GLP-1 agonists and other weight loss medications are changing what walks into your treatment room–what questions clients ask about, and what skin symptoms and goals they need support with. One in eight U.S. adults now report using weight loss drugs, and nearly half of adults with diabetes are on one for blood sugar management[1]. What we’re seeing in the skin—hollowed cheeks, laxity, crepiness, sagging, dullness—isn’t random. It’s physiology, and it’s predictable. The good news is that predictability means it’s also something we can support.
Why the Gut Comes First
GLP-1 drugs work by slowing gastric emptying and quieting appetite signals. That’s the mechanism—and it’s also why side effects follow. Research using wireless motility capsules found delayed gastric emptying in 80% of GLP-1 users and delayed whole-gut transit in 44%[2]. When food and waste move more slowly, the gut environment shifts, and some clients tip into dysbiosis or small intestinal bacterial overgrowth (SIBO)[3].
This matters for the skin because the gut, brain, and skin are in constant conversation. Dysbiosis is linked to increased intestinal permeability and systemic inflammation[4] while healthy gut bacteria produce short-chain fatty acids (SCFAs) that help calm inflammatory skin conditions from the inside out[5]. The skin is downstream of the gut. You can’t fully support one without the other.
What’s Really Happening to the Face
“Ozempic face” isn’t a formal diagnosis, but it’s a real pattern: facial hollowing, laxity, and a prematurely aged look during rapid weight loss[6]. A 2026 imaging study found facial fat pads shrank by 42–70%—far more than overall body fat[7]. Lean tissue is affected too: DXA substudies show roughly 25–40% of weight lost on semaglutide or tirzepatide is lean mass, not fat[8]. Add reduced food and fluid intake, and the face is simply under-resourced.
There’s also an inflammatory layer. Researchers propose that GLP-1 receptor activity on skin fibroblasts may reduce protective cytokines and dampen estrogen signaling that supports collagen[9]—though these medications may also lower inflammation and AGEs elsewhere in the body, so the net skin effect is still being studied.
Tirzepatide and retatrutide follow the same script. Tirzepatide outperforms semaglutide for weight loss[10], and retatrutide—a triple GIP/GLP-1/glucagon agonist still awaiting FDA approval—has shown even greater weight loss in trials, with similar GI effects and lean-mass patterns[11],[12]. Faster, deeper weight loss means the same foundational support matters even more.
The 3-Part Protocol
The most effective approach we’ve seen addresses root cause in three parts: support the gut, calm inflammation, and support the skin. Always coordinate nutrition and supplement recommendations within your scope of practice and the client’s prescribing healthcare provider.
1. Support the Gut
Motility and comfort come first. Ginger root, artichoke leaf, deglycyrrhizinated licorice (DGL), digestive enzymes, bitters, and targeted probiotics (Saccharomyces boulardii, spore-based strains) are commonly used to ease transit and reduce bloating[13].
2. Soothe Inflammation
Carotenoid antioxidants, omega-3s with specialized pro-resolving mediators (SPMs), collagen and elastin peptides, and butyrate-supporting probiotics all help quiet the inflammatory cascade and rebuild from within[14],[15]. Reducing refined sugar and processed foods supports both skin and blood sugar goals.
3. Support the Skin—Barrier First
This is where you shine. The barrier is already inflamed, so the goal is to calm it, hydrate it, and rebuild it—never provoke it.
- Balance moisture properly. Humectants (glycerin, hyaluronic acid, aloe vera, other mucilaginous herbs) draw water in; ceramide-rich emollients and occlusives seal it in. Humectants alone can backfire and increase water loss, so balanced skin moisture is key[16].
- Choose nutrient-dense botanicals. Sea buckthorn, rosehip, and amaranth oils bring pro-Vitamin A carotenoids and fatty acids that support barrier repair[17].
- Skip harsh actives and overstimulation. Set aside aggressive acids, scrubs, and intense resurfacing–already inflamed and weakened skin does not recover well from these.
- Use gentle manual work. Lymphatic drainage and fascial release, done with plenty of slip, support circulation and tone; studies show modest but measurable improvement in facial contour[18]. Acupressure and, through a licensed acupuncturist, facial acupuncture are gentle complements with encouraging early evidence[19].
Topicals and manual therapy improve hydration, comfort, and radiance—but they can’t rebuild lost volume. That’s something that comes from the inside. It’s important to set realistic expectations with your clients.
