Ultherapy Prime, Weight Loss and Ozempic Face Oh My

Season 2, Episode 113,   Feb 12, 03:00 PM

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Episode Summary:
In this episode, Dr. Liza Leal discusses how rapid weight loss from GLP-1 medications can affect collagen, muscle, hydration, thyroid function, and hormones. She explains why adequate protein intake, resistance training, proper hydration, and hormone optimization are essential for maintaining healthy skin, metabolism, and energy during weight loss. Dr. Leal also shares in-office treatment options that stimulate collagen production and emphasizes a personalized, whole-body approach to longevity and wellness.

Hi everyone, I’m Dr. Liza Leal, your host today for the Meridian Medical Dental Healthcare Podcast, powered by Meridian Health Institute — and I’m also known as your Everyday Health Hacker.

Today we’re talking about what’s really happening to your collagen, muscle, and hormones when you’re on GLP-1 medications — and more importantly, what you can do to stay looking healthy, strong, and vibrant while you lose weight.

 A lot of people using GLP medications experience rapid fat loss. While that’s wonderful for metabolic health, many people start noticing changes in their skin. Their face can look more hollow or sallow, skin may feel thinner or less elastic, and they may notice sagging in areas like the jawline, neck, arms, or abdomen.

 So let’s talk about how to prevent that.

🥩 Protein Is Non-Negotiable

The first thing I tell patients on GLPs is:

You must be eating enough protein.

At a minimum, most people need around 100 grams of protein per day, though that varies based on body size and muscle mass.

If someone isn’t eating enough, we may slow the titration of their GLP medication. Your body needs nutrients in order to regenerate tissue — especially collagen and muscle.

Even if you are taking collagen supplements, it often isn’t enough by itself during rapid weight loss.

Research shows that after significant weight reduction, facial collagen can decrease — which is why we have to be proactive.

🧬 Why Collagen Loss Happens

When fat volume decreases quickly, the structural support beneath the skin also declines. That can lead to:

  • Hollowing in the cheeks
  • Looser skin in the face and neck
  • Crepey skin on the arms or abdomen


This is sometimes nicknamed “Ozempic face,” but it’s really collagen loss combined with fat loss.

💡 How We Stimulate Collagen

 One treatment we use is Ultherapy PRIME, an FDA-cleared ultrasound treatment that stimulates fibroblasts to produce collagen.

It can be used on the face, neck, décolleté, arms, abdomen, and other areas that need tightening.

We also use Radiesse, a calcium hydroxylapatite (CaHA) biostimulator. When hyper-diluted, it isn’t used as a filler — it’s used to stimulate your own collagen production and improve skin firmness and elasticity.

 The goal is never to make you look “filled.” The goal is to help you look naturally supported and refreshed.

💪 Muscle Preservation = Metabolic Protection

People ask, “How do I keep muscle while losing weight?”

Two essentials:

✔ Protein

✔ Resistance training

If you’re over 40, lifting weights should be part of your weekly routine. Muscle supports metabolism, protects joints, and helps skin look better by maintaining structure underneath.

🔥 Thyroid & Weight Loss Resistance

Another hormone we have to talk about is the thyroid.

Your thyroid controls your metabolic rate. Some patients do everything right — exercise, eat well, follow their GLP plan — but still struggle with fatigue and slow weight loss.

They’re often told their labs are “normal.”

But there’s a difference between normal and optimal.

TSH (thyroid stimulating hormone) may fall within a wide lab range, but many women feel best when it’s in a tighter, more optimal window. Personalized thyroid care can include different forms of T3 and T4 depending on the individual.

There is no one-size-fits-all thyroid plan. Personalized medicine is key.

💧 Hydration & GLP Medications

GLPs often blunt thirst signals, which can lead to dehydration.

Aim for:

  • 8 or more large bottles of water daily
  • Add sugar-free electrolytes to 1–2 bottles


Hydration supports metabolism, skin health, muscle function, and energy levels.

🧠 Hormones in Midlife (Women)

In your 40s and beyond, hormonal shifts can affect fat distribution, mood, and skin.
Many women experience:

  • Increased estrone production from fat tissue
  • Lower estradiol and progesterone

Symptoms of progesterone decline may include:

  • Poor sleep
  • Night waking
  • Irritability
  • Breakouts

Balancing hormones supports body composition, mood, and overall vitality.

🥗 How to Calculate Your Protein

Here’s a simple method:

  1. Take your weight in pounds
  2. Divide by 2 to estimate kilograms
  3. Aim for about 1 gram of protein per kilogram


So if you’re 140–180 pounds, you may need roughly 70–90+ grams daily, often closer to 100 grams during active weight loss. 

Great sources include fish, lean meats, eggs, and protein smoothies.

✨ Collagen Nutrients

  • Collagen peptides: 10–20 grams per day
  • Vitamin C: 500–1000 mg daily to support collagen synthesis


Look for high-quality, pharmaceutical-grade supplements to ensure proper dosing.

⚖️ Safe Pace of Weight Loss

Ideal pace: ½ to 1 pound per week

Some patients lose 2–4 pounds weekly at first — often due to reduced sugar cravings — which can be fine short-term if nutrition and muscle support are in place.

When plateaus occur, we reassess protein, inflammation in the diet, hydration, sleep, and exercise.

😴 Sleep & Airway Support

Sleep is essential for metabolic and hormonal balance.

We sometimes use lower jaw orthopedic splints to support proper jaw alignment and airway function, which can improve sleep quality and recovery.

🧬 Regenerative Therapies We Use

In addition to ultrasound and CaHA biostimulators, we may use:

  • Radiofrequency microneedling
  • PRF (platelet-rich fibrin) for skin and hair support and healing

These therapies stimulate natural regeneration.

✨ Final Takeaway

GLP-1 weight loss can be life-changing — but protecting your collagen, muscle, hydration, thyroid, hormones, and sleep is what helps you look and feel your best long-term.
 
At Meridian, we believe in whole-body, personalized care.

I’m Dr. Liza Leal, your Everyday Health Hacker.

Thanks for joining us today on the Meridian Medical Dental Healthcare Podcast.

 Be sure to subscribe, and let us know what topics you’d like us to cover next — we’re here to be your trusted resource for medical and dental healthcare