How to Lose Weight Without Aging Your Face: Ozempic Face, Loose Skin & Facial Fat Loss | Dr. Idriss

Will losing weight make you look older is a topic at the top of everyone's minds these days. And I— before you roll your eyes and say, can't we just live? I am telling you, this is something most people who are losing weight actively, especially in the 30+ group, is thinking about. Who the hell am I? I'm Dr. Shereene Idriss, a board-certified dermatologist. My focus is on cosmetics, and I have my own practice in New York City in Bryant Park. And I'm hearing this conversation every single day in my office because people are losing weight at a rapid, rapid rate, not just through lifestyle changes, but because of a certain drug that has taken over society and the world in general. I'm talking about Ozempic. But before we get into Ozempic and weight loss in general from natural lifestyle habit changes, etc., it is important to understand that your face is impacted by weight loss as you get older. And no, you're not imagining it. And I also want to preface this video by saying that this was a very sensitive video for me to make because of course you want to promote a healthy weight and a healthy lifestyle. And I'm not telling you to eat everything to become obese, and I'm not telling you to lose everything so you don't gain weight, but there is a way in which you can lose weight in order to maintain your face as you age. Now, if you're also rolling your eyes saying, ugh, you're so vain. Yeah, of course we are. If you're not vain, guess what? You're probably depressed, and that's worse. It's important to acknowledge the fact that we should care about how we present and perceive ourselves, because when we don't feel good about how we look, impacts our brains and it affects us psychologically in the long run. So this video is for you to make sure that you're taking care of this when you look back at this in order to achieve a better this. Did that make sense? I hope it did. In this video, we're going to talk about why your face looks older when you lose weight, what is happening underneath the surface of your skin that makes your eyes look hollow and your neck look crepey and your cheeks look sunken in. We're going to hit on the big O, Ozempic, and how it's affecting you and your aging process. Plus, I'm going to give you guys very very easy 5 realistic lifestyle tips in order to minimize the dreaded shed on your face. And I'm going to talk about a little derm-guided plan to in-office treatments if that is something you are interested towards the end of the video. But before I jump in, I have an announcement. Dr. Idriss, my brand, is going to be at Sephora in Meatpacking next Saturday, Saturday, June 13th, for an event. Sign up below in order to get more details, but we're going to be handing out popsicles, we're going to be doing skin scans of your faces. I will be meeting all of you and talking to you about skincare one-on-one, and it's going to be hopefully a beautiful afternoon. So please make sure to check that out. Now, before we talk about how to fix your face, it's important to understand what is happening and why it is happening. And the easiest way that I can explain this to all of you is to compare your face to something in your living room. That's right, your couch. Forget the fact that I love lounging around, but your couch is truly the perfect way to understand why your face starts to look older as you get older and when you lose weight. Your couch has 3 main elements. It has a wooden structure holding up your couch. That is your bone structure. Then you have fluffing and filling and cushions and stuffing, and that fluffiness of your couch is your fat pads and your muscles of your face, creating that nice plump jumpiness in your face, right? Beyond that, we have the fabric of the couch. Couches come in all different fabrics and textiles, as do our skin, and that is our skin. The fabric of your couch is considered your skin. So as we age and we sit on this couch for a long time, the frame of the couch is going to get weaker and it starts to get a little bit wobblier. That frame is your bone structure. Your bone density starts to thin out. In addition, we start to hollow out around our eyes. Our cheekbones get narrower and higher. Our jawlines get narrower and recede, and eventually we look like a thumb. And I say this with love, and I know it's going to happen to me too. Okay, I'm not trying to freak you out. I'm just telling you what to expect. Okay. Um, but aging doesn't just happen in a single layer. In addition to our bone structure and our framework changing, as we sit on the couch, it doesn't have a bounce. It starts to flatten out. So do our fat pads. They start to shrink and our muscles that were once plumper start to thin out and the ligaments holding everything start to stretch out. And as that happens, things start to fall around a framework that is getting narrower. So we get hollow in our temples, around our eyes. We start to notice that we're flatter along the sides of our cheeks and we're getting jowly. And that is something to be expected from that middle layer. And the third aspect of your couch is the fabric. With wear and tear, we get some holes, we get some stains, we get some wrinkles. It starts to look a little bit extra floppy in certain areas. And so does our skin from UV damage, environmental changes, lifestyle habits, heartbreak, you name it. Not taking care of your skin, not using sunscreen, not having a skincare routine, not doing the things that are not sexy to maintain your skin or your couches, like cleaning them, our skin starts to lose elasticity and starts to get weaker and starts to develop built-in wrinkles over time, and things start to look looser. When you lose weight, you're not just shrinking your waistline, because when you're losing weight, your body and fat will not be differentiated