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American talk‑show icon Oprah Winfrey has long spoken about her weight struggles. In a recent People interview, she revealed how a GLP‑1 weight‑loss medication—one of the most effective peptide therapies—has dramatically improved her health and appearance. While her slimmer silhouette has attracted admiration, fans have also noted a new concern: pronounced wrinkles and visible tendons on her feet, a phenomenon dubbed “Ozempic feet.” This side effect is rooted in science.
Scott Isaacs, MD, president of the American Association of Clinical Endocrinology, explains to Health that Ozempic feet are characterized by sagging skin, loss of fat padding, and visible tendons or veins. This condition represents a form of fat‑pad atrophy, which naturally progresses as we age. Years of walking, standing, running, and jumping wear down the protective fat deposits in the ball and heel, leaving the underlying bone exposed.
Rapid fat loss induced by GLP‑1s accelerates this process. Isaacs notes, “When fat is lost quickly, the skin’s elasticity may not keep pace.” The result is an unsightly appearance that can also cause discomfort with each step. Factors such as reduced collagen and elastin, duration of overweight, age, and genetics can amplify the effect.
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GLP‑1 therapies—including the first oral GLP‑1 released in 2025—work by slowing gastric emptying and mimicking the natural hormone GLP‑1, which signals fullness to the brain. This dual action promotes sustained satiety and rapid weight loss, but it also affects other body areas. Rapid loss of subcutaneous fat can lead to “Ozempic face,” “Ozempic hands,” and “Ozempic butt,” where sagging skin and increased wrinkles become evident. The face may show sunken eyes and thinner lips, while the buttocks can appear flatter.
Isaacs emphasizes that the underlying mechanism mirrors that of foot fat‑pad atrophy: quick fat loss can outpace skin contraction, revealing underlying structures and contributing to an aged look. While these side effects cannot be fully prevented, they can be mitigated.
He recommends staying well hydrated to support skin elasticity and working with a healthcare provider to moderate the rate of weight loss, giving the skin more time to adapt and preserving foot fat padding.
