Ozempic Butt: Is It Really a Thing?

Losing Your Backside on a GLP-1? What It Says About Your Muscle, and How to Protect It

What GLP-1 users need to know about muscle loss, loose skin and how to protect their backside.

“Ozempic butt.” Yes, it’s a thing people are searching for.

First there was the face. Now it’s the bottom. People are even talking about feet and hands. At this rate, we’re going to run out of body parts.

But underneath the rather unfortunate nicknames is something I take very seriously as a Nutritional Medicine Practitioner. When people lose a lot of weight, they don’t only lose fat. They can lose lean muscle too, and that matters far more than the shape of anyone’s jeans.

First, is it actually real?

Sort of.

It isn’t a medical diagnosis, and no medication is specifically targeting your backside. It’s a nickname for a loss of volume around the buttocks, sometimes with loose or sagging skin and reduced muscle, that can follow substantial weight loss.

And it isn’t unique to any one medication. As Cleveland Clinic points out, similar changes can happen with weight loss from diet, exercise, bariatric surgery or GLP-1 medications. So let’s not blame the injection for personally stealing your bottom. The bigger issue is what we lose when we lose weight.

Your bottom isn’t just fat

Your glutes are some of the largest muscles in your body. You need them to walk, climb stairs, get out of a chair, steady your pelvis and stay strong and mobile as you age.

That’s why I’m far less interested in people simply becoming smaller. I want them becoming stronger.

The research backs this up. A 2026 systematic review and meta-analysis of 20 randomised controlled trials, involving 15,782 people, found lean mass made up roughly 25 to 39 per cent of the weight lost on incretin-based medications, depending on the medication. Weight loss from lifestyle changes alone also involved some loss of lean mass.

So this isn’t evidence that GLP-1 medications are uniquely “muscle-wasting”. It’s evidence that significant weight loss, by any method, deserves a muscle-protection strategy. Tellingly, in that same analysis, the programs that included resistance training had the best result, with lean mass making up only around 17.5 per cent of the weight lost.

Why might your bottom suddenly look different?

A few things may be happening at once:

• You’re losing fat from your buttocks.

• You may also be losing some muscle.

• After big or fast weight loss, your skin may not keep up with your new size.

Voilà. Your jeans fit beautifully around the waist and suddenly you’re wondering where your bottom went. No fun.

Unfortunately, we can’t send our fat cells a polite email saying, “Please take 5 kg from my tummy but leave my cheeks exactly where they are.” If only.

How to protect your muscle on a GLP-1: my three rules

These are the three rules I give people losing a lot of weight on GLP-1 medications.

Rule 1: Make the first bite of every meal protein

And yes, I mean the first bite.

Why? A small appetite is common on GLP-1 medications, and that creates a nutrition problem. You sit down to a meal, eat five mouthfuls, and suddenly you’re done. So get the heavy lifters in first: eggs, Greek yoghurt, chicken, fish, cottage cheese, lean meat, tofu, tempeh, or legumes paired with other protein-rich foods. Protein gives your body the amino acids it needs to maintain and build muscle.

This is also how people fall into what I call the Cracker Trap. They’re nauseous. They’re not hungry. Crackers are easy. Coffee, crackers, half a banana, perhaps another cracker. Meanwhile the scales are heading south, so everything looks marvellous, except your muscles never got the memo.

Small appetite? Protein gets first dibs.

Will protein stop loose skin? Of course not. Age, genetics, skin elasticity, starting weight, and how much and how fast you lose all play a part. But we can give your body the building blocks to hold on to its muscle. Less wasted muscle, more strong and healthy body. That’s the plan.

For more on protein targets, read GLP-1 Muscle Loss: How to Keep Your Muscle.

Rule 2: Give your muscles a reason to stay

Use them. Every day, think muscle.

That doesn’t mean seven punishing gym sessions a week. Your muscles need recovery too. It means building muscle-minded movement into your life, plus regular, progressive strength training.

