GLP-1s have gone from being buzzy weight-loss drugs to launching a full-blown health revolution. Ozempic, Wegovy, Mounjaro and Zepbound aren’t just shrinking waistlines; they’re also tackling metabolic disorders, heart health and even PCOS. As the conversation shifts from quick fixes to lasting wellness, new questions emerge: Are compounded versions safe? Is microdosing effective? How do we preserve muscle? And what’s next in weight-loss treatments?
Featured Experts
- Caroline Messer, MD is an endocrinologist in New York
- Dr. Spencer Nadolsky is an obesity expert
- Johnny Franco, MD is a plastic surgeon in Austin, TX
- Raoul Manalac, MD is the senior director of obesity science at Ro
Compound vs. Brand Name
When FDA-approved GLP-1 medications were in short supply, compounding pharmacies stepped in with alternatives, using semaglutide sodium, semaglutide acetate, or tirzepatide blended with B12 or niacinamide. But questions about potency and safety have lingered. “Anecdotally, I have seen no difference in outcomes in my own practice after treating hundreds of patients with the compounded versions,” says New York endocrinologist Caroline Messer, MD. “However, as they are not FDA approved and have not been vetted in long-term trials there is no way to guarantee their safety, efficacy or potency.”
Now, as drug manufacturers successfully push the FDA to remove semaglutide and tirzepatide from the shortage list, access to compounded versions may soon disappear. “With shortages ending, compounded versions may be gone due to FDA regulations,” says obesity expert Dr. Spencer Nadolsky. The shift leaves many wondering if they’ll be able to afford the switch to brand-name drugs.
Microdosing GLP-1s
For some patients, full-dose GLP-1s feel like too much, too soon. Whether maintaining weight loss or easing in for the first time, many are experimenting with smaller doses, a growing trend known as microdosing. “Compared to standard dosing, microdosing is likely less effective for weight loss,” says Dr. Nadolsky. “However, some individuals are hyper-responders, meaning even a small dose is enough to see results.”
Beyond weight management, patients are also exploring the use of GLP-1s for off-label benefits, from autoimmune conditions to cardiovascular health. “We’re seeing improvements in various conditions, but this needs long-term study,” says Dr. Nadolsky. Even in small doses, these medications can cause serious side effects like nausea, vomiting, gastroparesis, pancreatitis, gallstones, and, in rare cases, optic nerve issues leading to visual problems. However, Dr. Messer notes that with microdosing, the risk of these side effects is expected to be lower.
Supplement Support
One side effect of rapid weight loss? Nutrient depletion. With reduced calorie and protein intake, muscle loss and vitamin deficiencies become real concerns. “Supplementing to fill these gaps will be critical for sustaining weight loss while maintaining overall health,” says Dr. Nadolsky. Experts recommend increasing protein intake and adding vitamin B12, iron, collagen, electrolytes and creatine to help preserve muscle mass, energy levels and skin elasticity.
More than 50 percent of GLP-1 users plan to stay on the medication for at least a year
Source: 2025 State of Aesthetics Report
The ‘Ozempification’ of Aesthetics
GLP-1s are not only transforming weight loss; they’re also reshaping aesthetics. “We’re seeing younger patients with skin laxity and volume loss, which are issues we typically associate with more mature patients,” explains Austin, TX plastic surgeon Johnny Franco, MD. “These patients are coming in for circumferential bodylifts, arm lifts and thigh lifts. For sagging and volume loss in the face, many are opting for facelifts instead of overfilling with filler.”
More men are also turning to noninvasive skin tightening and muscle-building procedures, while auto-augmentation butt lifts—using a patient’s own tissue instead of implants or fat grafting—are also on the rise. “It’s become one of the most sought-after procedures and will likely keep growing into 2025,” says Dr. Franco.
The Next Wave
What’s next for GLP-1s? More options and accessibility. Novo Nordisk’s oral semaglutide, Rybelsus, is FDA-approved for type 2 diabetes and in trials for weight loss. Studies show it leads to up to 15.1 percent weight loss, offering a needle-free alternative. “Tablets and pills are easier to store and transport than injectables, making treatment more accessible,” says Raoul Manalac, MD, senior director of obesity science at Ro.
Meanwhile, Eli Lilly’s Retatrutide is generating buzz for delivering up to 24 percent weight loss in early trials, surpassing current GLP-1 options. Also in development is CagriSema, a semaglutide-cagrilintide combo designed to improve weight loss and metabolic health. “These medications are bringing us closer to the weight-loss outcomes seen with surgical procedures,” adds Dr. Manalac.
As new treatments emerge, weight management’s future is looking more personalized than ever. “The future of aesthetics lies in holistic, customized strategies,” Dr. Franco says. “Addressing not just weight-loss effects, but the full spectrum of a patient’s health can help them achieve their most confident selves.”
DID YOU KNOW?
Stanford researchers are developing a method to cut GLP-1 injections to three times a year.
