When I started on Ozempic, in April 2025, my appetite was by definition abnormal: I ate too much, too often, with little regard for anything besides quieting whatever compulsion drove me to this sort of behaviour. A weekly dose of the GLP-1 agonist semaglutide, which is sold under brand names like Ozempic and Wegovy, transformed me. It diminished both my hunger and my cravings for processed sugar and fried foods; it made me into the sort of person who eats when hungry and at no other time, which is something I hadn’t experienced for at least a decade.
We tend to talk more about the way these drugs reshape our bodies than the effect they have on our thinking. There is real psychological power in feeling, at long last, like you are in control of the appetites that once controlled you. Semaglutide slows the digestive process so that one meal keeps a person feeling fuller for longer, while also curbing cravings, so that all calories become more or less equal. Fried foods and processed sugar are no more appealing than a salad or some chicken breast, making it easier to tell yourself: No, I’m not going to eat a doughnut or some pizza. Instead I’ll have a protein bar or an apple or maybe nothing at all.
In my case, Ozempic lived up to its burgeoning reputation as a miracle drug. The weight came off so quickly at first that I found myself with questions about the effects this might have. Was it possible to get all the macronutrients I needed while eating so little? Would my fats and proteins spin out of balance? Was my skin ready for the body it contained to shrink so quickly? These questions were not always easy to answer.
There now exists a range of supplements targeting every possible post-GLP-1 anxiety.
GLP-1 drugs have gone mainstream so quickly, and are so often prescribed by weight-loss clinics rather than general practitioners, that users may need to rely on a great deal of self-directed research—countless hours spent reading medical journals and trawling Internet message boards, which in turn attracts algorithmically determined GLP-1-related content. In my case this content mostly consisted of short-form videos posted by wellness influencers, beauty brands, and plastic surgeons about GLP-1-adjacent care.
For the first time in my life I cobbled together what might be called a wellness ritual, an approach to my health that depended mostly on the opinion of a licensed medical professional but also on vibes, marketing, and online gossip. I started taking expensive collagen and biotin supplements soon after my doctor prescribed Ozempic. I also hydrated more obsessively than ever before in an effort to prevent the loose skin that can result from losing too much weight too quickly, and I used special lotions like Mederma to help avoid the appearance of stretch marks. After learning how important protein is for both skin health and maintaining muscle mass, I added a protein shake to my daily routine.
And then, in March of this year, and not without some anxiety over how my life might change, I stopped taking Ozempic. I just felt very strongly that this was the right time to quit. I had been successful, losing nearly ninety pounds in eleven months; when I looked in the mirror, the face staring back at me looked much as it had before I’d put on all that weight, aside from a few gray hairs. Yet I still had a little more weight to lose, and maybe some part of me wanted to lose it on my own. It’s hard to say. I started taking semaglutide because it felt like the right thing to do. When my gut said it was time to give it up, I felt like I should listen.
My appetite took weeks to return, but when it came roaring back it seemed to happen all at once. This started as I was recovering from a bout of flu that had kept me from eating much of anything at all. For a week I nibbled and pecked at the odd piece of food, then on a whim I ordered a bulgogi pizza. After eating most of it in one sitting, I tried telling myself this was only because I’d been eating so little. But as days passed, then weeks, I had to admit that my appetite was still unusually strong, which is another way of saying it had returned to normal.
Something else about my life shifted as well. I soon realized that the medical and aesthetic implications of every supplement, vitamin, and lotion I used were no longer linked. Efforts to stay hydrated and track my macros were no longer a matter of lessening my risk of kidney damage, and the collagen and biotin capsules I ingested several times each day were not necessary for preventing stretch marks. Without Ozempic, I would need a new ritual with its own justification, one for life after Ozempic, when the control it once gave me would be entirely in my own hands.
There’s no telling how many others have used Ozempic long enough to lose a significant amount of weight and now need to come off the drug. But the marketing of post-GLP-1 care suggests we are an emerging market for beauty brands, influencers, and plastic surgeons: a growing cohort of formerly obese Americans newly committed to fitness routines, healthy eating, and skin-care regimens, with a mounting fear of what life will be like without the drugs that helped transform our bodies. Once again they are offering something that is difficult to find elsewhere, and though it is hard to take them seriously, it is equally hard to ignore them outright.
When I was on Ozempic, I prepared a protein shake nearly every morning, one made using a Japanese whey-protein powder called Savas. Often I would add a scoop of powdered collagen peptides—basically rendered animal bones—a building block of healthy skin. For a person with a diminished appetite, a protein shake is less a supplement than a meal replacement that allows for maximum nutrition with minimal calories. I wasn’t so much preparing a meal as performing a calculation: Here were 400 calories but also the amino acids I needed to maintain muscle tone and taut skin.
As soon as I stopped taking Ozempic, though, protein shakes were no longer a meal replacement; they were a 400-calorie impediment to the real food I wanted to eat more and more of as the effects of semaglutide began wearing off. A fear of rebounding from weight loss has been around as long as dieting itself and is no less real for those on GLP-1 agonists. The same month I stopped taking Ozempic, The Lancet published a review of studies suggesting that people who lost weight taking GLP-1 drugs often gained back about 60 percent of it a year after they stopped.
