Ozempic, Buccal Fat Removal & Low-Rise Jeans: Is '90s Skinny on Its Way Back (& What Can We Do About It)?

ozempic cat
dasha burobina/purewow

In May 2021, I wrote about body neutrality. In essence, body neutrality means rejecting the idea of having to love or hate our bodies and instead, just accepting the fact that they’re there. Rather than celebrating the way our body looks, why don’t we focus on what our body can do? After years of body positivity (the concept of loving your body, no matter its shape, size, etc.) being at the forefront of conversations about self-image, body neutrality felt refreshingly realistic—and sustainable. (Body positivity is fine, in theory, but in practice can create a mindset that’s toxically black and white: If I don’t love my body, I must hate it.)

But recently, I and many other folks have noticed a concerning crop of trends geared toward the pursuit—and glorification—of thinness. There’s the recent influx of TikTok creators speculating that certain celebrities have been taking Ozempic, an injectable medication meant for patients with Type-2 diabetes, as a means for rapid weight loss; the proliferation of buccal fat removal, a cosmetic procedure that removes fat from the cheeks; and even the return of fashion trends, like low-rise jeans, that harken back to a time when thinness was prioritized over almost all else.

Dr. Erin Parks, PhD and co-founder and Chief Clinical Officer at Equip Health, a mental health platform focused on eating disorders, says, “It’s exhausting to see the influx and popularity of these trends. I was feeling optimistic that we were finally rejecting diet culture as Gen Z brought the body neutrality movement. While I'm disappointed, this whiplash back to the ‘90s will teach us something that will make our next battle against diet culture more effective.”  Meredith O’Brien, LCSW, author of Opening the Door: My Journey Through Anorexia to Full Recovery, adds, "It is very concerning. If there is a rise in weight-loss trends, then there will be an increase in eating disorders, which are serious mental and physical diseases that have the second highest mortality rate of any mental illness."

To learn how we got here—and try to figure out where we go now—I tapped experts in the physical and mental health fields to get the scoop on these alarming signs of a pendulum swing toward ‘90s-era skinny.

I first heard about Ozempic (the brand name of the injectable drug semaglutide) this past September when Variety touted it as “Hollywood’s secret new weight loss drug.” Per the article, “Moguls, reality starlets, veteran film producers and, of course, actors are quietly singing the drug’s praises on Signal, the encrypted messaging app mostly used for confidential conversations. Hair, makeup and styling teams for celebrities have come to accept the injections as part of grooming rituals ahead of major events.”

Are some of these the same celebrities whose voluptuous, ultra-curvy figures drove hordes of people to the Brazilian Butt Lift (BBL), an often dangerous procedure that involves sucking fat out of the stomach, thighs and other parts of the body and injecting it into the butt? They sure are. The message this back-and-forth jumping from body type to body type sends is a dangerous one: that body shapes and sizes are "trends." (See: the famously curvy Kim Kardashian sharing—quite proudly, in fact—that she lost 16 pounds in three weeks to fit into that Marilyn Monroe dress for the Met Gala.)

But back to Ozempic. Dan LeMoine, certified holistic nutrition expert and author of Fear No Food, tells me that while he thinks Ozempic (like any medication) has a place and purpose, that doesn’t mean he’s fully on board. His concerns with Ozempic for weight loss are three-fold: unknown long-term side effects, the sustainability of keeping weight off after discontinued use and the medication’s often brutal short-term side-effects.

In terms of lasting side effects, he tells me, “At this time, it's rather unclear what the long-term side effects are from taking this injectable medication (created originally to treat people with Type-2 diabetes)…If you do not have diabetes or related imbalances, it should beg the question: ‘Why take a type-2 diabetes medication? And if I do, how will this affect my health long-term?’” Regarding sustainability, he explains that there have been mixed results in the clinical studies as to how effective Ozempic is at helping an individual keep the weight off once they stop taking the medication—especially if other lifestyle and diet factors are not followed. “My intuition is that without proper lifestyle, nutrition and social and emotional changes, the likelihood of regaining some of (if not all) the weight over time is high,” he says. Lastly, the short-term side effects—including nausea, vomiting, diarrhea and constipation—which have been detailed in firsthand accounts published in The New York Times, The Washington Post, The Cut and more.

There’s also the question of whether those taking Ozempic for weight loss are making it harder for folks who take the medication for its intended purpose to fill their prescriptions. LeMoine explains that while Ozempic shortages could have to do with global supply chain issues or production shortfalls, “It would, however, stand to reason that if demand is outpacing supply, and if a large portion of that demand is coming from consumers without diabetes looking for a weight loss drug, then we might need to question if there's an issue at hand and if something ought to be done to protect those who depend on Ozempic to help manage their Type-2 Diabetes.”

His bottom line? “In short, weight loss is complex and can be influenced by many factors…I tend to be skeptical when it comes to fad drugs promising to be a quick and easy solution for a very complex problem, as we don’t exactly have a strong track record when it comes to ‘miracle’ drugs."

