Fitness Articles

The Weight-Loss Side Effect That No One Talks About

Will I Have Excess Skin Once I Lose Weight?

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Studies show that the vast majority of people who lose 50 percent or more of their body weight (whether through surgery or lifestyle change) report being unhappy with their bodies later. Why? Because even after all the work and the weight loss, losing that much body fat usually results in excessive amounts of loose skin on the abdomen, arms and thighs. However, medical experts agree that the health benefits of losing weight far outweigh any potential problems that might be caused by excess skin.

Does Everyone Have Loose Skin after Losing Weight?
Thankfully, no! There are many factors, including age and genetics, that determine how much your skin will "snap back" after weight loss. The younger you are when you lose weight, the easier it will be for your skin to adapt. As we age, our skin naturally loses elasticity, and this is exacerbated by things like sun exposure and even gravity. (Try avoiding that one without becoming an astronaut!)

The amount of weight you lose and whether your weight has cycled dramatically throughout your lifetime will also play a role in how your skin looks. There is no scientific evidence to the popular advice that losing weight slowly will prevent skin from sagging, so focus, instead, on losing weight at a pace that works for you and your body.

What Can I Do if I Have Loose Skin after Losing Weight?
The only way to really get rid of excess skin is to have it surgically removed. If you've maintained your new weight for 12-24 months but still have excess skin, you can safely assume that it won't shrink more on its own. Body-contouring surgery can address one or more problem areas. Common procedures include:
  • Panniculectomy: This procedure, which is sometimes covered by insurance, removes hanging skin from the abdomen. It's often performed along with an abdominoplasty.
     
  • Abdominoplasty: Also known as a tummy tuck, this option removes hanging skin from the abdomen and tightens the underlying abdominal muscles. It is usually not covered by insurance.
     
  • Belt Lipectomy: This "body lift" removes excess skin on the thighs and buttocks.
     
  • Medial Thigh Lift: Removes excess skin from the upper leg.
     
  • Mastopexy: Removes excess skin from the breasts and tightens the surrounding tissue.
     
  • Brachioplasty: Removes excess skin from the upper arms.
As with any kind of surgery, body-contouring procedures are not without risk. Full recovery can take many months, and it's usually necessary to take 2-4 weeks off work (more if you have a physically demanding job). There will certainly be pain, bruising, swelling and long-term scarring. Other risks include infection, asymmetry, uneven scarring, tissue death and seroma (a lump caused by fluid buildup in tissue).
If you decide to pursue surgery, ask your family doctor for a recommendation. Don't be shy about interviewing multiple plastic surgeons until you find one you trust. You can search for a board-certified plastic surgeon in your area through the American Society of Plastic Surgeons website.

If you've experienced medical problems because of your excess skin, insurance will sometimes cover certain procedures. That's why it's important to see your doctor if you develop a rash, infection or strange odor in a skin flap. Not only can your doctor help diagnose the real culprit (for example, a fungal infection versus a yeast infection), you'll need documentation if you plan to pursue insurance approval for plastic surgery.

Amanda Gignac (POOKASLUAGH) recently recovered from abdominoplasty and panniculectomy surgery and shares the details of her decision and surgery experience on her SparkPeople blog. "I decided to go through with this surgery for two reasons," she explains. "The first had to do with health. My skin was severely damaged and the stomach muscles separated during my third pregnancy 10 years ago. For the last decade, I've dealt with constant skin infections, due to having very sensitive skin. In the last year, some of the skin that had been infected the most had started to change texture and color and I was worried about that. Plus, with my core muscles separated, many exercises were very difficult. My balance was always off, which contributed to back pain and hip, knee and ankle injuries. The second had to do with my mental health. I'd lost over 100 pounds and was at a healthy weight, but still felt like I wasn't really a success. I was still very self-conscious about my body all the time because of my stomach. I have stretch marks on many parts of my body, but I could live with that. No matter how much I tried, though, I couldn't come to love that extra skin on my abdomen or the way it made me look. It was holding me back from really feeling good about my weight loss."

