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Notably, tirzepatide may reduce the effectiveness of oral contraceptives during dose escalation due to delayed gastric emptying

doi:10.1046/j.1365-201x.1996.42256000.x

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R., Borner, T., & De Jonghe, B

Whats happening is a combination of: Volume depletion in facial fat pads that support midface structure Muscle atrophy in the jawline, cheeks, and around the eyes Collagen breakdown , often accelerated by rapid body composition shifts Dehydration , which can impact skin tone and elasticity These facial changes can undermine the emotional benefits of weight lossand in some cases, make people feel older rather than healthier