The Hidden Toll for Clients With Diabetes
It’s important to understand that not every GLP-1 client chose this trade-off. Many clients with diabetes take these medications for blood sugar control, not weight loss—and stopping isn’t an option. Their average weight loss is often smaller than in non-diabetic trials[20], so they may see little of the “success” story while still losing facial volume and gaining laxity.
Diabetes distress is already common, affecting over 20% of people with diabetes[21], and visible facial change can add to that emotional weight. Clients may feel they have no right to be upset about their appearance while managing a serious health condition—or worry that caring about their face seems vain.
You can help simply by acknowledging it. Validate the change compassionately. Reframe goals around skin comfort, hydration, and resilience—wins you can actually deliver. And watch for signs of real distress; if a client mentions skipping doses over appearance concerns, gently encourage them to loop in their prescriber and care team.
Where Nutritional Aesthetics® Comes In
The esthetics, spa, nutrition, and coaching industries are all in flux, with more and more clients and patients either requesting weight loss medications or trying to find help with side effects like the skin changes discussed here. Nutritional Aesthetics is at the forefront of this convergence between beauty and wellness, and Certified Nutritional Aesthetics Practitioners are well equipped to have targeted conversations about topics like this with their clients—and to offer personalized ways to support skin from the inside out as well as the outside in.
This is exactly the kind of shift our field was built for. As more clients arrive already on a GLP-1, or asking for more information about these medications, the professionals who can speak confidently to both the aesthetic and the physiological side of that conversation are the ones who earn lasting trust. That means understanding not just which serum to reach for, but why the gut, inflammation, and skin are connected in the first place—and being able to explain that connection to a client in a way that feels grounded, not alarmist.
It also means having a real toolkit, not just talking points. Knowing which nutrients support barrier repair, which botanicals calm an inflamed complexion, and which manual techniques are appropriate when skin is fragile takes training that goes beyond an esthetics license or typical health coaching certification. That’s the gap Nutritional Aesthetics was created to fill, and it’s exactly why this space keeps growing alongside the medications reshaping it.
If you want to learn more about how to support your clients as we continue to see growth in functional pharma therapies such as GLP-1s, we dig even deeper into this topic and several others affecting clients right now in our full Certified Nutritional Aesthetics Practitioner Training Program.
Learn more and get certified here.
This article is for educational purposes for licensed skin and wellness professionals and is not medical advice. Always operate within your scope and refer your clients to licensed healthcare providers as appropriate.
References
- KFF Health Tracking Poll: GLP-1 use. November 2025. kff.org
- Impact of GLP-1 receptor agonists on gastrointestinal motility. PMC
- Diagnostic evaluation of SIBO risk with GLP-1 receptor agonists. 2025. PMC
- Beyond the skin: the gut–skin axis in inflammatory skin disease. PMC
- Xiao X, et al. The role of short-chain fatty acids in inflammatory skin diseases. Front Microbiol. 2023. PMC
- Daneshgaran G, et al. “Ozempic face” in plastic surgery: a systematic review. Aesthet Surg J Open Forum. 2025. PubMed
- Feng et al. GLP-1 receptor agonists and facial aging. J Cosmet Dermatol. 2026. Wiley
- Look M, et al. Body composition changes with tirzepatide, SURMOUNT-1. Diabetes Obes Metab. 2025. PubMed
- GLP-1RA and the possible skin aging. Endocrine. 2025. PubMed
- Comparative effectiveness of tirzepatide and semaglutide. PMC
- Grossi G. Retatrutide TRIUMPH-1 results. AJMC. 2026. AJMC
- Eli Lilly. TRIUMPH-2 and TRIUMPH-3 topline results. July 2026. investor.lilly.com
- Nikkhah Bodagh M, et al. Ginger in gastrointestinal disorders. Food Sci Nutr. 2019. PMC
- Zhou X, et al. Astaxanthin and human skin ageing. Nutrients. 2021. PMC
- Batool A, et al. Oral collagen peptides and skin rejuvenation. J Cosmet Dermatol. 2026. Dermatology Times
- Moisturizers. StatPearls. NCBI
- Lin TK, et al. Anti-inflammatory and skin barrier repair effects of plant oils. Int J Mol Sci. 2018. PMC
- Ahn et al. Facial roller and gua sha massage, RCT. J Cosmet Dermatol. 2025. PMC
- Haghir H, et al. Acupuncture for frown lines, RCT. J Cosmet Dermatol. 2025. PMC
- Efficacy and safety of semaglutide in adults with type 2 diabetes, STEP 2. PMC
- Diabetes distress: the psychological burden of living with diabetes. Lancet Diabetes Endocrinol. 2024. The Lancet