My anxiety had to do with more than just gaining back weight. Ozempic had also relieved me of a somewhat nihilistic view of my own body; past a certain point, obesity forces a person to choose between self-loathing, self-acceptance, and what might be called self-avoidance. To put aside the punishing social, medical, and existential realities of obesity, I chose not to dwell on them and instead trained myself to think as little as possible about my appearance and my health. It was the only way of alleviating some of the stress that comes along with living in a body that is a source of both shame and anxiety.
Self-improvement is not unlike self-avoidance in the sense that both are difficult for a person to compartmentalise. The more weight I lost on Ozempic, the more I allowed myself to imagine the possibilities of being a person unashamed of his own body: I bought new clothes, adopted a more rigorous skin-care routine, and even got a slightly less utilitarian haircut. By the time I stopped taking the drug, I’d given myself permission to look very closely at the person staring back at me in the mirror. The more I looked, despite my gains, the more I had to ask myself whether the skin beneath my chin wasn’t just a bit droopier than it had been before. And the more I asked myself this question, the more aggrieved I felt over the fact that I’d waited so long to lose the weight. At some point, I came to see it as a kind of punishment, a reminder that I could have acted sooner, when my skin was younger and more supple, but instead waited on the arrival of a miracle weight-loss drug.
Such thoughts could lead to depressive bouts of doomscrolling through Instagram Reels and TikTok videos devoted to GLP-1 aftercare. One day, I encountered a video from an account called the Contour Clinics. It described a hauntingly specific condition of loose and wrinkled skin called “Ozempic neck,” which the person in the video said was “more of an online phrase than a medical diagnosis.” This caveat did nothing to stop me from immediately buying stronger sunscreen and doubling my daily dose of biotin and collagen supplements, which I had not stopped taking when I got off Ozempic.
There now exists a range of supplements targeting every possible post-GLP-1 anxiety. Something called Mars Men, whose ads recently started appearing in my X feed, promises to address “the testosterone cost” of GLP-1 use. “It stops the muscle loss that makes you look ‘skinny fat’ instead of actually fit” and “protects your testosterone during rapid weight loss when it’s most vulnerable,” according to claims on the product’s website. Mars Men also advertises itself as protection against unproven but increasingly common claims of a diminished male sex drive owing to GLP-1 use—something the health and wellness writer Sami Reiss has pushed back against in his excellent Substack newsletter Snake Super Health by pointing out that a lower BMI tends to be associated with a higher sex drive.
Other corners of the post-GLP-1 wellness market are more grounded in actual research but have their own slipperiness, which amounts to putting a fresh coat of paint on tried-and-true products like fibre supplements, long known to increase satiety. In the same way that foods that never had gluten began advertising that fact a decade ago, products like ColonBroom now tout their effectiveness as post-GLP-1 health supplements.
The recommendations targeted at people like me, those living after Ozempic, tend to depart from the more even-headed counsel offered in dermatological studies that suggest the skin beneath my chin might firm up on its own if I drink enough water, eat the right foods, and keep taking collagen, biotin, and a good multivitamin. Dr Ben Taylor-Davies, for example, the cofounder of an aesthetic-medicine clinic in Edinburgh whose videos I was served, suggests trendy interventions: injectable “bio-stimulators” like Juläine, which purport to boost the body’s natural collagen production, and “energy-based” treatments like red-light therapy to help tighten the skin.
The post-GLP-1 nutrition discourse has more recently spilt over into the corner of the online world dedicated to what is known as “dark wellness,” encompassing everything from off-label use of GLP-1’s and injectable peptides to the supposed health benefits of raw milk and supplements like creatine and testosterone-replacement therapy. These spaces are among the more cavalier corners of a MAHA-adjacent world that can be especially appealing to people who have been deeply affected by drugs no one yet fully understands.
The promise of supplements was that they could help my body counter and recover from the effects of my dramatic weight loss, that they could keep the less-than-taut flesh beneath my chin from turning into Ozempic neck. But what if they didn’t? At some point, I realized, many GLP-1 users will need to ask themselves whether they might be the sort of person who would consider cosmetic surgery. To see how common this was, I decided to go straight to the source.
In April, I spoke with Dr Mark R. Murphy, a plastic surgeon based in Palm Beach Gardens, Florida, who markets himself as an expert in post-GLP-1 care. He discussed with me a dread condition called “Ozempic face,” which he described as a sort of acceleration of the changes many people have long associated with aging—namely a loss of fat volume that can make the face appear gaunt and hollowed out, with a looseness to the skin that makes it look “crepey.” Along with this comes a sagging of the skin that can be especially pronounced in the jowls. “The GLP-1 patients fit into that paradigm,” Murphy said, because of the “accelerated gravitational impacts and volume-related impacts” that come along with losing a great deal of weight in a relatively short period of time.
While building confidence, long the promise of the weight-loss industry, these drugs can also birth a kind of neediness.
