Wendy Lewis explores the connection between rapid weight loss, nutrient deficiencies, and hair loss, while aesthetic experts share strategies to help patients maintain confidence and scalp health

Picture this: You notice some hair on your pillowcase or pieces of hair in the shower drain. Your hairbrush needs to be cleaned after every use. When you wear a light-colored top or sweater, a few strands appear that you didn’t notice before.

This may be the downside of GLP-1, and it happened to me. I didn’t realise the source until the women in New York’s Yves Durif Salon in the Carlyle set me straight. They have been seeing this unfortunate side-effect frequently from a lot of their clientele. 

The use of GLP-1 medications has increased sharply in recent years since studies demonstrated that these drugs can help people significantly for weight loss, as well as a plethora of other benefits.  

Since 2020, the number of prescriptions for these drugs has more than tripled, according to a RAND study.1

Although GLP-1s were originally used to treat obese patients, it has become an uber-popular solution all around the world in record time.

GLP-1 in the USA

According to the Centers for Disease Control (CDC) in the US, obesity is defined as having a body mass index (BMI) of 30.0 or higher. Severe obesity is defined as having a BMI of 40.0 or higher.2

It is no surprise that Americans pay 2–4 times more for GLP-1s than in Europe or anywhere else. In 2026, some direct-to-consumer programmes have lowered the cost for some patients in the US. GLP-1 drugs are now available across a wide cash-pay range, from roughly $150 to $450 per month, depending on the drug, dose, and format. As many as 48 million Americans who want to lose weight expect to start a GLP-1 drug in 2026.3

In the US, Ozempic (Novo Nordisk; Bagsværd, Denmark) has become nearly synonymous with modern weight loss. GLP-1 medications are being hailed as breakthrough treatments, reshaping how we think about managing weight and metabolic health. Considering more than 40% of US adults have obesity,2 Novo Nordisk has received approval from the USA Food and Drug Administration for the first GLP pill for weight loss. Eli Lilly (Indianapolis, IN, USA) is expecting to have their own weight loss pill in the market later in 2026.3

The abundance of affordable and available choices has increased the number of patients seeking these treatments exponentially. Some patients may experience side effects that cause them to reduce their usage or stop GLP-1 medications altogether. If these side effects are not explained in advance to patients, it can come as a big shock. Thus, it is important to explain all potential issues in writing and create a comprehensive list of dos and don’ts so patients are adequately informed. 

Common side effects

While hair shedding after starting GLP-1 therapy may be temporary for some patients, it can still be extremely distressing, particularly if patients were not aware beforehand. The experience can feel especially unsettling for mature individuals who are already prone to thinning hair. This can be extremely upsetting when it comes as a surprise. 

In my case, I didn’t realise my own hair thinning experience until I had to call the handyman in my building to fix my bathroom, since it was clogged. He knew instantly that my strands of hair in the sink were the culprit. That was a rude awakening for me. 

‘Hair loss can occur while taking weight-management medications, such as GLP-1 and GIP agonists, because the gut is a nutrient gateway to the hair follicle,’ said Dr Jane Yoo, a dermatologist and Mohs surgeon in New York City. 

Many practitioners report using oral minoxidil to treat hair loss, which is a major step up from the original drug. To put it simply, it is a godsend for users. ‘The main benefit for our patients is that it is converted to an active orally, which makes it much easier to use and more effective, so they are more likely to take it,’ she explained. 

For many patients suffering from hair shedding from GLP‑1, minoxidil is widely considered the first step. Minoxidil encourages blood flow to the scalp and hair follicles, which can help nutrients and oxygen flow into the hair, so it grows back stronger. Some patients also benefit from adjunct therapies such as DE|RIVE® Hair Wellness System (Aesthetic Management Partners; Cordova, TN, USA). This works to support scalp health and optimise hair regrowth. 

Surgical and other options 

According to Plastic Surgeon Barry DiBernardo, MD, FACS, founder of New Jersey Plastic Surgery, ‘Significant hair loss post GLP-1 is a frequent concern of patients. The patients most susceptible tend to be women between 35 and 55, those who have lost weight rapidly, more than 2-3 pounds per week. Patients with a family history of hair loss and those with thin hair texture are especially vulnerable. The key is early intervention.’

