What does this video actually claim?
Dr. Gabbay tells his 300K TikTok followers that GLP-1 drugs like Ozempic cause loose skin because they "melt fat fast" and fat supports skin structure. He recommends slow weight loss, high protein intake, and resistance training to minimize skin laxity.
The plastic surgeon positions himself as an expert on post-weight-loss body changes. His advice targets people worried about "Ozempic face" and loose skin after rapid weight loss on semaglutide or tirzepatide.
He's essentially selling a problem and hinting at solutions, which makes sense since he's a plastic surgeon who profits from body contouring procedures.
Does the science back up his loose skin claims?
The loose skin part is accurate. The STEP 1 trial (Wilding et al., NEJM, 2021) showed 14.9% body weight loss at 68 weeks with 2.4mg semaglutide. Losing 30-50+ pounds in a year will cause skin laxity in most people over 30.
But Gabbay oversimplifies the mechanism. Skin elasticity depends on collagen and elastin fibers, not just underlying fat volume. Age, genetics, sun damage, and smoking matter more than speed of weight loss for skin recovery.
A 2019 study in Plastic and Reconstructive Surgery found that people who lost weight quickly through bariatric surgery had similar skin laxity outcomes to those with slower weight loss. The total amount of weight lost predicted loose skin better than the rate.
What did he get wrong about protein and resistance training?
His protein and resistance training advice is solid but he doesn't give specifics. The STEP 1 trial participants lost about 39% lean body mass along with fat, which is actually better than typical dieting.
Research shows 1.2-1.6g protein per kg body weight helps preserve muscle during weight loss. For a 200-pound person, that's roughly 110-145g daily. Gabbay doesn't mention numbers, just says "high protein."
The resistance training recommendation is smart. A 2021 study in Obesity found that people on liraglutide who did strength training lost 40% less muscle mass than those doing cardio only. But again, no specifics from Dr. Gabbay about frequency or intensity.
Is slow weight loss really better for skin?
This is where Gabbay gets it wrong. There's limited evidence that slower weight loss prevents loose skin better than faster loss when you're talking about 50+ pound reductions.
The bigger issue is that GLP-1 drugs work precisely because they enable faster, more sustained weight loss than traditional methods. The SURMOUNT-1 trial showed 20.9% body weight reduction with 15mg tirzepatide over 72 weeks.
Telling patients to slow down their weight loss to avoid loose skin could undermine the medication's effectiveness. You'll still get loose skin losing 40 pounds slowly, just with more time spent obese.
What should you actually know about GLP-1s and skin changes?
Loose skin is a predictable side effect of major weight loss, regardless of method. If you lose 20% of your body weight on semaglutide or tirzepatide, you'll probably have some skin laxity.
The good news? Most people care more about health improvements than cosmetic concerns. The STEP 1 trial showed major improvements in blood pressure, cholesterol, and diabetes risk that outweigh aesthetic issues.
Non-surgical skin tightening treatments have limited effectiveness for significant laxity. If loose skin bothers you after weight stabilization, surgical options like body contouring work well but cost $8,000-15,000+ per area.