Start small. Keep hand weights beside your desk. Do 20 squats. Do 20 shoulder presses. Use resistance bands. Try lunges, step-ups or glute bridges. If it suits you, add resistance to your walks, then move on to proper strength sessions that work your major muscle groups.

Muscle needs a reason to stick around. Your bottom doesn’t need punishment. Your glutes need a job.

Rule 3: Consider creatine monohydrate

Creatine isn’t just for enormous men wandering around gyms carrying water bottles the size of toddlers. It’s one of the most researched supplements in all of sports nutrition.

A 2024 systematic review and meta-analysis found that adding creatine to resistance training increased lean body mass by around 1.14 kg more than training alone in adults under 50. A separate review of 143 studies found creatine increased fat-free mass, with stronger effects when combined with resistance training. The research also supports better upper- and lower-body strength on that combination.

Creatine monohydrate is the form with the big evidence base. A maintenance intake of around 3 to 5 grams a day is common, but whether creatine is right for you, and how much, should be worked out individually.

If you have kidney disease or another significant medical condition, are pregnant, or take medicines that may affect your kidneys, speak with your doctor first. Also tell your GP you’re taking it, because creatine can raise creatinine on a routine kidney blood test.

Protein + weights + creatine

Not quite as glamorous as an Insta-famous wellness expert selling you a $200 bottom cream. But there’s a lot more evidence behind it.

It isn’t really about your bottom

This is the most important point of all.

Your bottom gets Google searches. Sarcopenia, the age-related loss of muscle and strength, doesn’t. But muscle, strength, mobility and healthy ageing are what I actually care about, and they’re what’s quietly at stake behind the cheeky headline.

The science here is nuanced and worth getting right. A 2026 meta-analysis found that although the total amount of lean mass can fall during GLP-1 treatment, lean mass as a proportion of body weight can actually improve. The authors still stressed nutrition and exercise alongside treatment. So be careful with headlines claiming these medications simply “eat muscle”. The reality is more measured.

But the practical message is beautifully simple. If you’re losing weight, on a medication or not, make it count. Nourish yourself. Prioritise protein. Build muscle. Protect your strength. Don’t just aim to become smaller. Aim to become stronger.

And if a stronger bottom comes along for the ride? I’ll call that a win.

Muscle and volume loss after weight loss: frequently asked questions

Is losing volume in your buttocks after weight loss permanent?
Not necessarily. Fat that’s gone won’t come back without weight regain, but muscle can be rebuilt with strength training and enough protein. Skin may tighten somewhat over time. Age, genetics and how fast the weight came off all affect the result.

Does everyone on a GLP-1 lose volume in their bottom?
No. It’s more likely with large or rapid weight loss, and when muscle isn’t actively protected. Prioritising protein and strength training helps protect your muscle.

How much protein should I eat on a GLP-1?
It’s individual, but most people do well with a solid serve of protein at every meal, eaten first before appetite fades. A nutritionist can tailor an amount to your body weight, goals and health.

Is it safe to take creatine with a GLP-1 medication?
Creatine monohydrate is well researched and generally well tolerated, but it isn’t right for everyone. If you have kidney disease, are pregnant, or take medicines that affect your kidneys, check with your doctor first.

Can you rebuild glute muscle after weight loss?
Yes. Progressive strength training, such as squats, lunges, step-ups, glute bridges and hip thrusts, combined with enough protein, is the most effective way to rebuild and strengthen your glutes.

Have you noticed changes in your strength, muscle tone or shape since starting a GLP-1 medication? I’d love to hear.

Sources: Cleveland Clinic, “Ozempic butt” (body changes after weight loss); 2026 systematic review and meta-analysis of 20 RCTs on lean mass and incretin therapies (PubMed 41877354); Desai et al, Journal of Strength and Conditioning Research, 2024 (creatine and lean mass); Delpino et al, Nutrition, 2022 (143 creatine studies); 2026 meta-analysis on lean mass proportion during GLP-1 treatment. Educational only, not a substitute for individual medical advice.