As drugs such as Wegovy and Ozempic soar in popularity for weight loss, pounds aren’t the only thing people report losing: Social media groups for people taking the medications include posts about losing hair, too.

Multiple news and medical organizations have begun reporting on this trend as well including NBC News and the American Hair Loss Association (AHLA). Although these glucagon-like peptide-1 (GLP-1) receptor agonists drugs have been approved by the FDA for the treatment of type 2 diabetes and obesity, their misuse for weight loss purposes can have serious consequences, including significant hair loss.

It is important to note that the rapid weight loss itself can also cause temporary telogen effluvium, a form of hair shedding that can further contribute to hair loss in those susceptible.¹ Additionally, AHLA experts hypothesize that the hormonal shifts from semaglutide and similar drugs can trigger not only temporary telogen effluvium but also early onset male and female pattern hair loss, also known as androgenic alopecia. Androgenic alopecia is a progressive condition that can continue to worsen over time, resulting in permanent hair loss.

In androgenic alopecia, the hair follicles become miniaturized, producing thinner and shorter hair strands over time. Eventually, the hair follicles may stop producing cosmetically appreciable hair altogether, leading to baldness or thinning hair in the affected areas.

While there’s no evidence that hair loss is a direct side effect of Ozempic, Wegovy, Zepbound or Mounjaro, and that these GLP-1 agonists weight loss drugs cause hair loss themselves. Rather, hair loss is a side effect of the stress and hormonal shifts and nutrient deficiencies associated with the rapid weight loss they cause and which can lead to temporary shedding of hair over several months.

Nutritional deficiencies, low protein or caloric intake and a sudden change in eating habits can worsen the possibility of hair shedding due to rapid weight loss with these medications. (these nutritional deficiencies can be avoided through supplementation with vitamins and dietary supplements – including Hush & Hush Deeply Rooted)

How does Ozempic, Wegovy, Zepbound and Mounjaro work?

Ozempic and Wegovy contain an ingredient called semaglutide. It works by suppressing the appetite by mimicking GLP-1, a hormone that signals to the brain that the stomach is full. In similar clinical trials, semaglutide has been shown to reduce body weight by roughly 15 percent (34 pounds) after 68 weeks.

By comparison, the tirzepatide in Mounjaro and Zepbound (Mounjaro is the version of the drug prescribed for treatment of diabetes, when prescribed for weight loss it will be Zepbound) works on both the GLP-1 and GIP pathways.

While those taking tirzepatide lost more weight than those taking semaglutide in separate trials, the data is not comparable due to potential differences in study length and population. More data is needed that compares both drugs at the higher doses needed for weight-loss, so it is too early to say if one is more effective than the other.

Can Ozempic, Wegovy, Zepbound or Mounjaro cause hair loss?

Hair loss has been reported with these medications after rapid weight loss, but it does not appear to be a permanent side effect. Not everyone will experience hair loss with Ozempic, Wegovy, Zepbound or Mounjaro.

Studies

• In Wegovy (semaglutide) studies, hair loss (alopecia) was reported in 3% of adults using Wegovy and 1% using a placebo (inactive) treatment. In children 12 years and older, hair loss was reported in 4% vs. 0% using a placebo. These were not considered common side effects by the manufacturer, occurring in < 5% of people.
• Hair loss or alopecia is not reported as a side effect in the Ozempic (semaglutide) studies in the package insert, but has been reported by some people using the medicine.
• Hair loss is also not listed as an adverse effect in the package insert for Mounjaro (tirzepatide). However, a clinical study from 2022 reported that hair loss (alopecia) occurred in 4.9% to 5.7% of people using a 5 mg to 15 mg dose of Mounjaro, compared to 0.9% of those using the placebo.

Hair shedding due to rapid weight loss after bariatric (weight loss) surgery and in patients with type 2 diabetes has also been reported.

Why do Ozempic, Wegovy, Zepbound or Mounjaro cause hair loss?

Experts think hair loss with Ozempic, Wegovy, Zepbound or Mounjaro may occur due to a medical condition known as telogen effluvium, and is not a direct effect of the medicine itself, but rather the stress it imposes on the body as well as nutrient deficiencies that are a common result of the reduced food consumption. It occurs due to disruption of the normal hair follicle growth cycle.

What is telogen effluvium?

Telogen effluvium is excessive shedding of hair in the “resting” (telogen) phase after some type of metabolic body stress, hormonal change, or medication use. Extreme and rapid weight loss may be a trigger for this condition.