Janet Gershen-Siegel (JESPAH) is quick to admit that her decision to pursue plastic surgery was partially driven by vanity. She documented her tummy tuck and breast lift in detail on her SparkPeople blog (here, here and here) and doesn't pull any punches when it comes to describing the grueling process of recovery. "It's been a few years and I am, overall, pleased with the results," she says of the surgery. "Even with some regain, my body shape is still better proportioned. That's essentially why I had it all done in the first place. I was (at the time) able to fit into medium-sized blazers, for example, but they would ride up my belly and hips as I had too much skin overhang. I also felt it was unattractive. The main thing that I think plastic surgery did for me was to make it harder, if someone had never met me before, to see that I had been over 300 pounds at one time." 

What If I Gain Weight Again After Having Surgery?
It is certainly possible to gain weight as any point in your life after having excess skin removed through surgery. This is a big reason that surgeons recommend that women wait until they're finished having children to undergo this type of procedure.

Jaynee Germond (FIT4MEIN2013), who lost 160 pounds and opted for surgery to remove excess skin from her abdomen, has a unique perspective. She regained 140 pounds after her procedure but worked hard to lose it all again. "Oddly, I do not have a lot of excess skin after this weight loss episode," she explains. "I have some, but I am a 56-year-old grandmother, not a 20- or 30-something woman. I have accepted who I am and will embrace it. The bottom line, no pun intended, is that we need to be happy with who we are before, during and after weight loss. None of us are going to look like super models. Even the supermodels don't look like supermodels before their makeup technicians and airbrushed photos! We need to accept the bodies that we were given and the 'battle scars' as proof of work well done."

What If I Don't Want (or Can't Afford) Surgery to Remove Excess Skin?
To prevent infections, rashes and other problems, do your best to keep excess skin as clean and dry as possible. For example, be sure to shower immediately after exercise and dry yourself thoroughly. To prevent chafing, some people wear shaping undergarments, which you can buy in any department store. If that doesn't provide enough support, there are also specially-designed bariatric garments for people who have lost a large amount of weight. Finally, there are several simple steps you can take to improve the overall health and appearance of your skin:
  • Don't smoke. If you smoke, this is just one more reason to quit. The reasons why smoking damages the skin are still unclear, but smokers tend to have more wrinkles than nonsmokers.
     
  • Protect yourself from the sun. Sun exposure accelerates the breakdown of elastin in the skin, which causes it to sag prematurely. Here's how to keep your skin safe and healthy.
     
  • Stay hydrated. Experts disagree on whether drinking more water can make your skin look better, but being well-hydrated definitely helps your body's largest organ function properly.
     
  • Moisturize. Protect the outer layers of your skin by applying a moisturizer within two minutes of a bath or shower (when your skin is best able to absorb it).
     
  • Lift weights. Building a shapely layer of lean muscle through strength training will make your skin look better by giving it some support from the inside.

Kristina Davis (TINAJANE76), who lost 110 pounds with SparkPeople, decided against surgery for her excess skin. "I've mostly come to accept my loose skin, but sometimes it bothers me," she says. "I think part of that is because I feel like I don't quite have the body I should in light of how much work I put in to lose the weight and maintain it. I also occasionally fall victim to comparing my body to others' and I feel like it's unfair. Most of the time, I'm OK with it and realize that even if I can't always wear certain styles of clothing because they accentuate my problem areas, I still look and feel a world better than I did when I was obese--and even more important, I'm much healthier. I've pondered surgery to have it removed and even went to a consultation once. In the end, I decided to accept my body as-is and work on other things I can do to minimize my problem areas like weight training, drinking lots of water and moisturizing."

Don Doornbos (DDOORN), who has lost more than 200 pounds with SparkPeople, has a similar outlook. "A huge part of losing the weight for me has been to greatly increase my ability to be kind and accepting toward myself, regardless of my weight," he says. "It's the final emotional muscle to develop! So I hope to be able to achieve enough emotional strength to be able to go shirtless in public and to be okay with it, no matter what stares I might get from others--to be strong enough, self-accepting enough to live my life to the fullest!"

