The increasing use of glucagon-like peptide-1 (GLP-1) receptor agonists, including semaglutide, for weight management has sparked interest in understanding their broader physiological effects, particularly on skin health. GLP-1 receptor agonists are effective at inducing fat loss in patients with obesity and type 2 diabetes, but their influence on collagen synthesis and skin elasticity remains underexplored. This literature review investigates the effects of fat loss induced by GLP-1 receptor agonists on dermal health, with a focus on collagen turnover and the skin’s ability to maintain elasticity. Collagen, a critical structural protein, is essential for skin strength, elasticity, and overall integrity. The mechanical properties of skin can be altered by fat loss, which raises questions about the balance between weight reduction and skin health during GLP-1 receptor agonist treatment. This review synthesizes findings from studies examining the role of fat loss on collagen production and skin elasticity, including clinical trials, animal models, and in vitro experiments. Comparative data from other weight loss interventions, such as bariatric surgery and lifestyle changes, are also considered to provide a broader context for understanding how GLP-1 receptor agonists influence dermal fibroblasts, collagen synthesis, and the development of skin sagging or laxity. We highlight gaps in the current literature and propose potential mechanisms by which GLP-1 receptor agonists might modulate collagen turnover, skin aging, and dermal elasticity, offering new insights into the broader effects of these medications.
Collins, L. and Costello, R.A. (2025) Glucagon-Like Peptide-1 Receptor Agonists. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK551568/
Watanabe, J.H., Kwon, J., Nan, B. and Reikes, A. (2024) Trends in Glucagon-Like Peptide 1 Receptor Agonist Use, 2014 to 2022. Journal of the American Pharmacists Association , 64, 133-138. https://doi.org/10.1016/j.japh.2023.10.002
Vilsboll, T., Christensen, M., Junker, A.E., Knop, F.K. and Gluud, L.L. (2012) Effects of Glucagon-Like Peptide-1 Receptor Agonists on Weight Loss: Systematic Review and Meta-Analyses of Randomised Controlled Trials. BMJ , 344, d7771. https://doi.org/10.1136/bmj.d7771
Lee, Y. and Jun, H. (2014) Anti-diabetic Actions of Glucagon-Like Peptide-1 on Pancreatic Beta-Cells. Metabolism , 63, 9-19. https://doi.org/10.1016/j.metabol.2013.09.010
Nauck, M.A., Niedereichholz, U., Ettler, R., Holst, J.J., Ørskov, C., Ritzel, R., et al . (1997) Glucagon-Like Peptide 1 Inhibition of Gastric Emptying Outweighs Its Insulinotropic Effects in Healthy Humans. American Journal of Physiology-Endocrinology and Metabolism , 273, E981-E988. https://doi.org/10.1152/ajpendo.1997.273.5.e981
Löffler, H., Aramaki, J.U.N. and Effendy, I. (2002) The Influence of Body Mass Index on Skin Susceptibility to Sodium Lauryl Sulphate. Skin Research and Technology , 8, 19-22. https://doi.org/10.1046/j.0909-752x
Guida, B., Nino, M., Perrino, N., Laccetti, R., Trio, R., Labella, S., et al . (2010) The Impact of Obesity on Skin Disease and Epidermal Permeability Barrier Status. Journal of the European Academy of Dermatology and Venereology , 24, 191-195. https://doi.org/10.1111/j.1468-3083.2009.03503.x
Enser, M. and Avery, N.C. (1984) Mechanical and Chemical Properties of the Skin and Its Collagen from Lean and Obese-Hyperglycaemic ( ob / ob ) Mice. Diabetologia , 27, 44-49. https://doi.org/10.1007/bf00253500
Darlenski, R., Mihaylova, V. and Handjieva-Darlenska, T. (2022) The Link between Obesity and the Skin. Frontiers in Nutrition , 9, Article ID: 855573. https://doi.org/10.3389/fnut.2022.855573
Deaver, J.W., Schrems, E.R., Brown, L.A., Haynie, W.A., Perry, R.A., Rosa-Caldwell, M.E., et al . (2021) The Effect of Diet-Induced Obesity on Extracellular Matrix Remodeling during Skeletal Muscle Regeneration. Sports Medicine and Health Science , 3, 212-217. https://doi.org/10.1016/j.smhs.2021.09.003
