The Great Shrinking: Peptides Are Taking Over Beauty

And Instagram is selling the drugs

About six months ago I wrote about my one-week Ozempic experiment. I called it quick-hitting. One jab, one reset, and then move on with life. My one hit let me drop a few pounds, quieted the food noise, reset my eating, and got back to my normal weight. The point was never to stay on it long term.

Something strange has happened in the last 6 months since I wrote that piece: Everyone around me is shrinking….like shrinking back to the Kate Moss era of skinny. The “nothing tastes as good as skinny feels” aesthetic has re-emerged.

This isn’t just the celebrity Ozempic discourse you read about in The Cut or the endless speculation around how emaciated Demi Moore looks. Megyn Kelly went off on Margot Robbie this week.

Demi Moore and Oprah’s scary-skinny weight loss journeys have been all over the internet. My readers know I have a love/hate relationship with Demi.

It’s not just celebrities. People I’ve known for years - friends, acquaintances, exes -seem to be withering away before my eyes. I see bobbleheads at dinner tables and cocktail parties. Sunken eyes. Draping skin. And women quietly sourcing their weight-loss injections from Instagram peptide dealers.

Six months ago Ozempic still felt like a slightly scandalous celebrity drug one admitted to use after the fact to lose large amounts of weight. Chrissy Teigen admitted she had used it to lose forty pounds of baby weight and Vogue writing about microdosing felt edgy.

Now? Now it feels like everyone is on it and trying to get as thin as possible.

With so-called “peptide coaches” everywhere and easy sourcing from grey market research websites. I felt compelled to tap my two favorite go to experts in women’s health and nutrition. Read on for their expert takes.

Not unlike all of my discourse on plastic surgery, where do you draw the line here? Who is legitimately using these drugs to help with real metabolic or weight issues and and who is using them out of body dysmorphia or plain laziness?

Let’s dig in…

How Are People Getting These Weight Loss Injections?

I am not against GLP-1s by any means. But many people in my wider social circle are getting them from grey-market peptide websites and using them under the tutelage of instagram influencers posing as health experts.

I spoke to Dana James, a triple‑certified nutritionist with advanced training in functional medicine and cognitive behavioral on the nuances of GLP-1s and her concerns around what she calls the “Wild West” of metabolic power molecules.

Anecdotally, all the women I know that are under doctor or professional supervision are being prescribed Wegovy and Zepbound. Then there is the off-label crew who are operating in the peptide research websites. They are mostly on Retatrutide, which is interesting because Retatrutide is not legally available yet.

Dana says “I am observing a precarious trend across social media: the casual, unsupervised administration of Retatrutide. Because Retatrutide is the “new shiny object” for rapid body recomposition, individuals are increasingly sourcing it through Looksmaxxing influencers and self-administering without professional oversight. This is not a sophisticated biohack but a gamble with metabolic stability.”

She stresses how important it is for the proper clinician to give you the correct GLP-1. ”An experienced clinician develops a preference for one over the other based entirely on the patient’s unique biochemical terrain and metabolic requirements.”

“To appreciate the clinical nuance, consider the distinction between Retatrutide and Tirzepatide as a psychiatrist might evaluate Effexor versus Lexapro. While they inhabit the same therapeutic neighborhood, their molecular ‘wiring’ is distinct.”

How Diet And Lifestyle Changes Are Crucial

I also spoke with Jennifer Hanway, a board-certified holistic nutritionist and certified weight management practitioner who specializes in GLP-1 nutrition and metabolic support for women experiencing hormonal weight gain.

“Most of my clients are on a GLP-1. They work with me because they know the medication alone is not the full picture. Personalized nutrition, supplements, and exercise are what protect lean muscle, maintain metabolic rate, and prevent the premature skin aging that rapid weight loss can cause,” says Jennifer.

As an example, Jennifer guides all clients to eat 1g of protein per pound of bodyweight and at least 30grams at breakfast. This is just the start of her protocols.

She works only with clients who receive peptides via a clinical recommendation. “They will be prescribed via a compounding pharmacy and if the patient isn’t able to get them through insurance they simply pay out of pocket.”

