Coauthored by Beverly Hills oculoplastic surgeon Dr. Kami Parsa, the paper describes a striking paradox: the skin is remodeling during rapid weight loss just as appetite and nutritional intake may be declining.

BEVERLY HILLS, Calif., Sept. 15, 2026 /PRNewswire/ -- Beverly Hills oculoplastic and reconstructive surgeon Dr. Kami Parsa has coauthored a new peer-reviewed narrative review examining nutrition as a potentially overlooked contributor to skin changes during GLP-1 receptor agonist-associated weight loss.

The paper, "The Impact of GLP-1 Receptor Agonist–Induced Nutritional Deficiencies on Skin Health: A Narrative Review With a Proposed Framework for the Aesthetic Practitioner," was published September 11, 2026, in Aesthetic Surgery Journal Open Forum. The published paper is available at https://doi.org/10.1093/asjof/ojag169.

Semaglutide and tirzepatide have transformed obesity treatment, but rapid weight loss can produce visible facial changes commonly described as "Ozempic face." While these changes are often attributed primarily to the loss of facial fat, the new review examines a more complete picture involving fat-compartment depletion, collagen remodeling, reduced nutritional intake, and the skin's ability to adapt and repair.

The Nutritional Paradox During Rapid Weight Loss

During rapid weight loss, the skin undergoes an active period of structural remodeling. Human biopsy studies following massive weight loss have demonstrated changes in collagen architecture, including reductions in thick, organized collagen fibers and increases in thinner, more loosely arranged fibers. Although these findings come from broader massive-weight-loss populations rather than exclusively from patients using GLP-1 medications, they demonstrate that significant weight loss can involve measurable changes within the skin itself.

At the same time, GLP-1 medications reduce appetite and total caloric intake, potentially making it more difficult for some patients to consume sufficient protein, vitamins, and minerals needed to support collagen synthesis, tissue remodeling, and wound repair.

"During rapid weight loss, the skin is undergoing major structural remodeling," said Dr. Parsa. "The paradox is that just when the skin may need nutritional support the most, the patient is often consuming substantially less. That is why what patients eat during weight loss matters."

A large claims analysis summarized in the review found that approximately 22.4% of patients received at least one nutritional-deficiency diagnosis within 12 months, including 13.6% who received a vitamin D-deficiency diagnosis. Across the broader literature, the review also identifies inadequate protein intake and deficiencies involving iron, vitamin B12, folate, zinc, and copper as potential concerns. These nutrients have biological roles relevant to skin integrity, collagen synthesis, and tissue repair.

Beyond the Traditional Explanation of "Ozempic Face"

The review concludes that GLP-1-associated facial changes are likely multifactorial. Rapid loss of facial fat remains an important contributor, but inadequate nutritional intake may plausibly compound changes in collagen remodeling and dermal repair.

Importantly, the paper does not demonstrate that GLP-1 medications directly damage collagen. Direct effects of GLP-1 receptor agonists on dermal cells remain preclinical, and prospective studies are needed to determine whether identifying and correcting nutritional deficiencies improves skin or surgical outcomes.

"This is not an argument against GLP-1 medications. These are highly effective treatments," said Dr. Parsa. "It is an argument for combining successful weight-loss treatment with intentional nutrition and better coordination among prescribing, nutritional, and aesthetic clinicians."

A Practical Framework for Aesthetic Practitioners

The paper proposes a risk-stratified framework to help aesthetic practitioners evaluate patients undergoing GLP-1-associated weight loss. Recommendations include reviewing dietary intake and nutritional risk, prioritizing adequate food and protein intake, using targeted laboratory testing in higher-risk patients, correcting identified deficiencies when appropriate, coordinating care with the clinician prescribing the GLP-1 medication, and considering nutritional status and weight stability when planning elective aesthetic procedures.

For patients at elevated nutritional risk, the authors encourage aesthetic practitioners to consider nutritional status and readiness for tissue repair when planning aesthetic treatments or surgery.

Multidisciplinary Authorship

The review was authored by Justin Karlin, MD, MS; Zhaoping Li, MD, PhD; and Kami Parsa, MD.

Dr. Karlin is affiliated with the Division of Ophthalmic Plastic and Reconstructive Surgery at the UCLA Stein Eye Institute/Doheny Eye Center. Dr. Li is affiliated with the Division of Clinical Nutrition at the David Geffen School of Medicine at UCLA.

The paper was published online September 11, 2026, in Aesthetic Surgery Journal Open Forum, an Oxford University Press publication on behalf of The Aesthetic Society.

About Kami Parsa, MD

Dr. Kami Parsa is an oculoplastic and reconstructive surgeon in Beverly Hills with more than 20 years of experience in aesthetic and reconstructive facial surgery. He is an Adjunct Clinical Professor at the USC Keck School of Medicine and the author of HEAL: Your Recovery Blueprint with 100+ Healing Recipes for Injury & Surgery. Dr. Parsa is also Founder and Medical Director of Mendora, a physician-founded skin-recovery company. His work focuses on the relationship among nutrition, tissue repair, skin aging, and aesthetic outcomes.

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