Jung, M.J., Kim, H.R., Kang, S.Y., Kim, H.O., Chung, B.Y. and Park, C.W. (2020) Effect of Weight Reduction on Treatment Outcomes for Patients with Atopic Dermatitis. Annals of Dermatology , 32, 319-326. https://doi.org/10.5021/ad.2020.32.4.319
Collagen Turnover
Mahil, S.K., McSweeney, S.M., Kloczko, E., McGowan, B., Barker, J.N. and Smith, C.H. (2019) Does Weight Loss Reduce the Severity and Incidence of Psoriasis or Psoriatic Arthritis? A Critically Appraised Topic. British Journal of Dermatology , 181, 946-953. https://doi.org/10.1111/bjd.17741
Reilly, D.M., Kynaston, L., Naseem, S., Proudman, E. and Laceby, D. (2024) A Clinical Trial Shows Improvement in Skin Collagen, Hydration, Elasticity, Wrinkles, Scalp, and Hair Condition Following 12‐Week Oral Intake of a Supplement Containing Hydrolysed Collagen. Dermatology Research and Practice , 2024, Article ID: 8752787. https://doi.org/10.1155/2024/8752787
Ricard-Blum, S. (2010) The Collagen Family. Cold Spring Harbor Perspectives in Biology , 3, a004978. https://doi.org/10.1101/cshperspect.a004978
Fisher, G.J., Quan, T., Purohit, T., Shao, Y., Cho, M.K., He, T., et al . (2009) Collagen Fragmentation Promotes Oxidative Stress and Elevates Matrix Metalloproteinase-1 in Fibroblasts in Aged Human Skin. The American Journal of Pathology , 174, 101-114. https://doi.org/10.2353/ajpath.2009.080599
Rittie, L. and Fisher, G.J. (2015) Natural and Sun-Induced Aging of Human Skin. Cold Spring Harbor Perspectives in Medicine , 5, a015370. https://doi.org/10.1101/cshperspect.a015370
Wang, H. (2021) A Review of the Effects of Collagen Treatment in Clinical Studies. Polymers , 13, Article No. 3868. https://doi.org/10.3390/polym13223868
Light, D., Arvanitis, G.M., Abramson, D. and Glasberg, S.B. (2010) Effect of Weight Loss after Bariatric Surgery on Skin and the Extracellular Matrix. Plastic and Reconstructive Surgery , 125, 343-351. https://doi.org/10.1097/prs.0b013e3181c2a657
King, A., Tan, X., Dhopeshwarkar, N., Bohn, R., Dea, K., Leonard, C.E., et al . (2025) Effect of Glucagon-Like Peptide-1 Receptor Agonists on Vascular Risk Factors among Adults with Type 2 Diabetes and Established Atherosclerotic Cardiovascular Disease. American Journal of Preventive Cardiology , 21, 100922. https://doi.org/10.1016/j.ajpc.2024.100922
El-Zayat, S.R., Sibaii, H. and El-Shamy, K.A. (2019) Physiological Process of Fat Loss. Bulletin of the National Research Centre , 43, Article No. 208. https://doi.org/10.1186/s42269-019-0238-z
Jafar, A.B., Jacob, J., Kao, W.K. and Ho, T. (2024) Soft Tissue Facial Changes Following Massive Weight Loss Secondary to Medical and Surgical Bariatric Interventions: A Systematic Review. Aesthetic Surgery Journal Open Forum , 6, ojae069. https://doi.org/10.1093/asjof/ojae069
Rocha, R.I., Junior, W.C., Modolin, M.L.A., Takahashi, G.G., Caldini, E.T.E.G. and Gemperli, R. (2020) Skin Changes Due to Massive Weight Loss: Histological Changes and the Causes of the Limited Results of Contouring Surgeries. Obesity Surgery , 31, 1505-1513. https://doi.org/10.1007/s11695-020-05100-3
de Sousa Neto, I.V., Durigan, J.L.Q., da Silva, A.S.R. and de Cássia Marqueti, R. (2022) Adipose Tissue Extracellular Matrix Remodeling in Response to Dietary Patterns and Exercise: Molecular Landscape, Mechanistic Insights, and Therapeutic Approaches. Biology , 11, Article No. 765. https://doi.org/10.3390/biology11050765
Ruiz-Ojeda, F.J., Méndez-Gutiérrez, A., Aguilera, C.M. and Plaza-Díaz, J. (2019) Extracellular Matrix Remodeling of Adipose Tissue in Obesity and Metabolic Diseases. International Journal of Molecular Sciences , 20, Article No. 4888. https://doi.org/10.3390/ijms20194888
Sun, K., Li, X. and Scherer, P.E. (2023) Extracellular Matrix (ECM) and Fibrosis in Adipose Tissue: Overview and Perspectives. Comprehensive Physiology , 13, 4387-4407.
