Ozempic, honesty and the modern slim-down: A PR perspective

There was a time when celebrity weight loss was treated like gospel. You’d see a dramatic transformation on a talk show sofa, followed by a fitness DVD deal and a magazine feature promising tips that “anyone could follow.” Remember Davina McCall’s iconic 7 Minute Fit or Power Box & Tone? For a while, we genuinely believed these things worked if you just stuck to the plan.

That trust has slowly eroded. Now, when someone in the public eye drops a few stone in record time and starts crediting “early mornings and gratitude,” the reaction isn’t admiration. It’s scepticism. Because we all know what’s really going on.

The rise of the GLP-1 era

Drugs like Ozempic, Wegovy and Mounjaro, all part of the GLP-1 agonist family, have rapidly reshaped how the public views weight loss. Originally developed for managing Type 2 diabetes, these injections mimic a hormone called GLP-1 to regulate blood sugar, suppress appetite, slow digestion and promote a feeling of fullness. They’re medically impressive and, in some cases, life-changing.

They’ve also become socially ubiquitous. At this point, every Tom, Dick and influencer seems to be on them. I’ve had clients ask whether they should start posting gym content to make it all look natural. Others are quietly using it without even telling their friends. And plenty of everyday people I know, people who aren’t in the public eye at all, are doing it too.

Even when I meet up with friends I haven’t seen in a few months, it happens. They look completely different and I’ll say, “Whoa, you look amazing,” and without missing a beat, they’ll reply, “Ozempic!” and laugh. It’s become so normal that there’s no awkwardness about it anymore.

I host dinner parties fairly often, and it’s now standard for someone to text beforehand saying, “Don’t make too much food,” or “I won’t have much of an appetite.” And sure enough, they’ll sit down and eat a few spoonfuls before saying they’re full. No big fuss, no drama. It’s just how things are now.

Even the NHS now prescribes these drugs for patients with a high BMI and related health risks, supported by NICE guidelines. But because demand has far outstripped supply, the backlash has grown, particularly from people with diabetes who rely on GLP-1s and have struggled to access them. This is where one of the key public criticisms lies: that aesthetic use is taking priority over genuine medical need.

The reality is more nuanced. These drugs are medically approved for obesity as well, and for many people, that’s a legitimate health concern. But in the eyes of the public, the optics of someone losing weight for a red carpet and taking medication in short supply will always be tricky. Especially if they don’t own up to it.

Ozempic face and the visual giveaways

One of the most common giveaways that someone might be using a GLP-1 drug is the speed and pattern of their weight loss. And yes, the internet has already given it a name: Ozempic face.

This isn’t a formal medical diagnosis, but it refers to something real. GLP-1 drugs like Ozempic (semaglutide) work by mimicking a hormone called glucagon-like peptide-1, which regulates blood sugar levels and slows down gastric emptying. This means food stays in the stomach longer, reducing appetite and triggering satiety sooner. The result is often a dramatic drop in calorie intake - which can lead to rapid weight loss, particularly in the first three to six months.

The problem is that fat loss doesn’t discriminate. The face, like the rest of the body, loses volume. When this happens quickly, it can leave the skin looking looser, less structured and more aged. Cheeks may hollow, jawlines become more pronounced, and fine lines appear sharper. Collagen and elastin also degrade more quickly during sudden weight loss, which can compound the effect. Dermatologists and aesthetic doctors have reported an influx of patients seeking fillers, skin tightening, or surgical options to address these changes.

There’s also the lesser-known issue of muscle loss. Some GLP-1 users, particularly those not balancing the medication with resistance training or adequate protein intake, may also lose lean muscle mass - which can further affect appearance and long-term metabolic health.

And then there’s the question of what happens when you stop. Studies have shown that many people regain much of the weight they lost once they come off the drug, particularly if no long-term lifestyle changes have been made. Because the medication directly affects hunger hormones, removing it can quickly reintroduce previous patterns, both biologically and behaviourally. A study published in Diabetes, Obesity and Metabolism in 2022 found that participants regained about two-thirds of their lost weight within a year of stopping semaglutide.

