Where Do You Lose Weight First on Ozempic? What Body Scans Show

Where you lose weight first on Ozempic was never measured, because the body scans in STEP 1 and SURMOUNT-1 DXA compare the start with week 68 and week 72 only. By the end, deep belly (visceral) fat had shrunk by a bigger share than fat overall, 40.1% against 33.9% on tirzepatide, and STEP 6 found visceral fat area down 40.0% on semaglutide 2.4 mg. Waist size fell 13.54 cm (about 5.3 inches) in STEP 1 at 2.4 mg, the usual Wegovy maintenance dose (Wegovy label).

Key facts

• SURMOUNT-1 DXA scans were taken at the start and at week 72 (or at early stopping); STEP 1 reports DXA change from the start to week 68.
• At week 72, pooled tirzepatide reduced weight, fat mass and lean mass by 21.3%, 33.9% and 10.9%, versus 5.3%, 8.2% and 2.6% on placebo (SURMOUNT-1 DXA).
• Estimated visceral fat fell 40.1% on tirzepatide against 7.3% on placebo in that subgroup (SURMOUNT-1 DXA).
• Waist size fell 13.54 cm (about 5.3 inches) on semaglutide 2.4 mg against 4.13 cm (about 1.6 inches) on placebo at week 68 (STEP 1).
• In adults with type 2 diabetes, liver fat fell 8.09 percentage points on pooled tirzepatide 10 mg and 15 mg versus 3.38 on insulin degludec at week 52 (SURPASS-3 MRI).

Where do you lose weight first on Ozempic?

SURMOUNT-1 DXA scanned at the start and week 72 (or at early stopping) only; STEP 1 reports change from the start to week 68. These trials never measured which area changed first; the scans show where loss had come from by the end.

Ozempic is approved for type 2 diabetes, with a maximum recommended dose of 2 mg once weekly; weight management is not a listed use (Ozempic label).

STEP 1 tested semaglutide 2.4 mg in adults with obesity or overweight without diabetes; its DXA group included 140 people with a BMI of 40 or less. STEP 6 also tested 2.4 mg, the usual Wegovy maintenance dose (Wegovy label), above Ozempic’s maximum (Ozempic label).

SURMOUNT-1 tested tirzepatide 5 mg, 10 mg and 15 mg; its DXA analysis included 160 people (SURMOUNT-1 DXA). Pooled means those dose groups combined.

The table separates SURMOUNT-1 DXA, STEP 1, STEP 6, SURPASS-3 MRI, the liver-fat trial and the facial-change review. Each trial measured fat differently, so compare each drug with its own control.

The 40.1% and 33.9% are each measured against that fat’s own starting amount, so visceral fat shrank by a bigger share of itself than fat overall. The facial findings come from separate evidence, rather than the body-composition trials.

Does Ozempic target belly fat?

Section 12.2 of the Wegovy label and Zepbound label describes greater fat-mass than lean-mass loss; neither names a body region.

Regional visceral fat fell 0.36 kg versus 0.10 kg in STEP 1, and CT visceral fat area fell 40.0% versus 6.9% in STEP 6, both on semaglutide 2.4 mg.

Visceral fat is inside the abdomen around the organs; subcutaneous fat is under the skin. Both compartments fell on tirzepatide in SURPASS-3 MRI.

A 2008 review of 61 studies found preferential visceral-fat loss with modest weight loss. That effect weakened as total weight loss increased.

How much visceral fat do you lose on Ozempic?

At semaglutide 2.4 mg, STEP 1 recorded regional visceral-fat reductions of 0.36 kg versus 0.10 kg on placebo at week 68.

STEP 6 measured abdominal visceral fat area by CT. At week 68, it fell 40.0% on semaglutide 2.4 mg and 22.2% on 1.7 mg, against 6.9% on placebo. The trial involved East Asian adults in Japan and South Korea.

For pooled tirzepatide doses, SURMOUNT-1 DXA reported a 40.1% fall in estimated visceral fat versus 7.3% on placebo at week 72. Its DXA estimate came from scanner software using the lower-trunk region.

SURPASS-3 MRI compared tirzepatide with insulin degludec in adults with type 2 diabetes over 52 weeks. Visceral and abdominal subcutaneous fat volumes both fell significantly on tirzepatide.

Where do you lose weight first on Mounjaro, Zepbound or Wegovy?

The order was not measured for these drugs either. By the end, STEP 1 recorded fat-mass loss of 8.36 kg (about 18.4 lb) versus 1.37 kg (about 3.0 lb) on placebo at week 68. With tirzepatide doses pooled, SURMOUNT-1 DXA reported fat-mass loss of 33.9% versus 8.2% and visceral-fat loss of 40.1% versus 7.3% at week 72.

Wegovy contains semaglutide, the same medicine as Ozempic, with a usual weight-reduction maintenance dose of 2.4 mg weekly (Wegovy label). Mounjaro contains tirzepatide, the same medicine as Zepbound, and is approved in the US for type 2 diabetes (Mounjaro label).

The weight loss projector estimates total loss, not where it comes off. For the results SURMOUNT-1 printed by week and dose, see Mounjaro weight loss by month.

Does Ozempic change your body shape?

On average, waist size fell 13.54 cm (about 5.3 inches) on semaglutide 2.4 mg against 4.13 cm (about 1.6 inches) on placebo at week 68 in STEP 1. That is the usual Wegovy dose (Wegovy label), above Ozempic’s 2 mg maximum (Ozempic label).

A waist measurement follows abdominal size but cannot split visceral from subcutaneous fat. Keep the tape position consistent using the instructions for where to measure your body.

Photos show your outline and skin changes, and comparisons depend on lighting and posture. Visceral fat sits inside the abdomen, so neither a tape nor a photo shows which layer changed.

To see your own shape change next to your weight and dose, Pensday logs weight and doses free and colors the weight report by dose. Pensday Plus adds a 3D body scan from a short guided capture. It estimates overall body fat, muscle and measurements; it does not estimate visceral or liver fat, and it is not a DXA scan. Processing happens entirely on your iPhone, and the photos never leave the phone.

Does Ozempic change your face?

The facial-change review reported a median 9% midfacial-volume reduction in serial imaging of 20 patients. It says “Ozempic face” “can imply a drug-specific adverse effect,” although similar changes occur after other substantial weight loss. Regression estimated about 7% midfacial-volume loss per 10 kg lost.

A survey of 1,226 people described in the facial-change review linked greater percentage weight loss with more reports of facial volume loss and laxity. The review calls the independent effect of weight-loss speed uncertain.

Use the goal weight calculator for an overall target, without treating its result as a forecast of your face or body shape.

Why do the scale and the mirror disagree on a GLP‑1?

The scale counts everything you lose. In the SURMOUNT-1 DXA group, average weight fell 21.3% and waist size 18.1 cm (about 7.1 inches) by week 72. Placebo reductions were 5.3% and 3.4 cm (about 1.3 inches).

Fat mass fell 33.9% and lean mass 10.9% in that group, so part of the scale drop came from lean mass, not fat.

SURMOUNT-1 reported these waist reductions at week 72, by dose.

Use repeated weight and waist readings in your Ozempic plateau checks to judge a possible stall.