Liu, Y., Aron-Wisnewsky, J., Marcelin, G., Genser, L., Le Naour, G., Torcivia, A., et al . (2016) Accumulation and Changes in Composition of Collagens in Subcutaneous Adipose Tissue after Bariatric Surgery. The Journal of Clinical Endocrinology & Metabolism , 101, 293-304. https://doi.org/10.1210/jc.2015-3348
Gallo, J.R.B., Maschio-Signorini, L.B., Cabral, C.R.B., de Campos Zuccari, D.A.P., Nogueira, M.L., Bozola, A.R., et al . (2019) Skin Protein Profile after Major Weight Loss and Its Role in Body Contouring Surgery. Plastic and Reconstructive Surgery - Global Open , 7, e2339. https://doi.org/10.1097/gox.0000000000002339
Anyiam, O., Phillips, B., Quinn, K., Wilkinson, D., Smith, K., Atherton, P., et al . (2024) Metabolic Effects of Very-Low Calorie Diet, Semaglutide, or Combination of the Two, in Individuals with Type 2 Diabetes Mellitus. Clinical Nutrition , 43, 1907-1913. https://doi.org/10.1016/j.clnu.2024.06.034
Ghusn, W., De la Rosa, A., Sacoto, D., Cifuentes, L., Campos, A., Feris, F., et al . (2022) Weight Loss Outcomes Associated with Semaglutide Treatment for Patients with Overweight or Obesity. JAMA Network Open , 5, e2231982. https://doi.org/10.1001/jamanetworkopen.2022.31982
Manzoni, A.P.D.d.S. and Weber, M.B. (2015) Skin Changes after Bariatric Surgery. Anais Brasileiros de Dermatologia , 90, 157-166. https://doi.org/10.1590/abd1806-4841.20153139
Cao, C., Xiao, Z., Wu, Y. and Ge, C. (2020) Diet and Skin Aging—From the Perspective of Food Nutrition. Nutrients , 12, Article No. 870. https://doi.org/10.3390/nu12030870
Klair, N., Patel, U., Saxena, A., Patel, D., Ayesha, I.E., Monson, N.R., et al . (2023) What Is Best for Weight Loss? A Comparative Review of the Safety and Efficacy of Bariatric Surgery versus Glucagon-Like Peptide-1 Analogue. Cureus , 15, e46197. https://doi.org/10.7759/cureus.46197
Zorina, A., Zorin, V., Isaev, A., Kudlay, D., Vasileva, M. and Kopnin, P. (2023) Dermal Fibroblasts as the Main Target for Skin Anti-Age Correction Using a Combination of Regenerative Medicine Methods. Current Issues in Molecular Biology , 45, 3829-3847. https://doi.org/10.3390/cimb45050247
Varani, J., Dame, M.K., Rittie, L., Fligiel, S.E.G., Kang, S., Fisher, G.J., et al . (2006) Decreased Collagen Production in Chronologically Aged Skin: Roles of Age-Dependent Alteration in Fibroblast Function and Defective Mechanical Stimulation. The American Journal of Pathology , 168, 1861-1868. https://doi.org/10.2353/ajpath.2006.051302
de Miranda, R.B., Weimer, P. and Rossi, R.C. (2021) Effects of Hydrolyzed Collagen Supplementation on Skin Aging: A Systematic Review and Meta‐Analysis. International Journal of Dermatology , 60, 1449-1461. https://doi.org/10.1111/ijd.15518
Shin, J., Kwon, S., Choi, J., Na, J., Huh, C., Choi, H., et al . (2019) Molecular Mechanisms of Dermal Aging and Antiaging Approaches. International Journal of Molecular Sciences , 20, Article No. 2126. https://doi.org/10.3390/ijms20092126
Zheng, Z., Zong, Y., Ma, Y., Tian, Y., Pang, Y., Zhang, C., et al . (2024) Glucagon-like Peptide-1 Receptor: Mechanisms and Advances in Therapy. Signal Transduction and Targeted Therapy , 9, Article No. 234. https://doi.org/10.1038/s41392-024-01931-z
Qa’aty, N., Wang, Y., Wang, A., Mao, S., Vincent, M., Husain, M., et al . (2015) The Antidiabetic Hormone Glucagon-Like Peptide-1 Induces Formation of New Elastic Fibers in Human Cardiac Fibroblasts after Cross-Activation of IGF-IR. Endocrinology , 156, 90-102. https://doi.org/10.1210/en.2014-1519
Rasmussen, M.H., Jensen, L.T., Andersen, T., Breum, L. and Hilsted, J. (1995) Collagen Metabolism in Obesity: The Effect of Weight Loss. International Journal of Obesity and Related Metabolic Diso rders , 19, 659-663.