As a reminder, Jennifer notes that the majority of GLP-1 weight loss comes from sustained calorie reduction “rather than direct correction of underlying metabolic dysfunction.” This is why it’s so important to change your diet and work with people who know what they are doing. Without those side-by-side changes and someone monitoring your intake levels, problems emerge..if not immediately....they will down the line.

While Jennifer supports use of GLP-1’s and peptides, she also urges “peptides should come LAST, not first.”

“Thyroid function is where I see the most significant unaddressed issues, and its importance has become overlooked in the quick fix era, even though it is one of the most common and most correctable barriers to weight loss in women. Rapid weight loss, caloric restriction, and reduced nutrient intake can all impair thyroid hormone production and conversion, which shows up as fatigue, hair shedding, and slower skin repair” says Jennifer.

If you do not make other lifestyle and diet changes when on GLP-1s, another major issue that can rear it’s head for women is bone density.

Dana James points this out as a long term issue. “What’s not discussed enough is the potential impact of GLP-1s on bone density. Bone is a metabolically active organ, and rapid weight loss can reduce bone density in the spine and hip by 2-3% for each 10% of body weight lost. Bone supportive nutrients and load bearing activity are crucial.”

Most true experts also suggest adding in at least 3-4 days of resistance and strength training because as Dana notes “mechanical load is a stronger stimulus for preserving muscle than simply pushing protein higher.”

Experts aren’t against the use of GLP-1s, quite the contrary, it’s just that you should be doing them with someone that can manage and monitor your treatment and to be sure you are truly a candidate.

I Am Having Ephedra Déjà Vu

The way I see the uneducated wielding of this injection in present day reminds me of my early 20s. Back then it was Ephedra. So many girls I knew were taking those pills and chugging sugar-free Red Bull. It was skinny magic.

I’m not going to pretend I didn’t try it one time. The crazy jitters and buzz it gave me was an immediate turnoff. And while legally available, something just didn’t feel healthy about it. I tried it once and never again.

Eventually, in 2004 - about a decade after it became mainstream - the FDA banned it because they realized just how dangerous it was. Ephedra is a Chinese shrub which has been used in China for medicinal purposes for several thousand years and is technically natural. It started as a treatment for asthma and then morphed into weight loss.

Researchers discovered that ephedrine boosted the metabolic rate (thermogenesis) and suppressed appetite, leading to its adoption for obesity treatment. It was hailed the new weight loss herb. It took a decade before it was banned because people started developing heart palpitations, hypertension, strokes, seizures, and myocardial infarctions.

Easy weight-loss solutions have a funny habit of aging poorly. I am not saying Ephedra is analogous to GLP-1’s. I am saying the way it’s being used reminds me of those days. And I guess I am just skeptical of things that are “too easy.”

I was an economics major, and one of the first lessons you learn is simple: there is no free lunch. That lesson tends to apply far beyond economics.

Retatrutide is widely being used in the “fitness bro” community to get “shredded” as well as in the LA crowd…who is getting dangerously skinny. It is is being touted as the “best” GLP-1, because it activates three metabolic receptors instead of one. Studies show an average body weight reduction of 24.2% in 48 weeks.” But does everyone need 25% body weight reduction in 48 weeks?

According to Eli Lilly “Retatrutide is not yet available for public use. Lilly is currently studying Retatrutide in Phase 3 clinical trials for obesity, type 2 diabetes, knee osteoarthritis, moderate-to-severe obstructive sleep apnea, chronic low back pain, cardiovascular and renal outcomes, and metabolic dysfunction-associated steatotic liver disease.”

I’ll say it upfront: I am far too thin for any doctor to prescribe a GLP-1 medication to me. At my normal weight - around 113 to 118 pounds at 5’6” - I simply don’t qualify. When I gain a bit of weight, certainly the temptation is there. Especially when you see everyone around you doing it.

The last time I saw one of my former long term partners, I was honestly startled when I saw him. His eyes were sunken in, his frame looked frail, and he had clearly lost an enormous amount of weight. He’s 49 years old but in that moment looked closer to 61.

Over the past year he’s lost around sixty pounds using Retatrutide. Like many people, he had been sourcing it online through Peptide Sciences, the same supplier that has now disappeared and was forced to shut down this past week.

