Loose Skin After Weight Loss on Ozempic, Wegovy or Zepbound: What's Normal, What Helps and What Doesn't

Loose skin is common after losing a lot of weight, whether through diet, bariatric surgery or medications like semaglutide (Ozempic, Wegovy) and tirzepatide (Zepbound, Mounjaro). From what’s known, it isn’t the drug acting on your skin: skin that was stretched for years loses some of its collagen and doesn’t always spring back. Nobody has measured how much loose skin these drugs lead to. Protein, strength training, not smoking and sun protection have support for looking after muscle and skin, though none has been tested against loose skin itself. Creams and collagen supplements don’t have that support.

This guide is about the body: belly, arms, thighs and chest. If your main worry is your face, I cover it in Ozempic face.

Why skin doesn’t shrink back after weight loss

The American Society of Plastic Surgeons (ASPS) puts it simply: after any major weight loss, from surgery or lifestyle changes, the skin and tissues often lack the elasticity to conform to the smaller body^[26].

Skin firmness depends mostly on two proteins in the dermis, the layer under the surface. Collagen gives it strength; elastin lets it snap back after stretching. Studies that looked at skin after major weight loss find those fibers altered:

• Less collagen. In a 2010 Brazilian study, belly skin from 40 women who had bariatric surgery had less collagen than skin from 40 women who had never had obesity. Elastic fibers, on the other hand, hadn’t decreased. The findings weren’t related to age^[1].
• Disorganized collagen and damaged elastin. In a US study of 10 people who had lost an average of 60 kg (132 lb) after surgery, collagen was disorganized and elastin degraded. That held even though about 20 months had passed since the operation^[2].
• Thinner collagen and damaged elastic fibers. A 2015 Egyptian study of 30 people in three groups found this. It compared skin from people who had lost a lot of weight (more than 30% of their weight or half their excess weight) with skin from people with obesity and from people without it^[3].
• Similar without surgery. In another 2024 Egyptian study of 77 people, collagen was similar in both groups: weight lost with or without surgery (diet, exercise and, for some, orlistat). Belly elastin was lower in those who’d had surgery, who were also older and had lost more^[4].

On collagen the studies agree; on elastin, not entirely. Where this evidence comes from matters: people who lost a lot of weight, almost always after bariatric surgery, and who ended up having surgery to remove skin. The samples are small and selected. I haven’t found skin biopsies from people losing weight on GLP-1 medications.

The closest thing is a 2026 review of 40 studies on GLP-1 drugs and skin, from a plastic surgery journal. It talks about a thinner dermis, less collagen and elastin, and poorer elasticity^[6]. But it pools case reports, observational studies and trials, and its abstract gives no figure for how many people end up with loose skin: I take it as a signal, not a measurement.

Who gets more loose skin

The honest answer is that little is known. A 2017 review looked for what predicts excess skin after bariatric surgery and concluded there isn’t enough evidence to say who is at higher risk^[5]. Here’s what the sources say, factor by factor:

What the Ozempic, Wegovy and Zepbound trials measured

Nothing about skin. The main trials, STEP 1 with semaglutide and SURMOUNT-1 with tirzepatide, were designed around weight change. Their papers don’t report loose skin as a measured outcome^[7,8]. The US labels for Wegovy and Zepbound and the EU labels for Wegovy, Mounjaro and Ozempic don’t mention sagging skin or loss of skin elasticity^{[11,12,13,14,15]}.

For context, here’s how much and how fast people lost weight on average:

These are averages: in SURMOUNT-1, 57% of people on 15 mg lost at least 20% of their weight^[8], and everyone moves at their own pace. In the SURMOUNT-1 body-composition substudy, about 75% of the weight lost was fat and 25% lean mass^[9] (summary).

My reading: average losses on medication are smaller than after surgery (60 kg on average in the US study^[2]). Applying what surgery taught us to GLP-1 drugs is reasonable, but it’s an extrapolation.

What may help, according to the evidence

None of these has been tested for preventing loose skin; they have support for other reasons.

Keeping your muscle: protein and strength training

As SURMOUNT-1 shows, part of the weight lost is lean mass. To hold on to it, the 2025 joint advisory from four US scientific societies calls for resistance training and an appropriate diet with enough protein^[16]. I have the numbers in protein and muscle on GLP-1 medications and the protein calculator. To find out whether you’re losing fat or muscle, see bioimpedance scale vs. DEXA.

There’s a small hint about skin. In a Japanese trial, 56 sedentary women aged 41 to 59 trained for 16 weeks. Both aerobic and strength training improved the elasticity of the skin on the cheek, and strength training also thickened the dermis. There was no non-exercise group, and the study wasn’t about weight loss^[17].

The pace of weight loss is up to your doctor

The 2026 review recommends losing weight gradually^[6], but, as the table above says, I haven’t found studies that compared speeds and measured skin. On a GLP-1, the pace depends mostly on the drug, the dose and how it’s stepped up, and that’s your prescriber’s call. If loose skin worries you, bring it up at your appointment.

Not smoking

According to the American Academy of Dermatology (AAD), smoking greatly speeds up skin aging and causes wrinkles^[19]. The ASPS also lists being a nonsmoker among the traits of a good candidate for skin-removal surgery^[26]. If you smoke and want to quit, your doctor can help.