Murphy’s proposed solution to Ozempic face is the harvesting of fat from elsewhere on the body so that it can be injected into the face to replace the lost volume—one of a number of procedures he calls a “gateway” to other cosmetic interventions, like the injection of Botox or lip filler, which are proving attractive to younger and younger patients.
The downward slide of the age at which people consider cosmetic surgery is part of what Murphy calls a post-GLP-1 “boom” for the industry. The kind of regret I experienced may be at least partly responsible: The wish to be trim and the wish to be young are not the same, but most of us who wish to be trim have a younger, healthier version of ourselves fixed in our minds. “You’ve got all these people who were just not surgical candidates before,” Murphy told me. “GLP-1’s have opened up a wide range of patients who never even thought about this stuff.” If “this stuff” sounds like an overly vague category, it seems to me an ideal way of describing an ever-expanding catalog of aesthetic maladies birthed by the GLP-1 wellness boom. The veracity and seriousness of conditions like Ozempic face, Ozempic neck, and Ozempic arms do little to diminish the appeal they may have as marketing tools.
The broader effects of GLP-1’s may not be fully understood for years: In addition to the cosmetic-surgery industry, fashion, food, and pharmaceuticals also stand to be reshaped by a slimmer, less hungry population—and they are far from the only industries susceptible. But for now, the most obvious changes are often individual and isolating. When I spoke to Murphy and learned that many of his own patients were as anxious as I was about giving up GLP-1 drugs, it was a relief to discover that my fears were common ones. He also told me that anxieties around the drugs go beyond people like me who have lost a significant amount of weight. Another class of patients, whom he calls “microdosers,” those who have used low doses of semaglutide or tirzepatide to shed five or ten pounds, now fear that they will never again reach their dream weight if they stop taking them. If I get off this stuff, they tell him, I’m going to go right back to where I was. “So they’re very different etiologies of post-GLP-1 anxiety, but they are all anxious,” he said. “The reasons why they are anxious are just different depending on why they got on them in the first place.”
The reasons may vary, but these anxieties seem to stem from one distinct quality of these drugs: how effective they are. Studies show that one in eight Americans who have tried GLP-1 agonists are likely to shed between 10 and 15 per cent of their total body weight, and since these drugs were initially developed to treat diabetes, they might also experience healthier blood-sugar levels. Some of these studies also find a correlation between GLP-1 use and improved cardiovascular health, which is in turn associated with reduced mortality. This is so far beyond what most people are able to achieve through conventional attempts at weight loss as to create a profound psychological vulnerability: While building confidence, long the promise of the weight-loss industry, these drugs can also birth a kind of neediness, a fear of surrendering the control one feels while taking GLP-1’s. This is amplified by the weight-loss industry’s decades-long campaign to market one product after another that simply did not work. For those who have been victimised by that industry, the arrival of a weight-loss product that does what it claims is not unlike finding God in a church one walked away from long ago.
Nearly two months after I stopped taking Ozempic, I still felt I could stand to lose about 20 more pounds. This may yet happen, since I’ve gotten back into running, a hobby I’d always enjoyed when I was younger. I’ve lost the absolute sense of control I felt on Ozempic, but not my renewed sense of optimism over how much control I do have.
There have been some adjustments: no more protein shakes, for example, and fewer meals consisting of broccoli and skinless chicken breast over quinoa. But I’m still using most of the supplements I began taking while on Ozempic: biotin, collagen, multivitamins. If I lose more weight, I may try some natural products that seem to have an effect similar to, if not as strong as, that of GLP-1 drugs. The evidence for these is thin—it primarily comes from studies in animals—but things like psyllium, yerba maté, ginseng, various probiotics, lean proteins, and some healthy fats may mimic the mechanism by which Ozempic curbs cravings.
What’s more important than what I’ve decided to do, I think, is what I’ve decided not to indulge in—no surgery, no injectables, and no junk science. To someone who has not been on a GLP-1 agonist, ruling out such things probably sounds trivial. It is not.
Ozempic reset my sense of what is “normal” behaviour and what is compulsive. It was only while taking the drug that I realised just how upset my eating habits had become. On the drug, it took me no time at all to develop a deeply ambivalent relationship with the food I ate, which felt much more normal than overeating. I wondered whether the pharmaceutical intervention may have been somehow more natural than what came before it, and so, of course, I also wondered what would come after.
Now that I am off it, what I crave most is regaining that sense of control. The search for probably ineffective post-GLP-1 elixirs and supplements is really a way to preemptively address the fact that these healthy habits I’ve developed while taking Ozempic need to be kept up, that they may fall away in time if I don’t tend to them carefully. What comes after Ozempic may be, most simply, an acute awareness of how easily our bodies can buck our desires.
On Sunday evenings, around the time I used to inject a dose of semaglutide into the soft tissue of my abdomen, I now massage some retinol onto my face and angle my chin upward as I glance in the mirror. I turn to the left, then to the right, and tell myself there’s still time for that loose bit of skin to bounce back and tighten up on its own—at least four months, maybe five, before it will be time to ask myself how far I’m willing to go to see a face that looks even a bit more like the one I remember.
