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So I'm down 41 pounds which is genuinely life changing. I feel better than I have in years and I don't regret starting for a second. But there's a list of things that have happened to my body that my prescriber never once mentioned and that I only figured out by falling down a research rabbit hole at 1am. The face thing hit me hardest. Around month 3 I started looking more tired in photos. Not thinner but older somehow. Hollow under my eyes in a way I'd never had before. I figured it was just part of losing weight and tried to push through it. Turns out it has a clinical name. Midface volume loss. There are fat compartments in your cheeks that give your face its structure and when you lose weight fast, they deflate before your skin can adapt. Research published last year found up to 9% volume loss in the midface per 22 pounds lost. That's not subtle. You can see 9%. The hair thing hit month 4. Shower drain, pillow, brush, way more than normal. Again, nobody told me this was coming. It's called telogen effluvium. 76% of GLP-1 users develop it. Peaks around month 3-4. The frustrating part is there's apparently a window where intervention actually changes the outcome and I had no idea I was in it until I was already past it. And the muscle thing I'm still processing. The STEP 1 trial in NEJM found up to 40% of weight lost on semaglutide can be lean mass without specific intervention. I've lost 41 pounds. If even a fraction of that was muscle rather than fat that explains a lot about why I feel weaker than I expected to. Anyway. Has anyone else had any of these? Especially curious about the face changes, whether it improved for anyone and what actually helped.
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