If most people hadn’t heard of weight-loss drugs such as Ozempic, Wegovy and Mounjaro two years ago, they certainly have now.
A host of famous faces, including Sharon Osbourne, Robbie Williams and Oprah Winfrey, have dropped serious pounds using such drugs – and they’ve now become increasingly mainstream for those keen to keep a healthier weight long-term.
The side-effects – which can prove debilitating for some – of such drugs have also become well known, with many reporting nausea, diarrhea and excessive gas.
However, say experts, there’s one longer term consequence of dramatic weight loss that isn’t being talked about enough – and one that people often don’t consider until it’s too late.
On average, those taking, for example, Ozempic might expect to shed around 15 per cent of their body weight – but such is the potency of the drug, often that figure is much higher, with some losing more than 50 per cent of their body weight.
When such significant weight loss happens, patients are likely to be left with loose skin anywhere where there was once fat.
One such patient who has first-hand experience of how taking weight loss drugs can help you achieve measurements on the scales you might have once only dreamed of but leave you with unsightly loose skin is Alexandra Collett.
The 31-year-old, who lives in Wandsworth, began taking Ozempic in May 2023 and weighed in at 17 stone, 6 lbs (112kg) before she started.
Alexandra Collett, 31, decided to start taking Ozempic in May 2023 after being told she was too heavy to qualify for surgery to ease her stage four endometriosis symptoms
After being diagnosed in her late teens with Addison’s disease, a rare disorder of the renal glands, Alexandra was given steroids, which caused her to put on weight, which sparked a spiral of weight gain in her 20s
The drugs, which saw her struggle with side effects including nausea and hair thinning, went from 112kg to her current weight of around 50kg. And while the weight loss has been a positive thing for Alexandra, she’s been left with a side effect that she hadn’t countered on
Alexandra, who lives in Wandsworth, says that she realised that parts of her body ‘didn’t look like a 31-year-old should look’ after she was left with loose skin on her tummy and sagging breasts
After being diagnosed with stage four endometriosis, where the uterine lining grows outside the uterus causing extremely painful periods and heavy bleeding amongst other symptoms, Alexandra was told she needed to lose weight before she could have surgery to ease the disease, which spurred her on to try weight-loss drugs.
Describing her weight gain as she went from her teens into adulthood, she told MailOnline: ‘My relationship with my weight as a child was completely normal but at 17 I was diagnosed with Addison’s disease, which changed everything.’
A rare disorder of the adrenal glands, the condition is often treated with steroids, which Alexandra says caused puffiness and sparked the weight gain that would negatively affect her mental health throughout her 20s.
The need for surgery to help her endometriosis made her determined to lose weight but she didn’t qualify on the NHS so, with help from her parents, Alexandra funded the drugs privately, using Ozempic first, and then later switching to Wegovy.
Since taking the weight-loss drugs, which she stopped last November, the 31-year-old has more than halved her body weight, and currently weighs 7 stone 8lbs (50kg) she underwent the uterine surgery and her endometriosis symptoms have improved greatly.
The impact on her mental health has been significant, she says. ‘I was really happy to get back to seeing myself the way I did when I was growing up because you feel alien to yourself. I got depression, I wasn’t socialising – I stayed in the house, I just didn’t want anyone to see me.’
Being left with loose skin those means Alexandra is now on a new journey – one that she didn’t consider when she took her first dose of Ozempic.
‘About six months in, I began to notice the loose skin. I think I thought it wouldn’t happen to me. When it did though, I thought “I’m 31, this is not what a 31-year-old should look like.’
The 31-year-old says her parents, including her mum, pictured left with Alexandra, have been hugely helpful in financially supporting her with surgery costs, after she made the decision to undergo a breast lift. She’s now currently awaiting a breast augumentation and a tummy tuck
Reality: Alexandra says she didn’t think about the potential for loose skin when starting her weight loss journey
The 31-year-old says she’s much happier in herself but that the loose skin issue hasn’t been easy to deal with
Alexandra pictured with Consultant Plastic Surgeon Dan Marsh from The Plastic Surgery Group. She estimates she’s spent around £14,000 so far on surgery with more bills to come when she goes under the knife in April
Before and after her recent surgery: Alexandra says she’ll undergo a breast augmentation after having a breast lift
Alexandra says there’s a big physical discomfort too, adding that she gets ‘little rashes’ where the loose skin is and has to have impeccable hygiene to ward off potential infections.
Creams, she says, claim to help loose skin but says she realised quickly that surgery is the only option that offers a genuine solution.
She’s already had a breast reduction to try and combat the effects of such a big weight loss, and will go under the knife again – with Consultant Plastic Surgeon Dan Marsh at The Plastic Surgery Group – in early April for a tummy tuck and breast augmentation.
The initial surgery cost around £14,000 with another big bill to come when she heads back into theatre.
She adds: ‘I didn’t understand fully that this would be the end point. Obviously, I wasn’t eligible for surgery on the NHS. Luckily, I’m in a position where I’m able to have help from my parents’.
