Ozempic Butt: What It Is, Why It Happens, and How to Strengthen Your Glutes

If you’ve been using Ozempic (semaglutide) or a similar GLP-1 agonist medication and lost a significant amount of weight, you may have noticed other unexpected changes in your body — especially in your buttocks. Some people describe their once-fuller glutes as looking deflated, saggy, or flat after weight loss, a phenomenon that is known as "Ozempic butt."

“Ozempic butt is the result of significant fat and muscle loss in a region where you naturally store more fat, such as your glutes,” says Claudia Canales, PT, DPT, a physical therapist at Hinge Health. “Despite the name, this issue is not unique to people on GLP-1 agonist medications. Anyone who experiences rapid and significant weight loss — whether through bariatric surgery or other means — may experience similar body changes.”

Beyond cosmetic changes, losing glute mass can also impact how your body moves and functions. The glutes are some of the most powerful muscles in the body, playing a key role in stability, balance, posture, and making movement feel easier and more natural. Weakened glutes can contribute to issues like lower back discomfort, less hip stability, and more difficulty with everyday activities like walking, climbing stairs, or standing up from a seated position.

But you don’t have to accept a weaker or flatter backside as an inevitable side effect of weight loss. The key to preventing and addressing Ozempic butt is strength training to regain mass, including exercises that target your glute muscles. Paired with proper nutrition, resistance training can help maintain muscle mass, improve skin elasticity, and create a more toned appearance.

Read on to learn more about what causes Ozempic butt and how to prevent and address it with tips and exercises from Hinge Health physical therapists.

What Is Ozempic Butt?

Ozempic butt is an informal term for a loss of volume, firmness, or shape in the buttocks after significant weight loss on Ozempic or similar GLP-1 receptor agonist medications. This class of drugs, originally designed for managing type 2 diabetes, is now widely used for weight loss because the medications curb appetite, slow digestion, and promote weight loss. While losing weight can have many health benefits, it often leads to changes in body composition, including reductions in both fat and muscle mass — which is what contributes to the appearance of Ozempic butt.

Unlike natural age-related muscle loss or weight fluctuations from diet and exercise, Ozempic butt is primarily driven by rapid fat loss without sufficient muscle preservation. The buttocks naturally store fat. When this fat diminishes quickly (without maintaining muscle), it can lead to a flatter, deflated, or sagging appearance. In some cases, loose skin may also develop, especially in people who have lost a significant amount of weight. 

While this change in the appearance of the glutes can be frustrating, it’s important to note that the underlying cause is often a combination of fat and muscle loss. It’s not just about the loss of fat but also the lack of muscle tone to maintain glute shape.

Causes of Ozempic Butt

Several factors contribute to the development of Ozempic butt, including:

• Rapid fat loss. The buttocks naturally store a significant amount of fat. When someone loses weight quickly, the fat in this area can shrink rapidly, which can lead to a deflated, sagging, or flattened appearance. 

• Loss of fat where you naturally store more fat. Everyone stores fat a little differently — some people carry more fat in their abdomen; others in their face, buttocks, or other areas. If you naturally store more fat in your glutes, you may notice a more pronounced change in their shape and fullness compared to someone who carries more weight elsewhere. “Part of this is simply a matter of genetics,” says Dr. Canales. 

• Muscle loss. “Any time you lose weight, you lose both fat and muscle. But the faster the weight comes off, the more muscle you’re going to lose — especially if you’re not eating enough calories or doing enough strength training,” explains Dr. Canales. Gluteal muscles (gluteus maximus, medius, and minimus) play a key role in the shape and function of your buttocks. When these muscles shrink, your butt may appear smaller, softer, or less lifted. 

• Loose skin. The ability of skin to bounce back after weight loss depends on factors such as collagen, elastin, hydration, and genetics. “If weight loss is too rapid, the skin doesn’t have time to adjust,” notes Dr. Canales. “This can create loose or sagging skin on your buttocks, making them appear deflated.” 

• Age-related changes. “Ozempic butt can affect people of all ages,” says Dr. Canales. But some people naturally lose collagen, elastin, and muscle mass as they get older, which can make the effects of rapid weight loss more pronounced. Older individuals may also find that their skin becomes thinner and less resilient, making it harder to adapt to changes in body composition.

The best way to counteract the effects of Ozempic butt is through movement — specifically, resistance and strength training moves that target your glute muscles. “Total-body strength training is always beneficial,” Dr. Canales emphasizes. “But if your primary concern is Ozempic butt, I recommend focusing on lower body and glute strengthening exercises specifically a few times per week.” Hinge Health physical therapists recommend starting with these exercises, but working with your own dedicated physical therapist can offer more tailored guidance. The key? Consistency. With the right approach, you can rebuild strength and keep your glutes strong and supported.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Treatment Options for Ozempic Butt

If you’re already seeing signs of Ozempic butt — such as sagging, volume loss, or a flatter appearance — there are several approaches to address it. Here are a few effective and sustainable solutions that focus on strengthening your muscles and improving overall fitness. 