Orpheu, S.C., Coltro, P.S., Scopel, G.P., Gomez, D.S., Rodrigues, C.J., Modolin, M.L.A., et al . (2009) Collagen and Elastic Content of Abdominal Skin after Surgical Weight Loss. Obesity Surgery , 20, 480-486. https://doi.org/10.1007/s11695-009-0019-0
Park, J., Kim, M., Shin, H., Ahn, H. and Park, Y.K. (2023) Low-Molecular Collagen Peptide Supplementation and Body Fat Mass in Adults Aged ≥ 50 Years: A Randomized, Double-Blind, Placebo-Controlled Trial. Clinical Nutrition Research , 12, 245-256. https://doi.org/10.7762/cnr.2023.12.4.245
Alorfi, N.M. and Algarni, A.S. (2022) Clinical Impact of Semaglutide, a Glucagon-Like Peptide-1 Receptor Agonist, on Obesity Management: A Review. Clinical Pharmacology : Advances and Applications , 14, 61-67. https://doi.org/10.2147/cpaa.s374741
Montecinos, K., Kania, B. and Goldberg, D.J. (2024) Semaglutide “Ozempic” Face and Implications in Cosmetic Dermatology. Dermatological Reviews , 5, e70003. https://doi.org/10.1002/der2.70003
Haykal, D., Hersant, B., Cartier, H. and Meningaud, J. (2024) The Role of GLP‐1 Agonists in Esthetic Medicine: Exploring the Impact of Semaglutide on Body Contouring and Skin Health. Journal of Cosmetic Dermatology , 24, e16716. https://doi.org/10.1111/jocd.16716
Chen, J., Fan, Z., Zhu, D., Guo, Y., Ye, K., Dai, D., et al . (2021) Emerging Role of Dermal White Adipose Tissue in Modulating Hair Follicle Development during Aging. Frontiers in Cell and Developmental Biology , 9, Article ID: 728188. https://doi.org/10.3389/fcell.2021.728188
Carboni, A., Woessner, S., Martini, O., Marroquin, N.A. and Waller, J. (2023) Natural Weight Loss or “Ozempic Face”: Demystifying a Social Media Phenomenon. Journal of Drugs in Dermatology , 23, 1367-1368. https://doi.org/10.36849/jdd.7613
Jafar, A.B., Jacob, J., Kao, W.K. and Ho, T. (2024) Soft Tissue Facial Changes Following Massive Weight Loss Secondary to Medical and Surgical Bariatric Interventions: A Systematic Review. Aesthetic Surgery Journal Open Forum , 6, ojae069. https://doi.org/10.1093/asjof/ojae069
Aguilera, S.B., McCarthy, A., Khalifian, S., Lorenc, Z.P., Goldie, K. and Chernoff, W.G. (2023) The Role of Calcium Hydroxylapatite (Radiesse) as a Regenerative Aesthetic Treatment: A Narrative Review. Aesthetic Surgery Journal , 43, 1063-1090. https://doi.org/10.1093/asj/sjad173
Yaribeygi, H., Maleki, M., Jamialahmadi, T. and Sahebkar, A. (2024) Anti-Inflammatory Benefits of Semaglutide: State of the Art. Journal of Clinical & Translational Endocrinology , 36, Article ID: 100340. https://doi.org/10.1016/j.jcte.2024.100340
Ågren, M.S., Schnabel, R., Christensen, L.H. and Mirastschijski, U. (2015) Tumor Necrosis Factor-Α-Accelerated Degradation of Type I Collagen in Human Skin Is Associated with Elevated Matrix Metalloproteinase (MMP)-1 and MMP-3 ex Vivo . European Journal of Cell Biology , 94, 12-21. https://doi.org/10.1016/j.ejcb.2014.10.001
Ezure, T. and Amano, S. (2007) Adiponectin and Leptin Up‐Regulate Extracellular Matrix Production by Dermal Fibroblasts. BioFactors , 31, 229-236. https://doi.org/10.1002/biof.5520310310
Kirichenko, T.V., Markina, Y.V., Bogatyreva, A.I., Tolstik, T.V., Varaeva, Y.R. and Starodubova, A.V. (2022) The Role of Adipokines in Inflammatory Mechanisms of Obesity. International Journal of Molecular Sciences , 23, Article No. 14982. https://doi.org/10.3390/ijms232314982
Widgerow, A.D. (2024) Adipose Tissue, Regeneration, and Skin Health: The Next Regenerative Frontier. Aesthetic Surgery Journal Open Forum , 6, ojae117. https://doi.org/10.1093/asjof/ojae117
