‘Ozempic butt’ isn’t always muscle loss—what experts want patients to know

As GLP-1 medications continue to transform obesity treatment, a new concern has emerged alongside stories of dramatic weight loss: muscle loss.

A July 2026 Gallup survey found that 11 percent of U.S. adults are now taking GLP-1 drugs for weight loss, nearly four times the share recorded in 2024.

Since then, terms such as “Ozempic butt” and “Ozempic face” have been floating around on social media, while some headlines have warned that a significant portion of weight lost on the medications may come from lean tissue rather than fat.

But obesity specialists believe the reality is more nuanced, and that losing some muscle during weight loss is neither unique to GLP-1s nor necessarily a sign that something has gone wrong.

Carol Eisenstat, a board-certified anesthesiologist and founder of the physician-run weight-loss program SlimMD in New Jersey, said losing some lean mass during weight loss is expected regardless of how the weight comes off.

“One thing that people sometimes lose track of is that loss of some lean mass is not specific to GLP-1s,” she told Newsweek. “Anytime someone loses a significant amount of weight whether that’s through dieting, bariatric surgery or medications, a certain amount of lean tissue will automatically come with it.”

So, how much muscle is typically lost?

Studies suggest roughly a quarter to 40 percent of weight lost on GLP-1 medications may come from lean mass.

That figure may sound alarming at first glance, but experts caution that lean mass is not the same thing as muscle, and that the majority of weight lost is still fat.

“Most of what patients lose is fat, and for the majority of people the ratio of fat to muscle in their body actually improves,” Dr. Jessica Duncan, a board-certified obesity medicine physician, told Newsweek.

‘Ozempic Butt’ Versus Muscle Loss

The term “Ozempic butt” refers to changes in body shape that can occur after rapid weight loss, when fat loss makes the buttocks appear flatter or less rounded.

Similarly, “Ozempic face” is used to describe a more hollow or gaunt facial appearance caused by the loss of fat beneath the skin.

Eisenstat, who frequently tracks changes in patients’ body composition while prescribing GLP-1 medications in her clinic, said much of the public conversation confuses fat loss with muscle loss.

“When you see things like, ‘Ozempic face’ or ‘Ozempic butt’ it gives the illusion that these medications are somehow causing people to lose muscle,” she said. “That’s really not what’s happening. What most people are noticing is a loss of fat and volume.”

Duncan agreed that the cosmetic changes associated with significant weight loss are often mistaken for muscle wasting, but stressed that preserving muscle should still be a priority.

“Real, clinically meaningful muscle loss is a genuine concern, and I never wave it away,” she said. “But it is a manageable one for the vast majority of people, and it is not the fate the scariest headlines suggest.”

She added that her concern is that alarming headlines could deter people from seeking treatment that may improve their long-term health.

Who Should Be Concerned?

A few groups deserve extra attention, Duncan said. The people she worries about most are older adults, where muscle and bone are already declining with age, postmenopausal women, patients who start treatment already carrying low muscle mass in the first place and people who are losing weight rapidly.

“These patients need more attentiveness,” Duncan said. “That means closer monitoring, a real focus on protein and strength work, and pacing the weight loss so the body has time to adapt.”

How To Protect Muscle

Both Duncan and Eisenstat agreed that two factors matter more than anything else: protein and resistance training.

“You do not need to be an athlete—you need to give your muscles a reason to stay,” Duncan said. “When patients do those two things consistently, the body composition story can look very different.”

Eisenstat recommended prioritizing protein and incorporating at least two resistance-training sessions per week.

“Patients who focus on those two things tend to do a much better job of preserving muscle than patients who aren’t concerned about those things,” she said.

Researchers are already developing drugs designed to be taken alongside GLP-1 medications to help preserve muscle during weight loss.

One of the most closely watched is apitegromab, an experimental therapy that showed promise in early trials by helping patients retain more lean mass while continuing to lose fat.

“Several of [the medications] are being developed with muscle preservation being one of the desired outcomes,” Eisenstat said. “I think that will change this conversation quite a bit in the coming years.”

Contact Newsweek editors on this story: Kara Dolman and Emma Lee-Sang