What are Ozempic Feet?

Reading and scrolling through the tabloid press, one can’t fail to miss the number of stories and endless commentary on the benefits of the Glucagon-like receptor agonists (GLP-1 drugs) such as Ozempic®, Mounjaro® and Wegovy®. The drugs have multiple benefits including reducing blood pressure and lowering blood glucose levels, but it has been the effects of weight loss which has attracted most of the media attention.

Can GLP-1 drugs cause heel pain?

The implications of these drugs for podiatrists are not obvious but as these drugs are still relatively new, research will begin to emerge. As one US podiatrist points out they may have direct influence of patient’s management. Improved diabetes control will translate into reduced risks of complications - neuropathy, infection and wound healing. Weight loss too, will alter foot mechanics [1].

One study published in 2024 has already demonstrated the benefits of GLP-1 drugs in diabetes where it was shown that patient using these drugs over traditional hypoglycaemics (sulphonyureas and insulin)  were less likely to suffer foot ulceration, hospitalization and lower limb amputation. The latter finding also being confirmed in an earlier study [2].

With all the upsides, the side effects are often forgotten. A recent review has highlighted a number of dermatological effects, rare but significant, including hypersensitivity reactions, fat inflammation (panniculitis), bullous pemphigoid, and measles-like (morbilliform) drug eruptions [3] that may occur with their use. From a podiatric perspective, time will tell but recently there has been a number of articles on social media discussing the side effect of “Ozempic Feet” (See links here and here).

What are Ozempic Feet?

Ozempic feet is a term coined to describe the effects of rapid loss of fat from the foot. It follows Ozempic teeth and Ozempic face, where there have been reports of rapid weight loss causing facial sagging and wrinkling, sunken eyes and hollow cheeks. On the feet, there have been reports of wrinkled, veiny skin on the dorsum of the foot in patients using GLP-1 drugs.  Rapid weight loss with subsequent rapid reduction of fat from the dorsum of the foot means that the skin may look aged and saggy.

With gradual weight reduction, loss of fat is slower and elastic fibres in the skin can remodel and contract meaning less visible sagging however, loss of dorsal fat on the foot may mean that the veins maybe become more visible.

Loss of Fibrofatty Padding

Of course, as podiatrists we know the most important fat on the foot is that on the plantar surface. There are two significant fat pads on the soles. The plantar heel pad is around 15-20mm thick and composed of fat globules encased in a collagen matrix to form an effective cushion. The thinner plantar forefoot holds the second fat pad cushioning the metatarsal heads.

Rapid weight loss, theoretically, could lead to fat loss from these areas. As we know from other fat pad atrophy disorders this may lead to heel and forefoot pain.

Is there any research evidencing the existence of Ozempic Feet?

How common is it? At this stage it is an unknown. It may be a rare event or more common than first thought as patients on these drugs do not make the link between their weight loss and foot pain. To date there have been few reports in the literature discussing this phenomenon, it has been restricted to expert based opinion in social media channels and the media. However, as with all new discoveries, like COVID, observations first emerge at a single case level that then that drives research which follows afterwards, so we may see studies following in the following months.

References

1.            Daniels, M. Understanding GLP-1 Drugs and Their Impact on Podiatry: A New Frontier in Patient Care. 2025  [cited 2025 May]; Available from: https://www.linkedin.com/pulse/understanding-glp-1-drugs-impact-podiatry-new-frontier-daniels-zbwzf/.

2.            Schäfer, Z., et al., Glucagon-like peptide-1 treatment reduces the risk of diabetes-type 2 related amputations: A cohort study in Denmark. Diabetes Research and Clinical Practice, 2023. 202.

3.            Salazar, C.E., et al., Rare cutaneous adverse reactions associated with GLP-1 agonists: a review of the published literature. Archives of Dermatological Research, 2024. 316(6): p. 248.