between your face or your ass. And the sad reality is, as we get older, we have to pick between our face or our asses. I was never a Victoria's Secret model or a Sports Illustrated muscle model, so I will always pick my face over my ass if I'm being quite honest. And I'm never going to have a skinny ass, so I'm going to put my money maker first. That is a decision that I leave up to you, but there are ways to help minimize how your face is affected if you want a skinny ass, and we're going to get to that in section 5 of this video. When you lose weight at 25, it hardly makes a dent in your face, but when you lose weight at 45, that dent is quite apparent because weight loss is not aging you. What it's doing is it's revealing the changes of aging happening underneath the surface of the skin. And that is why you start to notice that you look hollower, and that is why you start to notice that you look narrower, and you start to notice that you look more deflated overall. It's because weight loss itself is impacting those different layers of your body and your face in addition to your waistline, and it's revealing those changes happening underneath the surface of your skin. It's important to understand that not everybody ages the same way, and I like to simplify this with a sink or sag framework. Are we sinking or are we sagging? This is one of my favorite discussions when it comes to aging as a whole, but this discussion is directly related to weight loss as well, because weight loss is going to emphasize whether or not you are a sinker or a sagger. Now the reality is most of us are in the middle. It's a, it's a, it's a continuum of gray between black and white, and nobody is just a sinker or just a sagger. But to simplify it, sinkers are people who are losing volume. They tend to genetically be very, very small in their face, and as they get older, they're going to lose that fat. They're going to carve in, they're going to hollow out like this. Their skin can still be relatively tight or not. But the reality is, if they appear loose, it's because they're lacking underpadding. So think of that couch. If that couch loses its cushioning, the fabric of the couch is going to appear more loosey-goosey. But if you put back that cushion and the feathers back into the couch, the fabric is going to appear taut and tight. Those are sinkers. It's not about overfilling sinkers. It's not about trying to tighten sinkers, because if you try to tighten them too much, their face is going to look even smaller, especially if you don't give them back volume. It's about addressing really the volume first and then layering in the tightening aspect. Now, saggers are slightly different. They're not the ones who are going to look hollow. Instead, they have the issue of facial volume that starts to droop. They have a softer jawline. Everything starts to mesh into one. Their faces look heavier at the lower aspect. Of their faces. They have more noticeable jowling, they have looser necks, and their skin looks like it's, you know, hanging and flopping more than a sinker. It's not though just a skin issue because no matter how much firming cream you use, it's never going to tighten your skin to make you look less saggy. The issue here is a structural issue where your framework, right, the wooden structure of your couch, AKA your bone structure, is narrow and small, and maybe you have too much cushioning in your couch for framework. So your feathers are flopping around your framework, or in our case, our fat and our muscles are flopping around our framework, and it doesn't have anything to hold it up. And therefore, we start to drop and we start to sag. And that is why I get disillusioned when I see a lot of, you know, beauty brands out there talking about firming creams, showing people who are saggy. Because when you're sagging, a firming cream is never going to help you. You have to fix the structural element of your face. And I'm not saying get a facelift. There are treatments you can do that don't involve cutting, but it's really understanding that approach. And it's not just about, you know, stuffing your face with filler either, because you need to respect your bone structure and how much your face can visibly, physically hold. We'll talk about that in other videos if you guys are interested, and I'll hit a little bit on it towards the end of this video. But the point is, as we lose weight, when we get older, given that our framework starts to change, these differences become emphasized, and you start to notice them faster and way more. Everything we just talked about holds true for whether you lose weight from a healthy lifestyle, changes in diet, habits, postpartum, you name it. But we're going to talk about one weight loss method that is having a cultural moment right now because it seems that everybody is on it, and that is the reason why we are having this conversation: Ozempic and Ozempic phase and what that actually is. Ozempic itself is a semaglutide, which you've probably heard of, also known as a GLP-1 receptor agonist, meaning it's going to copy a hormone in your body that is going to help regulate your blood sugars and help to suppress your appetite and help to slow down your digestion. And this is a medication that was created for people with type 2 diabetes. You have heard of GLP-1 agonists probably through the news, also known as Wegovy or Ozempic or tirzepatide., but it's actually a peptide that we are injecting into our bodies that has gone through rigorous clinical testing and FDA approval. So not all peptides are actually free of side effects, which could be a video for another day because a lot of you guys are injecting peptides that are just like the Wild West. So how does Ozempic work for weight? It makes you feel fuller sooner. So you hear people feeling very nauseous. It keeps your stomach fuller longer and it slows down how your