MDs: Here's How to Outsmart Sneaky Weight-Loss Side Effects So You Feel Better Than Ever
From the constant TV commercials touting its weight-loss benefits to your friends debating whether to try it, Ozempic is literally everywhere. And for good reason: people who took Wegovy (the same active ingredient in Ozempic, which is FDA-approved for diabetes) lost almost 15% of their body weight over the course of about 15 months. It dials down hunger by helping to regulate glucose levels and slowing digestion — when your stomach empties more slowly, you feel fuller longer and eat less, explains family medicine and obesity medicine physician Michael L. Glickman, MD, founder of Revolution Medicine, Health and Fitness. But could it work too well?
“‘Ozempic face’ and ‘Ozempic butt’ have made headlines this year to describe weight loss in more undesirable areas of the body,” he says. “This occurs when the skin has been stretched due to excess fat and doesn't always shrink back completely.” He adds that hollowing out of the skin typically happens anytime there’s significant, rapid weight loss, and it’s not due to anything specific about Ozempic or similar drugs like Wegovy or Mounjaro.
While “Ozempic face” and “Ozempic butt” may be relatively benign aftereffects of speedy slimming, the attention they’re getting is shining a light on a few more bothersome downsides of trendy diet plans. Just read on for the weight-loss “side effect” of three popular regimens and the simple ways to outsmart them.
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Keto side effect: Diarrhea
The key to the popular keto diet is to load up on fat while drastically restricting carbs. Though research shows it speeds weight loss by 1,150%, keto is a study in extremes, notes gastroenterologist Will Bulsiewicz, MD, author of Fiber Fueled.
“The diet calls for about 70% of your daily calories to come from fat — that’s quite high and challenging for your digestive tract to break down,” he says, the pancreas goes into overdrive, pumping out more digestive enzymes while the liver and gallbladder churn out bile to break down the fat so that your body can utilize it. When the digestive system struggles to handle this deluge, he says “keto diarrhea” can be the unfortunate result.
Compounding matters is the diet’s conspicuous lack of carbs, adds functional medicine practitioner Lauryn Lax, author of Eating Healthy is Killing You. “Carbs help create bulk in the stool, slowing its transit through the digestive tract, so a diet that slashes this food group can throw your body off balance and lead to diarrhea.” One solution? Digestive enzymes.
“Ox bile digestive bitters facilitate gallbladder health and help your system break down fats, preventing diarrhea,” says Lax, who recommends taking 1-2 capsules with meals.
Also smart: Add in good carbs, encourages Dr. Bulsiewicz. “Many people don’t realize that when they go on a low-carb diet, they’re often sacrificing fiber, which helps prevent diarrhea by supporting digestion.” He recommends incorporating greens like broccoli into your regimen. “They’re low in calories and high in fiber, so they’re not going to compromise the keto diet.”
And to make them even more keto-friendly, Lax advises letting them cool after cooking. “Cooling root vegetables like sweet potatoes, for example, lowers their glycemic index, which helps with long-term weight loss.” In fact, a study in The FASEB Journal revealed that this simple step lowers the gycemic index of veggies by up to 40%.
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Low-fat diet side effect: Brain fog
Healthy fats, particularly omega-3 and omega-6 fatty acids, are essential for proper brain function, notes physician assistant Jacqueline Rehan, PA-C, who works with Dr. Glickman. If a low-fat diet is extremely restrictive and lacks sufficient healthy fats, it could lead to an essential fatty acid deficiency, which may lead to brain fog.”
To outsmart this pitfall, consider supplementing with omega-3 fatty acids that include both DHA and EPA, adds Dr. Bulsiewicz. A study in The American Journal of Clinical Nutrition found that supplementing with 1.16 grams (1160 mg) of DHA daily improved memory and reduced brain fog significantly.
Also smart? Consider Dr. Bulsiewicz’s omega-rich cocktail: In a glass, combine 2 Tbs. chia seeds (which contain Omega-3s), 10 grams fiber powder like Metamucil (helps you feel full), 2 grams matcha powder (has been shown to boost metabolism), a splash of apple cider vinegar (helps control blood sugar levels), a squeeze of lemon (may reduce appetite) and add water to fill the glass. “Drink it about an hour before a meal to boost satiety hormones — sort of like a natural Ozempic.”
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Low-calorie diet side effect: Fatigue
“When you restrict calories too long, your body naturally wants to conserve them by resting, and as result your metabolism will slow down,” says obesity medicine and internal medicine specialist Charlie Seltzer, MD, explaining that this survival instinct often leads to exhaustion and lack of weight loss as your metabolism plateaus and gets in a rut.
The good news is simply including enough protein in your diet, from sources like lean meat, fish and low-fat dairy, is often enough to offset this fatigue, he says. But if you’re still feeling draggy, consider a simple strategy called carb cycling. “It just means alternating between low-, moderate- and high-carb days,” he explains.
A study in the British Journal of Nutrition showed that this tactic helps improve insulin sensitivity and boosts long-term weight loss. That’s largely because it keeps your metabolism on its toes—on high-carb days, it revs itself up like an engine to burn more calories, increasing your energy levels and keeping you slim. In short, carb cycling allows you to continue to eat low-cal and keep your energy high.