Hany, M., Zidan, A., Ghozlan, N.A., Ghozlan, M.N., Abouelnasr, A.A., Sheta, E., et al . (2024) Comparison of Histological Skin Changes after Massive Weight Loss in Post-Bariatric and Non-Bariatric Patients. Obesity Surgery , 34, 855-865. https://doi.org/10.1007/s11695-024-07066-y
Ridha, Z., Fabi, S.G., Zubar, R. and Dayan, S.H. (2024) Decoding the Implications of Glucagon-Like Peptide-1 Receptor Agonists on Accelerated Facial and Skin Aging. Aesthetic Surgery Journal , 44, NP809-NP818. https://doi.org/10.1093/asj/sjae132
Gao, J., Guo, Z., Zhang, Y., Liu, Y., Xing, F., Wang, J., et al . (2022) Age-related Changes in the Ratio of Type I/III Collagen and Fibril Diameter in Mouse Skin. Regenerative Biomaterials , 10, rbac110. https://doi.org/10.1093/rb/rbac110
Franz, M.J., VanWormer, J.J., Crain, A.L., Boucher, J.L., Histon, T., Caplan, W., et al . (2007) Weight-Loss Outcomes: A Systematic Review and Meta-Analysis of Weight-Loss Clinical Trials with a Minimum 1-Year Follow-up. Journal of the American Dietetic Association , 107, 1755-1767. https://doi.org/10.1016/j.jada.2007.07.017
Gasoyan, H., Pfoh, E.R., Schulte, R., Le, P., Butsch, W.S. and Rothberg, M.B. (2024) One-Year Weight Reduction with Semaglutide or Liraglutide in Clinical Practice. JAMA Network Open , 7, e2433326. https://doi.org/10.1001/jamanetworkopen.2024.33326
Enright, C., Thomas, E. and Saxon, D.R. (2023) An Updated Approach to Antiobesity Pharmacotherapy: Moving Beyond the 5% Weight Loss Goal. Journal of the Endocrine Society , 7, bvac195. https://doi.org/10.1210/jendso/bvac195
Moiz, A., Levett, J.Y., Filion, K.B., Peri, K., Reynier, P. and Eisenberg, M.J. (2024) Long-Term Efficacy and Safety of Once-Weekly Semaglutide for Weight Loss in Patients without Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. The American Journal of Cardiology , 222, 121-130. https://doi.org/10.1016/j.amjcard.2024.04.041
Ayatollahi, A., Gholami, J., Saberi, M., Hosseini, H. and Firooz, A. (2020) Systematic Review and Meta-Analysis of Safety and Efficacy of High-Intensity Focused Ultrasound (HIFU) for Face and Neck Rejuvenation. Lasers in Medical Science , 35, 1007-1024. https://doi.org/10.1007/s10103-020-02957-9
Spataro, E.A., Dierks, K. and Carniol, P.J. (2022) Microneedling-Associated Procedures to Enhance Facial Rejuvenation. Facial Plastic Surgery Clinics of North America , 30, 389-397. https://doi.org/10.1016/j.fsc.2022.03.012
Tan, M.G., Jo, C.E., Chapas, A., Khetarpal, S. and Dover, J.S. (2021) Radiofrequency Microneedling: A Comprehensive and Critical Review. Dermatologic Surgery , 47, 755-761. https://doi.org/10.1097/dss.0000000000002972
Oni, G., Hoxworth, R., Teotia, S., Brown, S. and Kenkel, J.M. (2014) Evaluation of a Microfocused Ultrasound System for Improving Skin Laxity and Tightening in the Lower Face. Aesthetic Surgery Journal , 34, 1099-1110. https://doi.org/10.1177/1090820x14541956
Kapoor, K.M., Saputra, D.I., Porter, C.E., Colucci, L., Stone, C., Brenninkmeijer, E.E.A., et al . (2021) Treating Aging Changes of Facial Anatomical Layers with Hyaluronic Acid Fillers. Clinical , Cosmetic and Investigational Dermatology , 14, 1105-1118. https://doi.org/10.2147/ccid.s294812
Emer, J. (2019) Platelet-Rich Plasma (PRP): Current Applications in Dermatology. Skin Therapy Letter , 24, 1-6.
Quan, T. (2023) Human Skin Aging and the Anti-Aging Properties of Retinol. Biomolecules , 13, Article No. 1614. https://doi.org/10.3390/biom13111614
Bolke, L., Schlippe, G., Gerß, J. and Voss, W. (2019) A Collagen Supplement Improves Skin Hydration, Elasticity, Roughness, and Density: Results of a Randomized, Placebo-Controlled, Blind Study. Nutrients , 11, Article No. 2494. https://doi.org/10.3390/nu11102494