Protecting your skin from the sun

The AAD recommends sun protection every day: shade, clothing that covers you, and a broad-spectrum, SPF 30 or higher, water-resistant sunscreen on any skin left bare^[19]. In an Australian trial, 903 adults under 55 used sunscreen either every day or whenever they chose. After 4.5 years, only the second group showed more sun-related skin aging. The trial measured the skin’s surface texture, not sagging^[21].

Giving your skin time

According to the 2015 Egyptian study, citing an earlier review on bariatric surgery, skin may keep tightening for about a year after your weight stabilizes, and changes little after that^[3]. It’s an observation from massive weight loss; it hasn’t been measured on GLP-1 drugs.

Caring for the skin in folds

The AAD lists loose skin that folds on itself, causing rashes where skin touches skin, among the effects people on GLP-1 drugs may notice. It advises keeping those areas clean and dry and moisturizing your whole body^[18]. If you get pain, chafing that won’t heal or infections under skin folds, or if loose skin limits how you move, see your doctor or a dermatologist.

What doesn’t have support

• “Firming” creams. According to the AAD, a cream can’t penetrate deeply enough to lift sagging skin: results are subtle at best, and what you notice right away is usually moisturizing, which is temporary^[20]. The most favorable review I’ve found, from 2026, has three of its seven authors on the staff of a medical aesthetics company, and it only says creams “may” be an add-on^[22].
• Collagen supplements. In the EU list of authorized health claims (Regulation 432/2012), collagen appears only in the vitamin C claims: vitamin C “contributes to normal collagen formation for the normal function of skin.”^[24] I haven’t found any authorized claim for collagen itself. In 2013, EFSA assessed a collagen hydrolysate for skin elasticity and concluded the effect hadn’t been shown^[23]. In a 2025 meta-analysis of 23 trials, industry-funded trials showed an improvement, but independent and higher-quality ones didn’t^[25]. All of them were about skin aging, not skin after weight loss.
• “Firming” devices. The AAD describes radiofrequency, ultrasound and certain lasers done in a dermatologist’s office as giving “modest” tightening, sometimes over several sessions. They work best with a small amount of sagging; with a lot of loose skin, they may not help^[20]. I haven’t found studies in people losing weight on GLP-1 drugs, or on at-home devices.

When surgery comes up

Body contouring surgery removes excess skin and fat. According to the ASPS, it includes procedures for the arms, breasts, belly, buttocks and thighs^[26]. A good candidate, according to the society^[26]:

• Has a stable weight.
• Is healthy, without conditions that impair healing or raise surgical risk.
• Doesn’t smoke.
• Has realistic goals and keeps up healthy habits.

SECPRE, Spain’s plastic surgery society, describes a tummy tuck as major surgery that leaves a permanent scar, and says people who still need to lose a lot of weight should put it off^[27]. MedlinePlus notes that it can relieve rashes or infections under large skin folds, but isn’t an alternative to weight loss^[28]. The risks the ASPS lists include blood clots, infection, poor wound healing and some loose skin remaining^[26].

On a GLP-1, “stable weight” comes with a caveat. In the STEP 1 extension, people who stopped semaglutide regained about two-thirds of the weight they’d lost within a year^[10]; I explain it in stopping a GLP-1. It’s worth discussing with your doctor and, if it comes to that, with a board-certified plastic surgeon.

Wanting surgery and having it are different things. After bariatric surgery, according to a 2021 systematic review, most people wanted skin removed, but fewer than one in five survey respondents (18.5%) had had it done, mainly because of cost and lack of insurance coverage. Those who had it generally saw their quality of life improve^[29]. I don’t give prices or recommend practices here: if you’re considering it, talk to your doctor.

Skin, the mirror and other people’s comments

Excess skin isn’t only about looks. In the 2017 review, studies reported negative effects on physical life (67% of studies), on psychological and social life (75%), and on daily activities (83%)^[5]. If other people’s comments are part of it, I have a guide on what to say when people ask if you take Ozempic.

According to MedlinePlus, these signs are reasons to get help: changes in how you eat or sleep, pulling away from people and things you enjoyed, feeling hopeless, not being able to handle daily tasks, or thinking about harming yourself^[30]. If you don’t know where to start, talk to your primary care provider. See your doctor, too, if worry about your body leads you to eat much less than you need: eating disorders are serious health conditions, and there are treatments that help^[31]. If you’re thinking about harming yourself, call or text the 988 Suicide and Crisis Lifeline, any time, or call 911 in an emergency.

Frequently asked questions

Can you prevent loose skin on Mounjaro or Ozempic?

There’s no proven way to prevent it. Some of the factors cited can’t be changed, like sex, age or genetics; others can, like smoking and sun exposure^[4,5,6]. Protein, strength training and sun protection look after muscle and skin^[16,17,19], but haven’t been tested against loose skin.

Will exercise get rid of “bat wings”?

Strength training helps keep or build muscle in your arms, but no study shows it removes excess skin. The ASPS includes arm lifts among the options after major weight loss^[26]. For the belly, SECPRE considers tummy tuck candidates to be people whose excess skin doesn’t improve despite diet or exercise^[27].

Do compression garments or shapewear help with loose skin?

I haven’t found studies showing they prevent or reduce loose skin during weight loss. Where a compression garment is used is after a tummy tuck, according to SECPRE, as part of recovery^[27].

Does taking collagen help with loose skin?

There’s no evidence it does, as I explain above. The authorized EU claim you may see on some labels is the one for vitamin C, not collagen^[24].