Dysesthesia is also a symptom emerging from Retatrutide. Dysesthesia, an abnormal, often painful sensation affecting up to 20.9% of patients on high dosages. These, largely mild, neurological-type symptoms are thought to be associated with rapid, significant weight loss. Here is a great video from Dr. Rekha Kumar, a metabolism M.D. practicing at my esteemed alma mater, Cornell, explaining the phenomena.

But I do worry. And I find myself worrying about others too - especially the women around me who seem to be losing weight faster and faster. They aren’t using GLP-1’s as a kickstart or a boost or a small assist or layering them against any changes in diet or exercise. It’s simply the new diet pill that they can get their hands on.

Dana explains that “Retatrutide engages the glycogen receptor. When deployed with precision, it is a potent metabolic modulator. When used indiscriminately, you aren’t merely losing “weight” - you are potentially compromising bone mineral density, catabolizing essential skeletal muscle, and depleting the structural visceral fat required to maintain organ position.

It’s serious business don’t you think?

Meanwhile… Let’s Talk About Ozempic Face And Butt

In an unrelated topic, in the middle of all this, I recently had a facelift. And GLP-1s became a topic.

Yes - I finally got a facelift! And I will be writing about all the juicy details soon. Eighteen months of obsessive research, consultations, and spreadsheets of surgeons eventually led to the operating table. A truly embarrassing amount of content on that is coming your way soon.

One unexpected side effect of facelift recovery is that eating becomes very difficult for the first 1-2 weeks. Chewing is awkward. Swelling is real. Your appetite is off.

I went into surgery weighing 118 pounds and ten days later I weighed 111. Turns out you don’t necessarily need GLP1s to lose weight. Sometimes just not eating does the trick.

Mostly all surgeons insist you stop all peptides for at least 60 days before surgery because of anesthesia risks and complications during surgery including wound complications.

Because I am naturally thin and my face was hollowing out (a symptom of age not Ozempic face), in nearly every consultation I was immediately asked if I was on a GLP-1. When fat disappears quickly, facial skin loses structural support and elasticity.

Dr. Amir Karam recently did a great video discussing the impacts on facial aging coming from the use of GLP-1s. Obviously there is the classic ass versus face dilemma that Tatiana Boncompagni wrote about, but GLP-1s accelerate this because weight loss is so rapid.

“Ozempic face” has caused a massive rise in the requests of facial filler and facelifts, so much so that there is a study in the National Library of Medicine discussing the issue. After reading this, I also learned that “Ozempic Butt” is a thing which may also be why BBL’s (brazilian butt lifts) are on the rise. Brazilian Butt Lifts (BBLs) are now increasingly being used to treat this phenomenon by transferring fat from other parts of the body to the buttocks to restore shape.

The Pendulum Always Swings

The cultural shift here is fascinating. For a few years we lived in what felt like the body positivity era, where the prevailing message was acceptance. Weight gain was something to normalize. Now we seem to be entering a completely different phase.

Weight gain can be addressed with a weekly injection, suddenly the body becomes editable again…like trying to match the real life version of yourself to the easily editable instagram filtered version.

I grew up in the Kate Moss era where heroin chic, collarbones, and the idea that you could never be too thin was everywhere. Many of my friends had eating disorders because of this. For a while it seemed like we had moved past that aesthetic.

But lately I’m not so sure. Not through dieting. Not through exercise. Through pharmaceutical thinness. It’s not about being healthy now, it’s back to being super thin. Because you can order an injection from a website with no supervision.

Back in the 90s, girls had their own questionable appetite suppressants. Sugar-free Red Bull. Cigarettes. The occasional line of cocaine in a bathroom at a downtown party. I did partake in all of these often.

Nobody called it wellness. Nobody pretended it was biohacking. But at least everyone was honest about what they were doing.

Now we have grey market “pharmaceutical” injections and a “wellness influencer” lightly supervising. Which one is safer?

Honestly, I’m not entirely sure. But I will say this: if I had to choose between the unregulated peptide lab and the occasional bad decision at a 1998 NYC Soho loft party…

At least the cocaine never tried to convince me it was healthy. And nobody was selling it through an affiliate link. And it was a hella lot more fun. Just ask Kate Moss.