The Difference Between “Ozempic-Face” and “Mounjaro-Babies”

Followers of social and other media will have by now heard the term “Ozempic-” or “Wegovy-face”, which refers to the facial changes associated with the use of the anti-obesity medication semaglutide. These facial changes have been said to deepen facial folds, increase wrinkles, and often make people look older and, in extreme cases, rather unhealthy. 

Nothing about this is in anyway directly attributable to the specific action of semaglutide. In fact, these are the very facial changes that we routinely see in anyone losing a significant amount of weight, irrespective of the reason. 

Thus, we could call this “Keto-face”, “Atkin’s-face”, “Formula-diet-face”, “Gastric-Bypass-face”, or even “Marathon-face”, if that’s the reason you went and lost a significant amount of weight, respectively. 

Thus, “Ozempic-face” has nothing to do with any particular  biological action of semaglutide that specifically affects facial body fat depots but, rather, is simple the natural consequence of weight loss. 

This, however, is not entirely the case for “Mounjaro-babies”, a term that has been used for the occasional unplanned pregnancy in patients taking the GLP-1/GIP dual agonist tirzepatide or Mounjaro. 

Part of this is of course related to the fact that weight-loss (by any means) will increase fertility in women of child-bearing age. Thus,anyone working in bariatric medicine has probably seen “keto-babies”, “formula-diet babies”, and “bariatric-surgery babies” (and of course “Ozempic” and “Wegovy babies”), all attributable to the impact of weight-loss on fertility. 

However, this is only part of the story. It should be well-known by now that GLP-1 analogues can directly affect gastro-intestinal motility, often resulting in delayed gastric emptying, and in some cases, vomiting or even diarrhoea, especially during the early phase of treatment. This can markedly change the effectiveness of oral contraception – leading to unplanned pregnancies. 

Thus, pregnancies in patients on a GLP-1 or a GLP-1/GIP analogue can be due to the rather unspecific effect of weight loss on fertility, but also due to the medication-specfiic effects on gastro-intestinal motility and emesis.

This is something all women of chid-bearing aged should be warned of when using GLP-1 or GLP-1/GIP analogues. 

For e.g. the FDA-mandated label for Mounjaro clearly states for women of reproductive potential,

“Advise females using oral contraceptives to switch to a non-oral contraceptive method, or add a barrier method of contraception for four weeks after initiation and for four weeks after each dose escalation.”

As for women, who get pregnant whilst on Mounjaro, the FDA label states,

“Mounjaro should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.”

And, as a clinical pearl, always remember to check for pregnancies in women of child-bearing age complaining of persistent nausea or vomiting when on a GLP-1 or GLP-1/GIP analogue. 

DrSharma,
Berlin, D