A leading plastic surgeon told MailOnline that Alexandra’s story is just the tip of the iceberg.
Dr Ahid Abood, who runs clinics in both Cambridge and Harley Street (dr-abood.co.uk), says many plastic surgeons are reporting an increased amount of requests to remove lose skin from patients who’ve lost weight via drugs such as Wegovy, Ozempic and Mounjaro.
He says it’s unclear yet whether the quick rate of weight loss sparked by such drugs is leaving patients with more loose skin than they would encounter if they used more conventional methods to shed the pounds.
Back to theatre: Alexandra’s next op is planned for early April
He said: ‘We’re seeing a definite upsurge in patients. Because the drugs are so effective and people are losing weight so quickly, we think it’s not allowing their skin tissues to recoil, although it’s difficult to say definitively.
‘Whether it’s having some direct effect on the elasticity of the tissues, we don’t know – the long term studies haven’t been done yet because the drugs are still so new.’
Does age affect how loose skin manifests? Dr Abood says while younger skin has much more elasticity, if you’re losing a large amount of weight loose skin is still likely to be an issue.
He explains: ‘For example, people who have babies, the tummy will gradually get bigger and bigger – once it gets beyond a certain size, once you’ve the baby and your tummy shrinks down, the elasticity has gone, irrespective of your age.’
Dr Abood says that while most people might anticipate people have surgery because of the aesthetics of loose skin, there is a physical discomfort that often leads people to consider having it removed.
‘Loose skin has a massive impact on people’s quality of life. They’ll modify their clothes and almost tuck themselves in and find ways to literally stop skin flapping around.’
He adds: ‘It limits the activity you can do, it rubs, it gets sweaty, people can get infections in the skin. Psychologically it’s a big hit, people lose weight and feel great about that but they then have this issue of the excess skin.
Plastic surgeon Dr Ahid Abood, who runs clinics in both Cambridge and Harley Street, told MailOnline the number of people seeking surgery to remove loose skin is likely to rapidly increase as use of weight-loss drugs become more mainstream
‘To say it’s a cosmetic surgery procedure isn’t really accurate. It’s definitely a functional procedure – the outcome isn’t necessarily cosmetic.’
Patients are, he says, affected ‘anywhere where a person has had significant fat that has then disappeared – neck, arms, tummy – it could be anywhere but the tummy is the classic area.’
Patients at Dr Abood’s clinics must have a stable weight for six months to a year before surgery – if they have an operation and keep losing weight, they’ll likely face a similar issue months down the line.
‘Surgery’, he says ‘usually leaves a lengthy scar but one that’s often well hidden and will fade over time.’
As Alexandra’s story proves, it’s not a cheap option and many patients don’t anticipate such future costs when they start weight-loss drugs.
However, in terms of saving money for the NHS, it’s a no brainer, says Dr Abood and the need for such operations is likely to rapidly rise.
He says: ‘It’s just kind of starting. If you look at it from a health economics perspective. Millions of pounds are spent on Type 2 Diabetes – that patient cohort are a very expensive group of people because they have all sorts of health problems.
‘If you can treat that significant number within the population then, the plastic surgery requests we’re seeing now are likely just the beginnings. I can’t imagine these weight loss drugs are going away.’
The Plastic Surgeons currently treating Alexandra, Mo Akhavani and Dan Marsh, of The Plastic Surgery Group, agree that there’s been a boom in tummy tucks.
Mr Marsh said: ‘Alexandra is a perfect example of how effective a tummy tuck or abdominoplasty can be to remove unwanted excess skin which can be left behind after weight loss.
‘The modern advanced abdominoplasty techniques we employ at The Plastic Surgery Group usually combine both liposuction and skin excision to give a sculpted and youthful look to the abdomen – combined with a natural looking belly button.
‘We are seeing a steep increase in people seeking abdominoplasty after losing weight with weight-loss medication and it is something which we forecast will continue to be popular in 2025 and beyond.’
Last week, a mother of three from Chicago shared her story of dramatic weight loss followed by a new battle – loose skin.
In videos, Mrs Kane shows her saggy stomach to viewers in a bid to highlight this little-talked about side effect of weight loss drugs
Mrs Kane slimmed from over 136kg to 61kg and she has built an impressive following on social media with her inspiring posts
Amy Kane managed to shed more than half her body weight – slimming from over 136kg to 61kg.
She has built an impressive following on social media, with some of her followers describing it as the most ‘inspiring’ and ‘inspirational’ Ozempic transformation of all time.
Along with getting complimented on her new looks, Ms Kane says people treat her and her family differently when she is in public.
However, these pluses have come with one major downside: excess skin.
While it is not visible when she is wearing clothes, Ms Kane shows in her posts how she has a sack of unsightly sagging skin around her belly.
Now her aim is to try and reduce the sagging through self-care and cosmetic treatments.
Along with taking daily Ozempic injections, Mrs Kane transformed her diet by cutting out processed foods and opting for home-cooked meals.
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