Ultimately, the choice about how to deal with excess skin after weight loss is an extremely personal one. There is no one right answer for everyone. Learning how to dress to accentuate your assets is a great first step, but there is no harm in consulting with a surgeon to discuss your unique needs and options. In the end, the most important thing to remember is that losing weight will improve your health dramatically whether you ever feel comfortable enough to wear a bikini or not.

For more information and support about dealing with excess skin after weight loss, join the At Goal & Maintaining + Transition to Maintenance SparkTeam.
 
 
Sources:
Cleveland Clinic, "Aging Skin," my.clevelandclinic.org, accessed March 6, 2014.
 
Cleveland Clinic, "Tummy Tuck," my.clevelandclinic.org, accessed March 6, 2014.
 
Cleveland Clinic, "Body-Contouring Surgery after Significant Weight Loss," my.clevelandclinic.org, accessed March 6, 2014.
 
Gilmartin J. "Body image concerns among massive weight loss patients." Journal of Clinical Nursing. 2013 May:22(9-10):1299-309.

Staalesen T, Fagevik Olsen M, Elander A. "Experience of excess skin and desire for body-contouring surgery in post-bariatric patients." Obesity Surgery. 2013 Oct;23(10):1632-44.
 
University of Wisconsin-Madison School of Medicine and Public Health, "The Benefits of Drinking Water for Your Skin," www.uwhealth.org, accessed on March 6, 2014.

Wagenblast AL, Laessoe L, Printzlau A. "Self-reported problems and wishes for plastic surgery after bariatric surgery." Journal of Plastic Surgery and Hand Surgery. 2013 July 23.

WebMD, "Cosmetic Procedures: Sun Exposure and Skin Cancer," www.webmd.com, accessed on March 6, 2014.

WebMD, "Plastic Surgery after Weight Loss," www.webmd.com, accessed on March 6, 2014.
 
 

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Member Comments

  • After my initial 100 pound loss at the age of 61, I spoke to some of my Triathlete Coaches & Nutritionists. As I am an athlete now, and am not "that" vain, I look at my battle scars, realize where I've been and where I never want to return. I'm cool with it..
    I'm a Runner & Triathlete at 66! I couldn't be happier in my life. I worked to stay alive longer to watch my Granddaughter grow up and spend great times with my wife! I earned that! They're what's most important in my life.
    At the same time, everyone is unique. If you are younger, have fully accepted a Healthy Lifestyle, and believe you would feel better about it, then see a doctor about the possibilities to make an educated decision.
  • I have 2 more lbs and I'll be at my 100 lbs LOSS !! I still have another 40ish lbs to go.

