BEYOND THE SCALE

GLP-1 Medicines, Tirzepatide, and Caring for Your Health, Skin, and Muscle

By Kathleen Peara
KATHLEEN PEARA SKINCARE FOR LIFE™

Weight loss can change much more than a clothing size. It can change appetite, energy, strength, and the face looking back at us in the mirror. When medication is part of that journey, the whole body deserves care.

GLP-1 medicines and tirzepatide can offer important health benefits for appropriately selected patients. The goal is to support those benefits while protecting nourishment, muscle, and skin.

Understanding the medicines

Semaglutide, found in Ozempic and Wegovy, acts on the GLP-1 receptor. Tirzepatide, found in Mounjaro and Zepbound, acts on both GIP and GLP-1 receptors. These medicines help regulate appetite and blood sugar and slow stomach emptying. Their approved uses differ by product.

Tirzepatide can produce substantial weight loss, and Zepbound is also approved for moderate to severe obstructive sleep apnea in adults with obesity. However, nausea, vomiting, diarrhea, constipation, and other digestive symptoms can complicate treatment. pi.lilly.com

Muscle: protect what helps you live well

Weight lost is not always entirely fat. In a SURMOUNT-1 body-composition sub study involving 160 participants, approximately 75% of the weight lost with tirzepatide was fat mass and 25% was lean mass. These were averages, not predictions for every person.

Lean mass includes muscle, water, organs, and other tissues. A decrease in lean mass does not mean every pound lost was muscle. Nevertheless, protecting muscle and strength matters, particularly for older adults and people who already have limited mobility. PMC

Notice daily function alongside weight. Is rising from a chair becoming harder? Are stairs more difficult? Are you becoming less steady? Bring declining strength to your medical team rather than accepting it as the price of weight loss.

Nourishment when hunger becomes quiet

A smaller appetite still needs a thoughtful eating plan. Include protein regularly: eggs, fish, poultry, tofu, yogurt, cottage cheese, beans, or lentils. Add vegetables, fruit, whole grains, and appropriate amounts of healthy fats. Variety helps provide nutrients that a very restricted diet may miss.

An illustrative day might include yogurt and berries, lentil soup with tofu or chicken, and fish or beans with cooked vegetables and a whole grain. Portions should fit your needs and tolerance; this is not a calorie prescription. NIDDK

For some adults undergoing active weight loss, clinicians consider protein targets around 1.2–1.6 grams per kilogram daily. The appropriate weight used in that calculation needs individual assessment, especially with obesity. Kidney disease and other medical conditions can change the recommendation. A registered dietitian can help establish a suitable target.

If fullness makes meals difficult, try smaller meals, eat the protein portion first, and discuss a protein supplement if needed. Protein alone cannot reliably preserve muscle without resistance exercise. Persistent nausea or inability to eat adequately calls for a conversation with the prescriber. PMC

Water: make drinking a regular ritual

Sip fluids throughout the day rather than waiting until evening. Keep water accessible and ask your clinician about a daily fluid goal suited to your health, activity, and climate. People with prescribed fluid restrictions should follow their medical plan.

Vomiting and diarrhea can cause dehydration severe enough to injure the kidneys. Repeated vomiting, inability to keep fluids down, or markedly reduced urination requires prompt medical attention. Water alone cannot correct every serious fluid or electrolyte problem. pi.lilly.com

For constipation, discuss gradually increasing fiber, fluids, and movement with your care team. Large, fatty meals may worsen nausea; smaller meals may be easier to tolerate. PMC

Strength and rehabilitation: start where you are

Build toward at least two days of muscle-strengthening activity weekly, together with 150 minutes of moderate aerobic activity, as ability allows. Older adults also benefit from balance work. Begin with manageable amounts and progress gradually.

Strength work can include resistance bands, weights, and appropriately modified chair rises or wall push-ups. Walking supports health, but resistance exercise deserves its own place in the week. CDC

If pain, prior surgery, arthritis, weakness, or fear of falling limits movement, ask for physical therapy guidance. A therapist can help select movements suited to your limitations and goals. New or worsening weakness should be assessed before you try to exercise through it. National Institute on Aging

Skin: support the barrier and set realistic expectations

Substantial weight loss can reduce facial fullness and reveal sagging or a crepey appearance. The popular phrase “Ozempic face” describes an appearance, not a diagnosis. Similar changes can follow rapid weight loss by other methods. How much comes from weight loss versus direct medication effects remains under study.

Skin care can improve comfort, hydration, and surface appearance. It cannot replace lost facial fat or remove substantial excess skin.

Keep the ritual gentle:

Cleanse without stripping.
Apply a hydrating serum if tolerated.
Follow with a moisturizer; ceramides can support the barrier.
Protect exposed skin with broad-spectrum SPF 30 or higher.
Reduce irritating exfoliation when skin becomes dry or reactive.

Persistent rashes, troublesome skin folds, or significant facial changes deserve a dermatologist’s assessment. Hair shedding may also follow substantial weight loss; seek assessment if it persists or is pronounced. aad.org

Choose peptide and botanical products for realistic cosmetic goals, rather than promising to reverse medication-associated volume loss.

Keep your care team involved

Seek urgent assessment for severe persistent abdominal pain, especially if it travels to the back, or significant dehydration. Trouble breathing or swelling of the lips or tongue is an emergency.

Tirzepatide carries a boxed warning based on thyroid tumors in rats; the human risk is unknown. It is contraindicated with a personal or family history of medullary thyroid carcinoma or MEN2. Review suitability and medication interactions with the prescriber. pi.lilly.com

A whole-body approach

The body deserves to be nourished through change. Let progress include the strength to rise, the steadiness to walk, and the energy to participate in life.

At KATHLEEN PEARA SKINCARE FOR LIFE™, caring for skin belongs within caring for the whole person. Thoughtful skin whispering rituals can accompany medical care, nourishment, hydration, and movement—an integrative approach that honors the body throughout its journey.

Educational information; individual treatment, nutrition, hydration, and rehabilitation plans should be developed with qualified professionals.

Blog posts & pages