Side effects
What these drugs do to your body, what the label says, and what to do about it.
Side effectsWhat “Ozempic face” actually is, and what changes it“Ozempic face” is not a side effect of Ozempic. It is the hollowed, older look a face takes on after fast, substantial weight loss, and it happens the same way after bariatric surgery or a hard diet. Facial fat pads shrink along with fat everywhere else, and skin that has lost volume quickly does not always retract to match. It is not listed in the prescribing information for semaglutide, because the drug is not doing anything to your face that losing the weight another way would not. What you can influence is how fast you lose and whether you can stay on a steady maintenance dose instead of stopping and rebounding.Side effectsOzempic side effects, and the ones that actually make people stopThe common Ozempic side effects are gastrointestinal: nausea, vomiting, diarrhoea and constipation. They cluster in the first weeks and after each dose increase, which is why the drug is titrated slowly rather than started at the dose that does the work. Ozempic also carries a boxed warning for thyroid C-cell tumour risk and should not be combined with another GLP-1. The practical thing nobody tells you: most people who quit do it during titration, and what decides whether that costs them money is the seller's pause and refund terms, not the sticker price.Side effectsWegovy side effects, and why the top of the ladder is differentWegovy's side effects are semaglutide's side effects: nausea, vomiting, diarrhoea and constipation, worst in the first weeks and after each dose increase. What makes Wegovy different from Ozempic is not the molecule but the destination. Wegovy is dosed for weight management, climbing to 2.4 mg with a 7.2 mg high-dose strength above it, and dose is the main driver of how pronounced the gastrointestinal effects get. It also carries a boxed warning for thyroid C-cell tumour risk. One useful fact while you decide whether to push through: Novo's self-pay price is flat across every pen dose, so a slower climb costs a brand patient nothing.Side effectsSemaglutide side effects, and what compounding does and does not changeSemaglutide's side effects are gastrointestinal: nausea, vomiting, diarrhoea and constipation, worst early and after each dose increase. Those belong to the molecule, so they are the same whether it came in a Novo Nordisk pen or a compounding pharmacy's vial. What compounding changes is everything around the molecule. A compounded drug is not FDA-approved, so the finished product has not been reviewed for safety, effectiveness or manufacturing quality, and the FDA has said the enforcement discretion that allowed 503A pharmacies to compound semaglutide has ended. It also usually arrives as a vial and a syringe rather than a pre-set pen, which moves dose measurement to you.Side effects“Ozempic butt” is not a side effect either“Ozempic butt” describes loss of volume and sagging skin around the buttocks after fast weight loss. Like “Ozempic face”, it is not a listed adverse effect and not something the drug does to that area specifically. Fat leaves everywhere when you lose fat, including where you would rather it stayed, and skin that loses volume quickly does not always retract to match. It follows large rapid weight loss from any cause. The two things you influence are how fast you lose and whether you can afford to stay on a steady dose instead of stopping and rebounding.Side effectsGLP-1 hair loss: what is actually going onHair shedding on a GLP-1 is real and commonly reported, but the drug is not attacking your follicles. Rapid weight loss and the physiological stress that comes with it are long-recognised triggers for a temporary shedding phase, and that happens after bariatric surgery, illness and crash dieting too. It is usually temporary. Two things make it more likely: how fast you are losing, and whether you are eating enough protein and micronutrients while you do it. Both are worth raising with a clinician rather than solving from a website.Side effectsGLP-1s and alcohol: what is known and what is notThere is no blanket instruction on the label saying not to drink on a GLP-1. The specific risk that is well established is low blood sugar, and it applies to people who also take insulin or a sulfonylurea, where alcohol can compound the effect. Beyond that, two things are widely reported and not settled: that alcohol tolerance changes, and that interest in drinking drops. Both are worth mentioning to a prescriber and neither is something a website should turn into advice.