Published by Dermascope
In an age where body composition goals are increasingly achieved through pharmaceutical means, the popularity of glucagon-like peptide-1 (GLP-1) receptor agonists has soared (1, 2). These medications, lauded for their ability to help patients shed body fat, have become mainstays in obesity management and metabolic health improvement. Despite weight loss success, a critical aesthetic concern often goes overlooked: how can patients preserve a youthful facial appearance – particularly firmness and elasticity – in the midst of such rapid weight loss?
SKIN HEALTH & WEIGHT LOSS
Skin health reflects underlying collagen and muscle dynamics, the integrity of the extracellular matrix, and the body’s ability to maintain moisture and structural proteins as it transforms (3, 4). With sudden, sizable reductions in body mass, the supportive scaffolding of the skin can lag behind the body’s new dimensions. While often attributed to a decrease in facial fat, some literature suggests that the medication may decrease collagen production itself (5). This mismatch in fat loss and collagen production may then lead to looseness, sagging, and an overall less youthful appearance – despite weight loss success.
“When prescribing a GLP-1 receptor agonist, I always advise my patients to consider a comprehensive approach that includes collagen supplementation, skin hydration, and possibly noninvasive tightening treatments,” says Dr. Raman Mehrzad, a board-certified dual specialist of plastic and aesthetic surgery and internal medicine, based at Ocean Plastic Surgery Center in Orange County, California. “Rapid weight loss can leave skin lax and depleted if we don’t proactively address collagen and elastin support.”
CAUSE & EFFECTS
Skin elasticity and firmness largely hinge upon collagen and elastin, the fibrous proteins that give skin structure and resilience (3, 4). In a steady-state scenario, the body replaces collagen at a manageable pace. However, when weight loss occurs rapidly – often facilitated by medications like Ozempic that greatly suppress appetite and alter metabolic pathways—skin will not accommodate the body’s new proportions.(1, 2) This can create a visible discrepancy: while the scale shows success, the mirror may reveal laxity and fine lines where firmness once existed.
ENTER INGESTIBLE COLLAGEN
Ingestible collagen supplementation has recently moved from a wellness trend to a potential staple in aesthetic medicine protocols – particularly for patients undergoing significant body composition changes. Hydrolyzed collagen peptides, when taken orally, have demonstrated benefits in improving skin hydration, elasticity, and dermal density (6, 7, 8). Although research continues to evolve, a growing body of scientific literature suggests that ingestible collagen can stimulate the body’s own collagen production and support the extracellular matrix, potentially mitigating some of the cosmetic drawbacks of rapid weight loss.
It is essential to recognize that collagen supplements are not a magical panacea: they work best in synergy with a holistic lifestyle (9, 10). A well-rounded approach includes adequate protein intake, antioxidant-rich foods, proper hydration, regular exercise, and protective skin care regimens. Together, these strategies help maintain the collagen architecture, bolster skin elasticity, and minimize the visual signs of sudden body mass changes.
A Strategic Pairing
As semaglutide and similar medications usher in an era of targeted, effective weight management, integrating ingestible collagen into patients’ treatment plans may be a thoughtful, preventive step (1). For dermatologists, plastic surgeons, and other skin health professionals, recommending collagen supplementation can become part of a broader patient education process. By highlighting the interplay between nutrition, body composition, and skin quality, we can empower patients to adopt proactive measures before loose skin or textural concerns emerge (6, 7, 8).
RESPONSIBLE IMPLEMENTATION & REALISTIC EXPECTATIONS
As with any dietary or supplemental intervention, it’s critical to set realistic expectations and ensure the patient understands that results can vary. The emphasis should be on a long-term strategy that supports skin integrity through nutritional support, topical regimens, and noninvasive aesthetic treatments like microneedling, radio frequency devices, or ultrasound-based therapies, should the patient desire them.
Working in concert with patients’ primary care physicians, endocrinologists, and nutritionists, aesthetics providers can help individuals craft a comprehensive plan that addresses both health and appearance. By championing responsible supplementation and reinforcing the importance of skin health, we can shape a conversation that extends beyond weight loss to include the preservation of self-image, confidence, and quality of life.
LOOKING AHEAD
As the popularity of GLP-1 receptor agonists continues to rise, so too must our understanding of how best to support patients holistically (1, 2). Emphasizing the value of ingestible collagen supplementation provides a tangible, accessible tool for maintaining skin quality during times of physiologic change (6, 7, 8). In doing so, we can advance aesthetic medicine’s role in promoting skin health – ensuring that the journey to a healthier weight is not overshadowed by unintended cosmetic consequences.
By integrating these insights into patient care protocols, we set a new standard in which aesthetic medicine becomes a partner, not an afterthought, in the evolving narrative of weight management. The landscape of cosmetic medicine and plastic surgery is showing increasing interest in making more holistic approaches to aesthetic medicine mainstream (11).
References
1. Wilding JPH, Batterham RL, Calanna S, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. New England Journal of Medicine. 2021;384(11):989–1002.
2. Pi-Sunyer X, Astrup A, Fujioka K, et al. A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management. New England Journal of Medicine. 2015;373(1):11–22.
3. Naylor EC, Watson RE, Sherratt MJ. Molecular aspects of skin ageing. Maturitas. 2011;69(3):249–256.
4. Quan T, Fisher GJ. Role of age-associated alterations of the dermal extracellular matrix microenvironment in human skin aging: A mini-review. Gerontology. 2015;61(5):427–434.
5. Montecinos, K., Kania, B. and Goldberg, D.J. (2024), Semaglutide “Ozempic” Face and Implications in Cosmetic Dermatology. Dermatological Reviews, 5: e70003. https://doi.org/10.1002/der2.70003
6. Proksch E, Schunck M, Zague V, Segger D, Degwert J, Oesser S. Oral intake of specific bioactive collagen peptides reduces skin wrinkles and increases dermal matrix synthesis. Skin Pharmacology and Physiology. 2014;27(3):113–119.
7. Kim DU, Chung HC, Choi J, Sakai Y, Lee BY. Oral intake of collagen peptide improves skin hydration, elasticity, and dermal collagen density: results of a randomized, controlled, blind study. Journal of the Science of Food and Agriculture. 2018;98(5):2011–2019.
8. Asserin J, Lati E, Shioya T, Prawitt J. The effect of oral collagen peptide supplementation on skin hydration and the dermal collagen network: evidence from an ex vivo model and randomized, placebo-controlled clinical trials. Journal of Cosmetic Dermatology. 2015;14(4):291–301.
9. Bolke L, Schlippe G, Gerss J, Voss W. A collagen supplement improves skin hydration, elasticity, roughness, and density: results of a randomized, placebo-controlled study on healthy middle-aged women. Skin Pharmacology and Physiology. 2019;32(2):81–89.
10. Dureja H, Kaushik D, Kumar V. Developments in nutraceuticals. Indian Journal of Pharmacology. 2003;35(6):363–372.
11. Ruan QZ, Chen AD, Tran BNN, et al. Integrative Medicine in Plastic Surgery: A Systematic Review of Our Literature. Ann Plast Surg. 2019;82(4):459-468. doi:10.1097/SAP.0000000000001676
Dr. Galbraith is a postdoctoral researcher in plastic and reconstructive surgery. He has always been interested in holistic approaches to health and finding ways to combine these with advancements in aesthetic medicine. His work focuses on improving patient outcomes by bridging the gap between science, artistry, and overall well-being through innovative and compassionate care. He also works as a scientific consultant to Lemon & Co.