Also surging in popularity (with more than 175 million views on TikTok), there’s buccal fat removal, a procedure that’s been around for many years but that has recently been thrust into the spotlight, largely thanks to social media detectives hypothesizing about certain celebs’ suddenly gaunt cheeks. Dr. Kimberly Lee is a board-certified facial plastic and reconstructive surgeon who’s been performing buccal fat removal for more than 15 years. She explains, “Buccal fat removal is an extremely popular procedure in my office, even before the current social media popularity. It used to be a clandestine procedure that patients could come and do in the office under local anesthesia and look five to ten pounds thinner without much, if any, downtime.”

Though she thinks it’s a great procedure when done correctly, she cautions that, “[Unlike] a clothing, hair or makeup fad, because this involves your face, it isn't easily changeable or reversible if the fad changes, so it's important to seek an expert in facial plastic surgery.” (TL;DR: Please don’t see your favorite celebrity looking snatched on a red carpet, click on the first Google search result for buccal fat removal in your area and schedule an appointment without further research.)

It's important to note here that there isn’t anything inherently wrong with taking Ozempic as a weight loss tool (there are tons of folks who say their experience has been life-changing) or having your buccal fat removed; it is, however, interesting to consider the cultural subtext and implications of the simultaneous surge in popularity of these procedures, medications and other trends.

Though far less invasive and expensive than Ozempic or buccal fat removal, we’ve also seen certain fashion trends creeping back onto runways that seem to signal a return to the putting on a pedestal of super-skinny bodies. Take, for example, low-rise jeans. As PureWow fashion editor Abby Hepworth wrote back at the end of 2021, “I distinctly remember the frustration I felt as a young woman attempting to make myself look like Amanda Bynes and Lindsay Lohan—lamenting the fact that my stomach wasn’t flat like theirs and how cropped tees worn with low-rise jeans made me feel self-conscious and uncomfortable rather than trendy or cool.” Then there’s Indie Sleaze which, though not inherently problematic from a body-image standpoint, is intrinsically linked to Tumblr, a platform where pro-ana (pro-anorexia) content reigned supreme for years.

I’m 31 years old and even I’ve found myself looking in the mirror with sucked-in cheeks; I can’t imagine what this feels like for impressionable tweens and teens or for my peers who are now the parents of impressionable tweens and teens. What do you do if, say, your 14-year-old cries to you because the jeans she saw in her favorite influencer’s latest clothing haul don’t fit her body? Or what if your 10-year-old is eating suspiciously less than usual at dinner? Pediatrician Dr. Shari Turner stresses that it’s crucial to remember that, as a parent, you’re neither your child’s doctor nor therapist. “There are options for getting professional support and you don’t need to navigate challenges on your own. If a child expresses concerns or behaviors that are or appear distressing and not easily resolved, it is never too early to speak with your pediatrician, therapist or school guidance counselor.” Dr. Turner also notes that if, as a parent, you’ve struggled with eating disorders of your own, “acknowledging that your child may be developing one can be highly triggering. Please make sure to seek support for yourself if you need it.”

But what about the seemingly rising tides of body positivity and body neutrality? Weren’t we in a place where the pursuit of thinness was less of a priority? Parks is quick to note, “Diet culture never retreated, it was just rebranded as ‘wellness.’ With the rise of Ozempic and buccal fat removal, we’re just seeing more transparency about decisions to align with the thin cultural idea. We're no longer lying to ourselves about eating kale because it's delicious.”

So…where do we go from here? In 2023, social media—where many of these trends live—is all but unavoidable, whether consumed directly or indirectly. This is, of course, a double-edge sword: Yes, social media its most harmful ideals are inescapable, but we’re also better able to recognize this harmful content (even if it’s wrapped up in a nice, aesthetic “wellness” package). Parks says, “I recommend that people unfollow the influencers and brands that reinforce unrealistic body image and lifestyle expectations. O'Brien is on the same page. "Consumers can delete social media that promotes the need to change our bodies anyway," she urges. "Bodies are supposed to be different. It is important to celebrate and promote body diversity and to destroy the myth that there is an unattainable beauty ideal. It does not exist. It is a lie and hopefully, together we can dismantle this destructive message."

Parks adds, "As a user, be honest and kind with yourself, and ask: ‘Am I jealous of people who got access to Ozempic? Does a small part of me want to try it?’ We have all lived in a diet-filled culture, and for most of us, it is nearly impossible to avoid negative thoughts about our bodies or judge ourselves through the lens of what's trending.” Keep an eye out for even the most subtle toxic diet culture mentions (spoiler alert: gut health content is a minefield) and seek out creators (like Tiffany Ima, Mik Zazon and Ashlee Bennett) who are actively teaching body acceptance.

Parks also suggests spending as much time in community, off our devices, as we do on them, noting that, “When we build a rich life outside of social media, we start to live the truth that our bodies are truly the least interesting thing about us.”

Aside from taking a closer look at who I follow on social media and being more careful about the way I think and talk about my own body, I'm trying to focus on that last sentiment, especially. Because really, if you think about it, what is so interesting about the size of our boobs or the length of our legs or the fullness in our cheeks? Not much.

sarah stiefvater

Wellness Director

Sarah Stiefvater is PureWow's Wellness Director. She's been at PureWow for ten years, and in that time has written and edited stories across all categories, but currently focuses...