Usually, your hair goes through a natural cycle of growth (anagen phase), transformation (catagen phase), and rest (telogen phase), leading to hair shedding. During the resting phase (about 3 months long), your hair stops growing and eventually sheds. The average person naturally loses about 50 to 150 hairs a day.

If you have telogen effluvium, it is thought some type of stressful change in your body sends more hair follicles (about 7% to 35%) into the resting and shedding phase. For example, with telogen effluvium you may lose about 300 hairs a day instead of 100, on average, leading to a noticeable hair loss. This may begin about 2 to 3 months after your rapid weight loss starts.

What causes telogen effluvium?

Researchers are not exactly sure what the mechanism is, but common triggers for telogen effluvium may include:

• a serious or chronic, debilitating illness or infection
• major physical trauma
• childbirth
• major surgery
• high fever
• hormone imbalances (like low or high thyroid) or androgen excess
• rapid or extreme weight loss
• nutritional or vitamin deficiencies that require supplementation
• psychological or emotional stress
• certain medications

Low-level but continuous stress in whatever form, be it incessant background noise, poor diet, or drawn out work troubles, has been shown to contribute to hair loss. Chronic stress can also occur as a negative feedback loop, whereby the stress of worrying about your hair falling out actually contributes to its continuing demise—the self-fulfilling prophecy.

Hormonal imbalances play a key role in the state of your hair as well. Long-accepted hormonal contributors to hair loss include:  low ratio of estrogen to testosterone in women (which often occurs during and after menopause), underactive thyroid hormone in both men and women (and which is impacted by significant reductions in caloric intake), as well as excess testosterone in both men and women insulin resistance in both men and women  While prescribing hormone-specific solutions for your hair is a whole article in itself, the key here is to focus on but one word: balance. As cliched as it sounds, true health is achieved by balancing all the systems, processes, inputs and outputs in your body…and the same is true for hair loss. Your first step might be to do a hormone test, or it might be to get back to basics with diet and lifestyle.

And again, in addition to sudden changes in eating habits and caloric intake, nutritional deficiencies resulting from low protein or caloric intake can dramatically increase the possibility of hair shedding due to the rapid weight loss associated with these medications and a diet rich in nutrient dense foods combined with vitamin and nutrient supplementation is strongly recommended.

Is hair loss with Ozempic, Wegovy, Zepbound or Mounjaro permanent? Will I go bald?

The good news is that hair loss or hair shedding (telogen effluvium) is usually a temporary side effect of rapid weight loss with these medications, and is not typically permanent. It’s also relatively uncommon, occurring in less than 5% of people, based on available clinical data, and typically only affects hair on the scalp.

Most people report that their hair tends to thin and may come out more frequently in the hairbrush, rather than leaving a bald spot. You may notice hair falling out when shampooing or brushing your hair, but it does not fall out in clumps.

Usually, once your weight stabilizes, this side effect will subside and your hair will regrow to its original thickness before you started treatment. Although you may notice hair thinning, other people may not recognize it all.

When does hair loss start?

Telogen effluvium hair loss usually starts about 3 months after weight loss begins, lasts for several months, and reverses over 6 to 12 months once your weight loss is stabilized, although the timeline can vary.

If you experience hair loss that is worrisome or does not go away when using Ozempic, Wegovy, Zepbound or Mounjaro, contact your weight loss healthcare provider, dermatologist or trichologist for a further evaluation. There can be other causes for hair loss that may be more serious or permanent. Your doctor can determine if treatment for hair loss is needed.

How can I prevent hair loss when losing weight with Ozempic, Wegovy, Zepbound or Mounjaro?

When you start treatment, talk with your healthcare provider about your expected weight loss goal, the time frame, and how you should approach a healthy diet, including recommendations for nutritional supplements. You may also want to meet with a registered dietician for diet, meal planning and nutritional supplement advice.

Find out what mix of healthy food and beverages you should be consuming, and how often. While this may not prevent temporary hair loss with Ozempic, Wegovy, Zepbound or Mounjaro, it’s always a good idea to follow a healthy and recommended diet for weight loss. when using these medications making sure to include enough protein, iron, B vitamins — especially biotin — and zinc can all help reduce and/or prevent hair shedding if malnutrition is a factor.

Weight loss with these treatments usually continue over a year, before you stabilize at your goal weight, and then continued, often at lower dosages, to help maintain your weight loss.

