<\/p>\n
No one knows GLP-1s quite like a doctor who was prescribing them long before they were cool. New York endocrinologist Rekha Kumar, MD was using them off-label for weight management 20 years ago, back when patients were wary of trying them and wouldn\u2019t tell anyone if they did. Now, she said, she hears things like, \u201cI went out to lunch and I was the only patient not on this. I want this.\u201d<\/p>\n
At NewBeauty\u2019s first The State of Aesthetics<\/em> Roundtable in New York, Dr. Kumar, who attended as a guest of Novo Nordisk, walked the room through how far these medicines have come and what patients need to get the most from them. She joined dermatologists, plastic surgeons and brand partners at the table, including Novo Nordisk, the company behind Ozempic and Wegovy. Its next potential option, CagriSema, a once-weekly shot that pairs semaglutide with cagrilintide, a long-acting version of the hormone amylin, is under FDA review.<\/p>\n<\/div>\n Before there was an FDA-approved GLP-1 for weight management, doctors like Dr. Kumar prescribed diabetes medications off-label, and patients resisted. \u201cEven the smartest patients, when they saw the pen and they saw the needle, they were like, \u2018That\u2019s insulin. I don\u2019t want to do this,\u2019\u201d she said.<\/p>\n Those who did try them kept quiet. \u201cWe would see patients that would have tremendous success, and they would tell other people that they got that way from various lifestyle intervention programs, but we obviously knew the truth,\u201d Dr. Kumar said.<\/p>\n Some of her earliest success stories were young women with what is now called PMOS (formerly PCOS), whose cycles resumed and skin improved. She stressed that these patients needed close monitoring. Still, she said, \u201cthey would say things like, \u2018This is the first time I feel normal.\u2019\u201d<\/p>\n What turned skeptical physicians around was heart data. Novo Nordisk\u2019s SELECT trial of Wegovy (semaglutide) found that the medication reduced the risk of major cardiovascular events in adults with heart disease and overweight or obesity, and in 2024 the FDA added that benefit to Wegovy\u2019s label. \u201cThe SELECT trial that showed a 20 percent reduction in heart attack, stroke and cardiovascular death actually convinced the PCPs that there was real biology here,\u201d Dr. Kumar said.<\/p>\n Before that, she said, many doctors dismissed the medication as cheating, or stopped it once a patient reached a healthy weight. \u201cAnd then they\u2019d regain all the weight.\u201d<\/p>\n Today the options keep widening. Wegovy now comes as a once-weekly injection, a higher-dose Wegovy HD for patients already on treatment and a daily pill for people who would rather skip needles.<\/p>\n That\u2019s one reason Dr. Kumar\u2019s advice on sourcing is simple. \u201cI would always say to use a branded product if you can,\u201d she said. Compounded versions surged during shortages that have since ended, she explained, and with direct-to-consumer pricing on some branded options, some people now pay more for a compound than they would for the brand.<\/p>\n So why do compounds persist? In Dr. Kumar\u2019s view, patients are paying for the experience. Successful GLP-1 treatment takes far more touchpoints than a typical office visit allows: \u201cfrequent visits, dietitian, exercise physiologist, behavioral support, very hands-on care.\u201d That\u2019s a big reason telehealth took off. \u201cIt was able to actually scale something that wasn\u2019t scalable in a brick-and-mortar practice,\u201d she said. \u201cI think that the reason compounds are still around aren\u2019t price, but rather the experience around the care they\u2019re getting.\u201d<\/p>\n Austin, TX plastic surgeon Johnny Franco, MD also attended as a guest of Novo Nordisk. He has lost 90 pounds on GLP-1 medication himself and hears what happens when that support is missing. \u201cThey said, \u2018Sure.\u2019 They sent a prescription. I never heard from them again. Every month, they just increased my dose. I told them I\u2019m sick. They said they sent in some Zofran. Like, that was it,\u201d he said, describing what patients tell him.<\/p>\n The takeaway: The best results come from the right medication paired with real follow-up.<\/p>\n Many GLP-1 patients now find their way to aesthetic practices, and the doctors at the table were candid about what they see. New York dermatologist Amanda Doyle, MD pointed to research on facial volume during GLP-1 weight loss. \u201cIf you lose 22 pounds, you can lose up to 7 percent of your facial volume,\u201d she said, citing a small 2025 imaging study of the midface.<\/p>\n Other observations are earlier-stage. \u201cThis is anecdotal, admittedly,\u201d said Beverly Hills, CA plastic surgeon Charles Galanis, MD of patients on GLP-1s, \u201ctheir skin is different.\u201d Dermatologists also flagged hair thinning and the importance of protein and strength training to protect muscle.<\/p>\n Does every dermatologist and plastic surgeon need to prescribe? Dr. Kumar doesn\u2019t think so. \u201cI don\u2019t think they should have to, but I think that they should have either some very close connection, collaboration or somebody in the office,\u201d she said. Dr. Franco agreed: \u201cIf you don\u2019t want to prescribe it, partner with somebody, but don\u2019t just let them go.\u201d<\/p>\n New York dermatologist Doris Day, MD summed it up. \u201cThis is a lifelong approach,\u201d she said. \u201cIt\u2019s not just to get to this point and then you\u2019ll stop.\u201d<\/p>\n Like any prescription medication, GLP-1s carry side effects, most often gastrointestinal, and they aren\u2019t right for everyone, so the decision belongs with a qualified provider. But for Dr. Kumar, the bigger story is how much these medicines have changed what\u2019s possible. \u201cThere was a time when your biology or your genetics was your destiny,\u201d she said. Her hope is that idea becomes history.<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":" No one knows GLP-1s quite like a doctor who was prescri […]<\/p>\n","protected":false},"author":1,"featured_media":3470,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[55],"tags":[],"_links":{"self":[{"href":"https:\/\/nichebeaty.com\/index.php\/wp-json\/wp\/v2\/posts\/3469"}],"collection":[{"href":"https:\/\/nichebeaty.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/nichebeaty.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/nichebeaty.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/nichebeaty.com\/index.php\/wp-json\/wp\/v2\/comments?post=3469"}],"version-history":[{"count":0,"href":"https:\/\/nichebeaty.com\/index.php\/wp-json\/wp\/v2\/posts\/3469\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/nichebeaty.com\/index.php\/wp-json\/wp\/v2\/media\/3470"}],"wp:attachment":[{"href":"https:\/\/nichebeaty.com\/index.php\/wp-json\/wp\/v2\/media?parent=3469"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/nichebeaty.com\/index.php\/wp-json\/wp\/v2\/categories?post=3469"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/nichebeaty.com\/index.php\/wp-json\/wp\/v2\/tags?post=3469"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}From Secret to Status<\/h2>\n
The Trial That Changed Minds<\/h2>\n
More Ways to Take It<\/h2>\n
The Care Around the Medication<\/h2>\n
Where Aesthetic Doctors Fit In<\/h2>\n
A New Kind of Destiny<\/h2>\n