stomach empties out. So food backs up in your stomach and you can no longer continue to eat, and that slows everything down. And as a result, people are going to eat less, much more naturally on the drug. Weight loss can be quite significant and it can happen at a very rapid rate because you're eating less and because you're, you're not really absorbing the nutrients as much or as efficiently. You're going to see that weight loss happen pretty fast, but weight loss is not going to differentiate between your body and your face. And therefore your face is going to get affected. Now, the reason why you're seeing Ozempic face so much more prominently is because most people who are on Ozempic are probably in their 30s, 40s, 50s and beyond. And it's not usually the younger generation. And therefore, because they're losing their weight so fast, they are emphasizing the natural changes happening underneath the surface way sooner than they should. Additionally, the other part that people do not talk about so much with regards to Ozempic is that weight loss is not just fat loss. So as we are losing weight, um, and as we stop eating, right, we first go through our fat stores in order to make up for the calorie deficit that we are feeling. And that's how we're shedding the fat off of our body and we're starting to look more lean. But as we stay on the medication longer and as we continue not to eat as much, especially if you're not taking into account your diet and lifestyle, which we will talk about in the next section and how to minimize these risks from happening. We start to eat through our muscle mass and our muscle mass becomes thinner and we're trying to get those nutrients from our muscles. And we start to notice people start to get thinner calves, which could be nice, but it also affects our face and our face starts to hollow out. And so remember, between the sinking and the saggars, if our muscles are thinning, people who are naturally predisposed to become saggars might be saggy sinkers. So that's why I said there are shades of gray. It is starting to take into account more than just your fat, and then it goes into your connective tissue and then other metabolically active tissues as well, leaving you looking like you are wasting away. And we have seen it, and I've seen it quite a lot, to the point where last week I had two patients who had actually gained weight, and I was like, you look so good, what are you doing? Thinking they were going to tell me something like miraculous, and like, we gained pounds. And I was like, that is why I think this term Ozempic face is something that has become normalized. And it's not a real medical diagnosis, but we have to understand that Ozempic face is weight loss face, especially at a rapid rate where people are losing more than just fat but also muscle mass. And probably, I bet you, bone density is getting thinner as well. And so it's accelerating that aging process on a visible level. How can we prevent Ozempic face is something that I am very, very passionate about because I think if you want to be healthy, it's not just about chasing a number on a scale, but it's about taking into consideration how we lose weight. And I don't want this video to be a fearmongering video. So here are 5 very, very, very palpable, easy-to-do tips that you guys can incorporate in your weight loss journey in order to save your faces. Number 1, do not treat weight loss like a sprint. We have to treat it like a marathon. This is not— no one wants to hear. Everyone wants results yesterday. Everyone wants, everyone wants things fast. But what is my favorite saying in life? Consistency over intensity. And that applies to your weight too. The more slow and steady you are at losing weight, the better your face will be and the less worn out you will look. Especially, especially if you are a 40+ female watching this video. Avoid crash dieting. Avoid trying to get on the highest dose of any GLP-1 to try to lose weight quickly. Quickly and super fast. Avoid trying to just slash calories so that you're barely eating. You need to aim for that consistency over the speed, understanding that it will take a little bit more time, but it will be done in a much healthier, gentler way while keeping your face supported. Number 2, we need to also prioritize protein at every meal, especially if you are on a GLP-1, because like I said, it's going to eat through your muscle mass. And you want to make sure that you are eating protein to keep your muscles alive and well and to give your body another support to get nutrition from than from your own muscles. And if we're not getting enough protein, our muscles are going to start to thin out and we're going to start to look more like sinkers. And if you are naturally saggers, you're going to be sinking saggers, which is not a good place to be. So every meal should be surrounded around some sort of protein, and it doesn't just have to be beef, chicken, or fish. There's also other vegetarian options: lentils, tofu, tempeh beans, Greek yogurt. I've been doing with cottage cheese, had a moment. But one thing I've been doing is mixing chia seeds with protein powder, and I drink protein-fortified milk, Fairlife milk. There's zero sponsorship in this video, but it does help to get the fiber and the protein first thing in the morning. It definitely makes it easier to try to get that intake throughout the day. Coffee and 3 almonds, it's not a meal. Body needs those building blocks to make sure that it can hold on to its structure so you don't look like a cryptkeeper. We want to be hot and beautiful, right? So that's what we're trying to achieve. Number 3 is strength training, and this is one that I have struggled with, and a lot of women I know avoid strength training in general because they do not want to look like the Hulk or Arnold Schwarzenegger, and I tend to get a little bit bulky, but trust me, I