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The “Ozempic body” phenomenon

Osmund Agbo, MD
Conditions
January 15, 2024
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In a serendipitous encounter, I crossed paths with an old schoolmate of mine whimsically dubbed Fluffy Carol during our shared medical residency. Famous for her arresting charm and infectious smile, she was, in many ways, the life of the party if we ever had one.

Despite her endearing qualities, one mischievous fellow in our group had bestowed upon her a less-than-ideal nickname that stuck, though it was seldom uttered in her presence. Thank goodness. Nonetheless, Carol exuded a nonchalant attitude, seemingly impervious to such trivialities. Nothing seemed to weigh her down or affect her cheerful disposition, or so we thought.

Fast-forwarding to recent weeks, an unexpected tap on my shoulder unveiled a startling transformation – Fluffy Carol was no more. Instead, she had transformed into Skinny Carol, having shed an astonishing amount of weight, rendering her unrecognizable. Commending her dedication and hard work, I was taken aback by her tepid response, hinting at a discontentment with her newfound appearance.

Our conversation unfolded, revealing Carol’s journey through the vicissitudes of weight loss, a path she embarked upon with the aid of one of the revolutionary wonder shots. Despite the substantial weight loss, a shadow loomed over her elation; she grappled with what I now call the “Ozempic body” issues and the emotional demons that came with it.

The term “Ozempic body,” though perhaps unfairly singling out a specific drug, encapsulates the pervasive dysmorphic body types following rapid weight loss. This phenomenon extends beyond Ozempic and its class of incretin mimetics, raising questions about the unintended consequences borne by those seeking such interventions.

We carry within us remnants of our former selves, a concept made starkly literal for those shedding excess weight. The loose skin, akin to an apron, becomes an inescapable reminder of a bygone life. Surprisingly, individuals undergoing massive weight loss often find themselves still discontent with their bodies.

The Ozempic body emerges as an uncharted realm within the realm of extreme weight loss. While the body may shed pounds, it becomes burdened with folds of sagging skin, ushering in a torrent of emotional and, at times, physical pain. Chafing, denoting the rubbing of body parts against each other, adds to the discomfort.

Individuals undergoing weight loss, whether through surgery or injections, often find dissatisfaction lingering due to the presence of excess skin. One vividly described the sensation as akin to wearing a fat suit, where a thin person resides within an oversized facade. Clothing ceases to fit, excess tissues persist, and an overarching feeling of incompleteness and unhappiness prevails.

Externally, the public may perceive these individuals as trim or even skinny. However, beneath the concealment of clothing lies the reality of sagging skin, evoking comparisons to a deflated balloon. A veil of embarrassment shrouds these individuals, preventing them from revealing their bodies even to their partners, compelling a perpetual need for cover.

The root cause of loose skin lies in the rapid loss of a substantial amount of weight within a brief timeframe. While exercise contributes marginally to skin elasticity, the swifter weight loss experienced by surgery patients often outpaces the skin’s ability to rebound.

Addressing loose skin often necessitates recourse to cosmetic surgery, particularly body contouring. Approximately 21 percent of bariatric surgery patients opt for such procedures, with the circumferential body lift standing out. This involves incisions across the back, flanks, and abdomen, excising excess skin and tightening the remaining tissue through sutures.

The narrative imparts a poignant lesson – the natural course often proves superior. This is not a condemnation of those exercising autonomy over their choices. It underscores society’s unkindness toward the overweight, a factor propelling many toward extreme weight loss measures. Propagation of awareness regarding the potential consequences, epitomized by the Ozempic body, becomes imperative for those contemplating rapid weight loss. In doing so, individuals like our dear friend Carol may avoid the clutches of buyer’s remorse.

Osmund Agbo is a pulmonary physician.

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