• Strength training. “Resistance exercises can help rebuild lost volume in your glutes,” says Dr. Canales. “It’s one of the best ways to restore both appearance and function after significant or rapid weight loss.” 

• Work with a physical therapist. If pain is limiting you from working on strengthening your glutes, a physical therapist can help create a personalized plan to reduce pain and safely work toward your goals. They can assess muscle imbalances, recommend targeted movements, and ensure you're engaging the right muscles effectively. This is especially helpful if rapid weight loss has led to decreased muscle function, postural changes, or joint discomfort. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.

• Eat a protein-rich diet. Protein is essential for muscle repair and growth, making it a key part of restoring volume in your buttocks, notes Dr. Canales. Foods like lean meats, fish, eggs, dairy, tofu, legumes, and protein shakes can help provide the necessary building blocks for muscle recovery. Aim to spread protein intake throughout the day to support consistent muscle growth. Combining protein with strength training enhances your ability to regain muscle mass in areas affected by weight loss.

• Hydrate. Water supports protein metabolism, nutrient absorption, and circulation, all of which contribute to muscle repair and growth. Proper hydration can also help maintain skin and muscle firmness, which may improve the appearance of sagging after weight loss. Aim to drink at least half your body weight in ounces of water each day to keep your muscles and tissues healthy. 

There are also more expensive options such as cosmetic treatments for Ozempic butt, like dermal fillers, fat transfer (BBL), or skin-tightening procedures. These can restore volume to your glutes but they don’t address the underlying muscle loss that contributes to changes in shape and firmness. A more sustainable and health-focused approach involves strength training, nutrition, and hydration to rebuild muscle and support overall body composition. 

How to Avoid Ozempic Butt

If you're currently taking a GLP-1 agonist medication, there are steps you can take to minimize the risk of developing Ozempic butt. 

• Incorporate strength training early. Incorporating strength training from the start of your weight loss journey can help maintain and even build muscle mass in your glutes.

• Move your body. While focusing on glute exercises is important, overall body movement — such as walking, cycling, or swimming — helps promote balanced muscle preservation. 

• Eat healthy fats. Essential fatty acids, like those found in avocados, nuts, seeds, and olive oil, support skin elasticity and muscle recovery. Healthy fats also play a role in maintaining overall body composition and can help prevent excessive fat loss in certain areas.

• Try to lose weight gradually. Rapid weight loss increases the likelihood of losing both fat and muscle, leading to a more pronounced change in body shape. Slow, steady weight loss allows your body to adjust while minimizing muscle breakdown. “If you’re taking a medication like Ozempic for weight loss specifically, talk to your doctor about your dose. They may be able to adjust your dose to help you lose weight more gradually,” says Dr. Canales. 

PT Tip: Celebrate Your Progress 

Weight loss is a personal journey, and it’s important to celebrate the progress you’ve made. “It’s easy to focus on what’s changed in your body — or what you wish you could change — but remember why you started,” says Dr. Canales. “You’re working toward a healthier version of yourself, and that’s something to be proud of.” Instead of dwelling on perceived imperfections in your appearance, focus on your improved health, strength, and mobility. Recognize that taking care of your body — through strength training, nutrition, and movement — is an investment in your long-term well-being. 

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Wilding, J. P. H., Batterham, R. L., & Calanna, S. (2021). Once-Weekly Semaglutide in Adults with Overweight or Obesity. The New England Journal of Medicine, 384(11), 989–1002. doi:10.1056/NEJMoa2032183

2. Bergmann, N. C., Davies, M. J., Lingvay, I., & Knop, F. K. (2022). Semaglutide for the treatment of overweight and obesity: A review. Diabetes, Obesity and Metabolism, 25(1). doi:10.1111/dom.14863

3. Garvey, W. T., Batterham, R. L., Bhatta, M., Buscemi, S., Christensen, L. N., Frias, J. P., Jódar, E., Kandler, K., Rigas, G., Wadden, T. A., & Wharton, S. (2022). Two-year effects of semaglutide in adults with overweight or obesity: the STEP 5 trial. Nature Medicine, 28(10), 2083–2091. doi:10.1038/s41591-022-02026-4

4. Sardeli, A., Komatsu, T., Mori, M., Gáspari, A., & Chacon-Mikahil, M. (2018). Resistance Training Prevents Muscle Loss Induced by Caloric Restriction in Obese Elderly Individuals: A Systematic Review and Meta-Analysis. Nutrients, 10(4), 423. doi:10.3390/nu10040423

5. Gross, K., & Brinkmann, C. (2024). Why you should not skip tailored exercise interventions when using incretin mimetics for weight loss. Frontiers in Endocrinology, 15. doi:10.3389/fendo.2024.1449653

6. Kim, J. E., O’Connor, L. E., Sands, L. P., Slebodnik, M. B., & Campbell, W. W. (2016). Effects of dietary protein intake on body composition changes after weight loss in older adults: a systematic review and meta-analysis. Nutrition Reviews, 74(3), 210–224. doi:10.1093/nutrit/nuv065