If you notice hair loss while using any of these medications, or if you are losing weight more rapidly than expected, contact your healthcare provider. While telogen effluvium is typically a short-lived event and resolves on its own, you may need adjustments in your calorie or protein intake, vitamins or other nutritional supplements.

Let your healthcare provider know about all the medications you take. Be sure to include prescription drugs, over-the-counter medicines, and any vitamins, herbal or dietary supplements.

Your doctor or trichologist can also evaluate your diet and stress levels, and help to confirm there is not another contributing, or alternative cause of your hair loss, such as altered thyroid levels, polycystic ovary syndrome, or iron deficiency. If lab testing is needed, your doctor can assist with this.

If you notice hair loss, this might also be a good time to take a break from harsh chemical additives or rough styling tools for your hair. Use more gentle cleansing products and avoid excessive heat and tugging on your scalp.

For additional tips see Four Ways to a Healthier Scalp that can Help Prevent Hair Loss and 10 Ways to Make Your Hair Grow Back.

Which drugs can cause hair loss (telogen effluvium)?

There is a long list of drugs and drug classes known to cause temporary hair loss from telogen effluvium. Some of the more common agents include:

• Statins
• Blood thinners
• Seizure medicines
• Some thyroid medicines
• Beta blockers
• Hormones (for example: oral contraceptives, hormone replacement therapy, octreotide)
• Levodopa
• NSAIDs (for example: ibuprofen or naproxen)
• Certain mental health drugs (for example: antidepressants, anti-anxiety, or antipsychotics)
• Selective estrogen receptor modulators (SERMs)
• Sedating (H2) antihistamines
• Antifungals

*Note that not all drugs within each class have been linked to telogen effluvium, but if you are experiencing unexplained hair loss, contact your health care provider for further evaluation.

What are Ozempic, Wegovy, Zepbound and Mounjaro approved to treat?

Ozempic and Mounjaro are approved for the treatment of type 2 diabetes. At this time, Zepbound and Wegovy are the only medications approved specifically for weight loss. Phase 3 studies evaluating tirzepatide (Mounjaro) for use as a weight-loss treatment are under review by the FDA at this time.

• Both Mounjaro and Zepbound (tirzepatide), from Eli Lilly, and Ozempic (semaglutide), from Novo Nordisk, are currently approved to help control blood glucose (sugar) levels in patients with type 2 diabetes, when used in addition to a diet plan and regular exercise. Ozempic is also approved to reduce the risk of major cardiovascular events (like a stroke or heart attack) in adults.
• Wegovy (semaglutide), from Novo Nordisk, are used in addition to diet and exercise for chronic weight management in adults and teens. In adults, it is used for overweight (BMI ≥27 kg/m2) or obese (BMI ≥30 kg/m2) patients. In pediatric patients aged 12 years and older, it is used in those with an initial BMI at the 95th percentile or greater for age and sex (obesity).

Semaglutide (Ozempic, Wegovy) are glucagon-like peptide-1 (GLP-1) receptor agonists, also known as incretin mimetics. Mounjaro is a dual-acting glucose-dependent insulinotropic polypeptide and GLP-1 agonist. All three medicines are given as subcutaneous injections (given by a needle under the skin).

What are the most common side effects with these drugs?

The glucagon-like peptide-1 (GLP-1) receptor agonists are well-known for causing stomach side effects, but these are typically tolerable and short-term for most people. These include mild or moderate nausea, diarrhea, vomiting, constipation, and stomach pain.

More serious, but less common or even rare side effects include a risk for thyroid cancer, which has been seen in animal studies, inflammation of the pancreas (pancreatitis), gallstones (stones in the gallbladder), and low blood sugar (hypoglycemia).

Low blood sugar (hypoglycemia) is also a common side effect when used in people taking certain other diabetes treatments like sulfonylureas or insulin) and can be serious.

Other side effects to be aware of include those in the eye (diabetic retinopathy) and serious allergic reactions.

This is not all the information you need to know about Ozempic, Wegovy, Zepbound or Mounjaro for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.

Both we and the AHLA strongly warn against the misuse of Ozempic, Wegovy, Zepbound or Mounjaro and similar drugs for rapid weight loss purposes due to the potential for both temporary and permanent hair loss. We urge individuals to take this warning seriously and to seek appropriate medical guidance before using any medication for unintended purposes.