This doesn’t mean the drug is ineffective, it works exactly as it’s designed to. But it does mean that people using it without long-term planning, or those promoting it as a quick-fix transformation, may find themselves facing both aesthetic and reputational consequences later on.

And while not everyone experiences visible side effects, when someone’s face looks dramatically different in a short space of time, people will notice. When that same person then starts pushing “clean eating” and pilates as the reason, it comes across as performative. And the backlash isn’t usually about the drug. It’s about the pretending.

The Oprah example

Oprah Winfrey is probably the clearest case study of how this can play out. She’s long been tied to WeightWatchers, both as a spokesperson and a board member, promoting the company’s behavioural approach to weight loss.

But in 2023, she admitted publicly that she’d used a weight-loss injection under medical advice. She didn’t name it directly, but the context made it obvious. Her reasoning? That she was tired of the shame and tired of people assuming she had failed, when in reality, she was addressing her health differently.

The backlash came not because she used the drug, but because of the contradictions. People felt she had made millions promoting a different method while secretly using something else. The lesson for public figures is simple. The criticism isn’t about the method. It’s about the messaging. If the two don’t align, you look like a hypocrite.

What I tell clients

From a PR perspective, I usually advise clients to be honest if asked. You don’t have to put it in your Instagram bio, but if someone directly asks in an interview, there’s no need to lie. Say it plainly, without making it a “journey” or a public health message. “Yes, I used it under medical supervision as part of a wider change” is enough.

It’s just too easy to slip up. I had a client who didn’t want to come clean publicly about using Ozempic, and I was overseeing their content to make sure nothing went out that might raise eyebrows. One day, they filmed a “fridge restock” video for Instagram, and in the background, clear as day, was the Ozempic box on the top shelf. They hadn’t noticed. If that had gone live, it wouldn’t have taken long for someone to pause, zoom in, and start spreading it online. These are the details that get people caught out. Not because they did anything wrong, but because they tried to hide it and forgot how closely people look.

The general public is smart. They’ve seen enough side-by-sides. The only thing they really resent is being misled. Especially when someone claims to have achieved something through willpower alone and then uses that illusion to sell books, fitness plans or wellness brands.

Silence can be strategic, but only if it doesn’t become misleading. If your brand has nothing to do with health, fitness or transformation, you don’t need to say anything. But if you’re making money from your body or your routine, the silence quickly becomes an issue.

Being smart with brand partnerships

This is also where public figures really need to be strategic. If you’re approached to promote anything in the fitness, health, or skincare space, you need to stop and think about whether your current reality lines up with the message you’re about to put out. It’s not just about whether the ad works. It’s about whether it’s believable.

I had one client who was actively using Ozempic when they were approached by a very well-known fitness clothing brand for a partnership. I advised them to disclose the truth to the brand. Not because they owed them their medical records, but because if the campaign went live and the public caught on (and they usually do) it would damage the brand, the client, and everyone involved. From my side, I was clear. I couldn’t have my name attached to promoting something knowingly misleading. If the company ever found out I had known all along and kept quiet, that could have reputational consequences for me too.

These decisions aren’t always black and white, but you have to weigh up the risk. If you're doing a protein shake ad while barely eating, or a skincare campaign when people are pointing out that your rapid weight loss is changing your facial structure, those contradictions are going to be noticed.

Public trust is harder to earn back than it is to lose. Sometimes a quiet heads-up to the brand, or a sentence of clarity in the caption, is enough. But the smarter option is always to get ahead of it, not scramble to explain after the fact.

Final thoughts: Integrity over illusion

You don’t owe the internet your full medical history. But if your image is built around transformation, credibility matters. Audiences are more forgiving than you think, especially now that Ozempic is becoming the new normal.

Trying to cover it up only invites scrutiny. You’re not fooling anyone, and you don’t need to. GLP-1s are changing the way we talk about weight loss. For public figures, the smart move isn’t pretending you’re still living in the era of detox teas and 5am jogs. It’s acknowledging the change, being consistent, and knowing that the truth is usually far less damaging than the cover-up.