction, the Emerald laser is considered safe to use while on a GLP-1. You can continue taking your GLP-1 injections since there is no anesthesia and no risk of aspiration. There’s also zero downtime. Within 30 minutes of having your laser session, you can resume your normal activities. The procedure is also safe for individuals with higher BMIs. In fact, it’s the only FDA-market cleared laser treatment for patients with a BMI up to 40. This means people can have the procedure done even before reaching their goal weight.
Best of all, results are visible within 4 to 12 weeks.
However, there are times when waiting is advisable.
This includes:
- During pregnancy or when breastfeeding
- During cancer treatment or in areas of the body with active cancer
People in the following groups should avoid the treatment:
- People with pacemakers placed
- People with photosensitive epilepsy
When are you an appropriate candidate?
The timing of laser lipo depends largely on your specific goals, although you can start it at any point in your journey. Most people elect to target known stubborn zones such as the abdomen or under the jawline during the early stages of taking a GLP-1. Others elect to have the procedure performed midway through their treatment when stubborn fat pockets are more visible. Loose skin candidates are more likely to undergo the procedure at the end of their treatment.
Optimal treatment protocol
An optimal treatment protocol for individuals undergoing laser lipo while taking a GLP-1 includes:
- Having treatment twice per week for six to 10 sessions
- Staying hydrated to flush fat through your lymphatic system
- Engaging in regular movement to continue burning fat
Although this protocol follows the most up-to-date clinical data and current regulations, a final framework should be provided by both the plastic surgeon and your prescribing GLP-1 physician. They will ensure all of your lab work is up to standard and that you are a good candidate for the procedure.
When To Get a Consultation
If you’re wondering, “Can body contouring help after GLP-1 treatment?”, it is time to consult with a plastic surgeon. They can assess your areas of cosmetic concern and provide the best treatment protocol to help you meet your goals. Most importantly, avoid stopping your GLP-1 without your prescribing physician’s permission, even if you’ve reached your weight goal. Doing so could cause a rebound effect and delay your laser treatment.
Bio:
April Khan, PhD, DHlc, is an accomplished medical, lifestyle, and business writer with more than 20 years of experience. With over 4,000 articles published by prominent organizations such as AOL, Gartner, and Healthline, she bridges the gap between complex data and consumer health. As a board-certified wellness practitioner and lifestyle educator, Dr. Khan is dedicated to health equity and creating digital content that sparks change.