    Maybe it's because I am older (58) that I do not care about the flapping in the wind stuff. Instead I am PROUD of what I am doing. The flapping stuff is a constant reminder to me on how HARD I am working. So if others want to stare,,, they stare. If I notice it,,, lets face we usually do I tell them a very short version of my story. EACH and EVERY time I hear "Congratulations ! I WISH I could (or someone they love) could do this." So I tell them about Sparks. I am NOT going to be ashamed of the immense work I've done.
  • While my loss wasn't as large as these other folks, I have the same side effects. Since my weight yo-yo my entire life I have them now on my arms, face, and abdomen. I either have to use some sort of abdominal spanx or live with it, because can't afford surgery LOL. Some are lucky enough to have their insurance cover parts of their surgery due to medical reasons, so look into it.
  • I think this is probably one of the things I think about most as I am on this journey. I am one of those people who will feel good for having lost the weight on the one hand, but would very likely feel disappointment if I end up with a lot of loose skin afterward. I would definitely consider surgery--but in the meantime, I will do what I can to mitigate this possibility...str
    ength train, hydrate, flexibility exercises...whate
    ver may help...emphasis on "may" help...I know there are no guarantees one way or the other. I'd like to be someone who could just be happy with the weight loss (and better health), and we can just call it vanity, but I don't think I would be happy if I had to deal with this issue.
  • Even small weight loss seems to affect facial contour and make older people look even older with more wrinkles. But, if you feel healthier and are healthier, it is worth it, just a little disappointing if you planned on looking better as your main goal.
    As an older person, my weight loss goals are to get healthier and not to go down to my lowest weight I liked as a young person. I think it is enough to be in a "high healthy" BMI range.
  • I believe that everybody's skin reacts to weight loss very differently. I was in my 50's when I lost my weight and I did it the "right way" --- about 8-10 pounds per month - no fad diets. I began eating clean and exercising.
    My belly and my arms were a mess after I lost over 100 pounds. Three different doctors told me that the excess skin wasn't going anywhere.
    I opted for surgery (abdominoplasty and brachioplasty) and have never regretted it.
  • I would hardly call this "the Side Effect That No One Talks About"... Extra/loose skin is almost always touched on in any article (at least that I have read) regarding extreme weight loss. Not to mention it's just common sense...
  • Loosing weight and maintaining a healthy lifestyle is honestly a hard fought, individual battle. While it is true that components of the process are the same for everyone, individual needs and health restrictions, etc can dramatically change the how and why we lose. Loose skin that accompanies a significant weight loss, should not be the reward for winning the battle. Self acceptance is key at any weight, but it is hard to love excess anything. While I have literally walked away many a pound with Leslie, I also had an epiphany one day that walking would not produce IN ME the outcomes I wanted. It was then I added strength training, HIIT workouts, and cardio sculpting routines to my fitness arsenal. I have lost plenty of me while I have gained muscle...and learned an entirely different kind of strength. Was it easy? Did it happen overnight? We all know the answers to these questions, I built slowly and was unwilling to settle for less than my best effort. The day I hit my goal weight I want a fit, strong, healthy woman looking back at me in the mirror...loose skin won't deter me.
  • CHRISC1971
    This was a great read. It is a serious downer to have this result after working so hard.
  • Where else but SparkPeople could I get such well-documented answers to a question that is nagging at me since I am really losing a lot of weight this time. Thank you so much for this article. Well done, much to consider.
  • Great article! Gives me much to think about.
  • JULIA211X
    Thank you for this article. Yes, this has been my road block lately. I can cover up the body, but I'm starting to see loose skin on my face. I've always used moisturizer, since I was 16, (re: a comment below) and although my skin is soft and I get compliments, it doesn't prevent sagging. I wish now I had been more fitness oriented and made lifting weights part of my beauty routine, but I will keep going on with my weight loss.
  • I am not real big on doing surgery if other options will work. If I had the skin problems that some have experienced, it would be as a last resort.
    YET, this article answers a lot of questions that many of us are embarrassed to ask/discuss and I think it helps to know that we are not alone. It also gives me a lot of sympathy for those who may have these issues.
  • I had the excess skin removed from my upper arms and wore compression sleeves for more than a month and the arms looked and felt great for maybe 6 months but quickly began sagging again. I don't now why and the doctor was surprised, too, but I didn't feel like doing it again. I also had the panniculectomy done (stomach) because the skin hung so low after losing that 130 lbs. I woke with a girdle on that fit below the breasts to the knees. Other than washing time, I wore it 24/7 for 2-3 months including a group tour to Germany, Austria and Switzerland. I am still very happy with that surgery and I am sure wearing the girdle did help keep it from stretching out. I highly recommend that surgery because of the possibility of infections under the "apron". My insurance paid all but $100 which was a great bonus. The doctor's office did all the work of getting that approved.
    BTW I also live in Florida and had no issues with the girdles (arms and stomach) and the heat.
  • Moisturize! It's the best advice my grandmother ever gave me. Especially if you live in a dry climate (like California) you need to moisturize every day. It keeps the skin from hanging and wrinkles from forming.

About The Author

Megan Patrick Megan Patrick
Megan Lane Patrick has been a professional writer and editor for the past 16 years, and was a chronic dieter for at least 30. A combination of weight-loss surgery, mindful eating and daily exercise finally allowed her to maintain a weight loss of more than 100 pounds. When she's not lifting weights at the gym, you can find her walking shelter dogs as a volunteer for the SPCA.



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