He continued, ‘For patients presenting with GLP-1-related hair loss, we check their nutritional status, protein intake, iron levels, vitamin D, and B vitamins. Many patients on these medications struggle with adequate nutrition due to decreased appetite and food intake. I typically recommend a multi-modal approach starting with nutritional optimisation. Low-level laser therapy options have shown excellent results in stimulating follicles affected by telogen effluvium.

‘Hair loss laser therapy paired with pharmaceutical-grade hair growth serums applied during sessions targets the dormant follicles affected by metabolic stress from rapid weight loss. The GetHairMD® Dual-Wave Energy Cap (Southlake, TX, USA) offers an at-home treatment and can significantly enhance the effectiveness of our in-clinic protocols. The consistency of home therapy amplifies the clinical results.’

Marianna Blyumin-Karasik, an integrative dermatologist and co-founder of Precision Skin & Body Institute in Davie, Florida, explained, ‘Malnutrition, malabsorption, and microbial dysbiosis can lead to nutrient deficiencies that stress the hair and contribute to alopecia. Hence, GLP-1’s appetite suppression, altered intestinal processing, and absorption can deprive hair follicles of essential nutrients, such as amino acids, minerals, and micronutrients, resulting in shedding and slowed growth.’

‘Nutraceuticals like Xtressé™ (Maitland, FL, USA) with stress-resistant adaptogens, such as ashwaganda and curcumin, energy boosting NAD+, as well as micronutrient restoring vitamins and minerals, give hair resiliency to withstand various nutrient deficiency pressures. Thus, GLP-1-induced alopecia, such as telogen effluvium, is notable in our patients. We recommend keeping a well-balanced diet and lean on supplemental support,’ she added. 

Oral minoxidil changed the game

Many practitioners report using oral minoxidil to treat hair loss, which is a major step up from the original drug. To put it simply, it is a godsend for users. 

According to New York City Dermatologist Jane Yoo, MD, PLLC, ‘The main benefit for our patients is that it is converted to an active orally, which makes it much easier to use and more effective, so they are more likely to use it.’

Dendy Engelman, MD, FACMS, FAAD, a cosmetic dermatologist in New York City, explained, ‘I’m seeing an increasing number of patients, both women and men, with hair shedding due to medications such as semaglutide or tirzepatide. While these drugs themselves are not directly toxic to hair follicles, rapid weight loss and insufficient nutritional intake can result in weaker hair and increased shedding. Metabolic stress has the potential to trigger telogen effluvium, a form of temporary hair loss in which more hairs than usual enter the resting stage of the hair cycle, thus resulting in sudden hair loss.’ 4 

‘My first recommendation is to optimise their diet and nutrient intake, ensuring that they are getting adequate protein, iron, vitamin D, zinc, and essential fatty acids. I also recommend the NULASTIN® Vibrant Scalp Treatment (Boulder, CO, USA), a serum that delivers elastin-replenishing technology, peptides, and essential nutrients directly to the follicles to help support stronger, healthier hair growth. It is clinically proven to yield results in 12 weeks, and many people notice visible changes in as early as six weeks,’ said Dr Engelman.

Newer scalp-focused options are also emerging, including Obagi Nu-Cil® BioStim™ Scalp Serum (Long Island, CA, USA), a new product from Obagi designed to support scalp health and improve the appearance of thicker, fuller-looking hair.

Jeanine Downie, MD, FAAD, director of image Dermatology® PC in Montclair, NJ, shared, ‘Drastic calorie restriction or reduction can cause hair to go into the resting phase or the telogen phase, where it all starts shedding. It’s like putting the body into starvation mode, and the hair does not like it. I recommend Nutrafol® (Unilever, London, UK) for men and women and DefenAge® 150K hair serum (Progenitor Biologics, LLC; Carlsbad, CA, USA) for the hair, and ZO® Firming Serum (ZO Skin Health; Irvine, CA, USA) to help with loose skin. Lambdapil® shampoo (ISDIN S.A. Barcelona, Spain) and spray for once or twice a week, limited or no heat with heat protectors, deep penetrating protein conditioners, and minimal colour that is semi-permanent are helpful.’  

Every practitioner has their own secret sauce to address the side effects of thinning hair. Dermatologist Vivian Bucay, MD, FAAD, from San Antonio, TX, uses laser-assisted delivery of topicals, such as growth factors and exosomes. ‘Occasionally, I use PRP [platelet-rich-plasma], but with the emergence of targeted recombinant exosomes and growth factors, I also recommend a red-light therapy device for home use, but consistent use is key for results.’