need to take my own advice and I'm going to tell you guys this, we need to be strength training 2 to 3 to 4 times ideally a week. And you don't need to go really, really high. You could do more repetitions, but we need to be strength training not just to build our muscles but to help our bone density. Remember, the bone is holding our faces up. It is what's the framework. It's holding the structure up. So if our bone density gets thinner and frailer, our faces are going to be taking a hit, especially if we're losing weight fast. So make sure that we are building up our bone density, and that is— I you know, key, key, key, key, key. And it's not just cardio. Number 4 is keeping your skin quality super strong, having a very, very solid skincare routine, making sure that you're feeding your skin from the outside in through a skincare routine, and also taking into consideration lifestyle and habits. Cut the smoking, cut the alcohol. It's not, you know, maybe you don't want to hear it, but it's just— I'm telling you something that you don't want to hear, but it is the truth. Making sure that you are sticking to a routine very, very regularly and that you are not only washing your face at night, wearing a sunscreen in the morning, understanding how to moisturize your face for the environment that you're in. And as you hit 40+, exfoliating more regularly, not because you're acne prone, but because you're getting rid of those dead skin cells that make your skin look ruddier over time. But skincare alone is never going to replace the architecture of your skin, which number 5, do not panic treat your face while weight is still changing. I have a lot of patients who go in trying to do so much on their face all at once, and that is not the goal with any sort of cosmetic procedure. We don't go ahead and just get a facelift because we just lost weight. We want to be slow and steady in how we are approaching our face from a structural standpoint. We're really, really just trying to chase it at every point. You're going to have a moving target. And so you want to make sure that your weight is stabilized and your weight has has settled before you do anything drastic like a facelift. Okay, which leads me to a derm-guided plan for you so you guys can take it a step beyond lifestyle and habits in your bathroom into an office and hold on to your face to the best of your abilities. And this is a discussion that I have with a lot of my patients. We start with establishing your baseline before you start losing weight. And yes, it is generalizing, but we try to figure out, are these people who are going are we going to be more sinkers or are we going to be more saggers? And we look at the architecture of your face, understanding your framework first and foremost so you can understand how your face would go if you went wrong and strong. And that is not what we are going to do. But the reason why you want to understand your baseline is because if you know you are somebody who has predispositions to sagging and you know you want to lose weight, obviously we're going to do this consistently and slow and steady. But skin tightening is probably where you want to focus on because you want to keep your skin firm as you're losing the weight so that the weight doesn't just drop and you're not left with a floppy mess. If you are somebody who tends to sink, hollowing happens with your face. It's about restoring that volume to your face as you lose weight. And one healthy way to think about this is for every 10 to 15 pounds of weight loss that you lose, it impacts your face and you could do less, slightly more regularly, keeping that conversation alive and making sure that you are documenting that process with your provider so you can look back to really see how your face is evolving. Now, a third option that I absolutely love is bio stimulators. You're talking about Sculptra, but more so than that, fat transfers. If you are on a GLP-1 like Ozempic, the data is still— the jury's still out. Some people say that people on GLP-1s do not respond as well because it changes the nature of your fat, whereas other people say that something is better than nothing. So I'm kind of in the camp of something is better than nothing, especially as people are losing weight. And I use my sister as an example. She lost a lot of weight and her face started to sink, and we did a fat transfer on her. She had beautiful results that are holding up and getting better over time. I did the procedure on her., and we are just watching her weight now, and she's holding a healthy weight and her face is staying stable. So that's where it's important then to know when is surgery an option for you, especially if you've lost the weight and you have a lot of redundant loose skin and where you are in your weight loss journey so you can time it accordingly. But surgery itself is never a definitive answer because you are constantly aging, your couch is constantly changing, and you need to make sure that we are maintaining your face as you age. So I hope this video was helpful. I know there's a lot of information in this video, and I really wanted to address this in a way that is thoughtful because people are jumping the gun and trying to do a million things and not understanding how they're losing weight. But when you have an understanding of weight loss, especially as you're older in life and how it impacts your face, which is naturally aging, and how it can accentuate that aging process, it makes you take a step back so you can look at the forest, you know, and not just the single tree to understand what it is that I want for my face in addition to my body and my health as I'm aging. Because it's not just physical health, it's also mental health. If you appreciated this video, it's a very long one. Let me know whatever questions you may have, and I will see you guys next week. Have a beautiful Saturday.