Ozempic & Co: when the number on the scales is right, but the image in the mirror is not yet.
There are moments in medicine when a success makes a new problem visible. GLP-1 agents are such a moment. Semaglutide, tirzepatide — medicines originally developed for the treatment of type 2 diabetes have, within a few years, changed something that decades of nutritional medicine had not achieved: they enable lasting, substantial weight loss for people who previously could not achieve it despite everything. That is real medical progress. And it brings with it a follow-on question that is still talked about far too little. People come to us who have lost twenty, thirty, sometimes forty kilos in a year and a half. People who, for the first time in their lives, are no longer bothered by their weight in everyday life and in their self-image. And yet they are not satisfied when they look at themselves in the mirror. Because: there is still a great deal of loose skin, which, after many years of stretching, no longer retracts on its own. Skin is not an infinitely elastic material that adapts at will. It has limits — limits that depend on age, genetics, the speed of weight loss and the starting situation. Anyone who loses a lot of weight in a short time also loses volume — in the breasts, the face, the arms. The skin that enveloped this volume remains. It slackens. It hangs. And GLP-1 agents change nothing about that. They act on the metabolism. Not on the skin structure.
A phenomenon that medicine is only just beginning to understand
The figures give this a dimension: searches for body contouring treatments rose by more than 2,000 per cent in 2025. Surgeons worldwide report a new, growing group of patients with a specific profile: successful, motivated, physically healthier than ever — and deeply unsettled about what they see in the mirror. The image we have of ourselves influences how we move in our bodies, how we interact with others, what we trust ourselves to do. The link between body perception and psychological well-being is well documented. And it does not end with the scales showing a certain weight. What happens to the body when weight is lost quickly is not a malfunction. It is a physiological consequence that nobody deserves and nobody is to blame for. Anyone who does not communicate this clearly is making a mistake — regardless of whether they have a treatment to offer afterwards or not.
When a procedure makes sense — and when it does not
This is the question we answer most often. And the honest answer is uncomfortable but important: in many cases the time has not yet come. Surgery after weight loss — whether a lift, breast correction or liposuction of remaining stubborn fat deposits — requires a stable foundation. Weight must have been constant for at least six months. Anyone who is still in the process, who is still adjusting or dosing medication, whose body is still reorganising itself: should wait. A procedure on a shifting foundation does not produce a lasting result. This is not a cautious clinic policy. It is medical logic. What may make sense in the meantime — non-invasive skin tightening, regenerative techniques, accompanying diagnostics — depends on the individual situation. There is no standard answer. There is only a good medical history and an honest conversation.
If you would like to learn more about the topic, book a consultation with one of our doctors here.