‘Many of our patients are either peri or menopausal or post-menopausal, so it is important to establish a diagnosis, as the hair loss may represent telogen effluvium associated with this class of medications,’ said Dr Bucay.

‘Our first line of treatment includes topical 5% minoxidil. I may prescribe oral minoxidil and/or oral dutasteride, a 5-alpha reductase inhibitor to reduce levels of dihydrotestosterone, a form of testosterone associated with pattern hair loss.’

Kavita Mariwalla, MD, a dermatologist in Long Island, New York, said, ‘For patients on GLP-1, my recommendation is to talk to them early-on for strategies for hair loss. Oral minoxidil pulses have worked well in my practice along with KerafactorMD™ (SkinQRI, Lincolnshire, IL, USA). For facial volume loss, I think they need to be combined with skin tightening procedures like Sofwave® (Yokneam, Israel) and Ultherapy® (Merz Aesthetics; Raleigh, NC, USA). The loss of elasticity is a major driving factor in some of the physical changes we see. I think periodic sessions of CoolSculpting®  (AbbVie/Allergan Aesthetics; North Chicago, IL, USA) can help define shape along the GLP-1 journey, especially in the mid-section.’

Lifestyle matters

Protein is essential for healthy hair and growing new hair cells. In addition to advising patients on what they should do at home and what to avoid, many practitioners are taking the time to educate patients about good hair health in general.

‘If their diet is missing the critical nutrients to produce the enzymes needed to support healthy hair growth, they won’t achieve the results they are seeking. At a minimum, we educate them about the need for daily multi-vitamins to fill in the gaps. I recommend adding products with iron and zinc to their diet, as these play an important role in a healthy scalp and hair follicles,’ explained Dr Yoo.

‘We tell patients to avoid clips, pins, tight ponytails, or braids as these can put stress on hair. Avoid rough brushing and heat styling. Using a mild shampoo that won’t strip their scalp of its natural oils is important, as over-washing the hair can cause irritation, so we recommend shampooing no more than three times per week. Scalp massage can stimulate blood circulation to the scalp, improving its overall health and promoting hair regrowth. Using a massage brush or their fingertips to massage the scalp can help distribute haircare products more evenly so they are more effective,’ she added.

Conclusion

GLP-1-related hair loss can be reversible with intervention and the right approach for each patient. Undoubtedly, there are variations of new drugs in the works that may be cheaper, better, and easier to tolerate. There are many tools for practitioners to educate patients and manage potential side effects. Among common treatments, fillers and energy-based devices are often used to help maintain facial contours and offset facial laxity.

Additional trials are underway to address more conditions in the near future: 

  • Zepbound® (Eli Lilly, Indianapolis, IN, USA): Recently approved to treat sleep apnea in some patients with obesity, and trials are underway to study brain diseases and substance abuse disorders. 
  • Teva Pharmaceuticals® – This pharmaceutical company from Tel Aviv, Israel, got US FDA approval for the first generic weight loss GLP-1.  
  • Veradermics® (New Haven, CT, USA): Their VDPHL01 is designed to be the first non-hormonal oral therapeutic for hair regrowth in women and men. Phase 3 trials for males and females are underway.

References

  1. Bozick R, Donofry SD, Rancaño KM. New Weight Loss Drugs: GLP-1 Agonist Use and Side Effects in the United States [Internet]. Rand.org. RAND Corporation; 2025. Available from: https://www.rand.org/pubs/research_reports/RRA4153-1.html
  2. Centers for Disease Control and Prevention. Adult obesity facts [Internet]. CDC. 2024. Available from: https://www.cdc.gov/obesity/adult-obesity-facts/index.html
  3. Jr BL. What to watch for in weight loss drugs in 2026: Price changes, GLP-1 pills and more [Internet]. NBC News. 2026. Available from: https://www.nbcnews.com/health/health-news/weight-loss-drug-prices-2026-glp-1-pills-trumprx-what-expect-rcna249520
  4. Neubauer Z, Ong MM, Singal A, Lipner SR. Increased risk of telogen effluvium with tirzepatide compared to other weight loss medications: A retrospective cohort TriNetX database study. Journal of the American Academy of Dermatology [Internet]. 2025 Aug 22 [cited 2026 Jan 26];93(6):1612–4. Available from: https://www.jaad.org/article/S0190-9622(25)02659-3/abstract