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Medically reviewed by
Constance Tambakis Odom, MD graduated in 1987 with her Doctorate of Medicine from the New York Medical College, and was an Anesthesiologist Resident from 1988 to 1991 at the Brookdale Medical Center PGY II (CA-I)-PGY IV (CA-III). She is Board Certified by the American Board of Anesthesiology since 1998 and American Academy of Anti-Aging Medicine since 2002. Constance Odom, MD is affiliated with the American Medical Association, American Academy of Anti-Aging Medicine, American Society of Anesthesiology, Georgia Society of Anesthesiology, Hellenic Medical Society of New York, North Carolina Society of Anesthesiology, and Society of Ambulatory Anesthesia.
To determine whether an individual is a healthy weight for their height, a measurement known as BMI (or Body Mass Index) is assigned based on these factors. An ideal BMI rating is anywhere between 18.5 and 24.9 kg/m2. Those who are below the low end of the scale are considered underweight while those who exceed the higher end are overweight. There are varying levels of being overweight; however, those who have BMI scores above 30 are considered clinically or morbidly obese. Carrying this much extra weight amplifies the health problems experienced by those who are overweight. This often inspires those who need to lose a significant amount of weight to take control of the situation and seek help with losing weight. One big concern that these individuals are faced as they experience success is loose skin.
As a person loses weight, there can be a number of reasons that they begin to notice loose skin throughout various areas of their bodies. Some of the most common include:
Aging: Weight loss is a process that may take several years to achieve, particularly if you are aiming to lose 100 pounds or more. During this time, the aging process continues. As a person ages, their skin naturally loses elasticity as the body slows collagen production. If you have been on a weight loss journey for 5 years, for instance, your skin will be significantly less elastic than when you first began. This compounded with other factors can cause loose skin.
Rapid Weight Loss: When a person loses a significant amount of weight in a short amount of time, it is hard for the body to keep up with the weight loss. This most commonly happens in cases with surgical intervention--like bariatric surgery. But it may also occur if a person has suffered from an illness that caused rapid weight loss or if they approached weight loss too quickly through natural methods. Unlike slow and steady methods where the skin is able to contract, this doesn’t occur and instead, the skin hangs in place.
Weight Gain Over Time: Many individuals who are struggling with their weight have been obese for many years or even decades. This weight was not gained overnight and throughout the years, their skin has been slowly stretched to its limitations. After the skin has reached its maximum, it is extremely difficult to get it to “snap back” without surgical other extreme forms of intervention.
Genetic Disposition: In some cases, people are born with the genes for saggier skin than others. This may not be noticeable until you begin to age and can be exacerbated by significant weight loss.
Overall Health and Diet: Those who have certain underlying health conditions may have skin that appears less healthy or less elastic than those who do not. Diet also plays a part in the look and feel of the skin. It is crucial to eat foods that are high in vitamins that support skin health and to stay adequately hydrated each day. Experts recommend as a general guideline that adults should consume between 6 to 8 cups of water each day. This amount may be more or less based on overall activity levels and any pre-existing conditions.
Unfortunately, there is no surefire way to prevent loose or sagging skin as a component of significant weight loss. Because other factors are at play, like genetics, overall health, and the natural effects of aging, sagging skin may be unavoidable for some people. Despite this, there are steps that you can take in regard to your weight loss journey to decrease the risk of developing loose or sagging skin.
The most crucial step is to lose weight gradually whenever possible. While some people require surgical interventions for weight loss, it is best to lose as much weight as you can on your own. By following a lower-calorie diet and exercising regularly, a normal weight-loss journey will allow you to lose around 1 to 2 pounds per week. This slower pace gives your body the time it needs and provides your skin with the ability to contract week by week.
By comparison, those who undergo bariatric surgeries of any form generally lose around 1 to 2 pounds per day during the first 60 to 90 days after their operation. This weight loss slows over time but still remains much faster than average weight loss efforts. Overall, bariatric surgery patients lose around 50-70% of their body fat within the first year after surgery. At this speed, the body is continually losing fat and the skin is unable to contract properly to keep up.
Oftentimes when people are exercising to lose weight, they stick with exercises like cardio. Jogging, for example, can help you burn calories and lose weight but it doesn’t do much for avoiding sagging skin. The key here is to replace the fat that is lost with lean muscle. This muscle will essentially take the place of the fat and help fill out the skin and avoid sagging. This is done by strengthening exercises versus cardio. This includes exercises like weight lifting, lunges, and squats. If you are unsure of the best methods for your particular situation, consider working with a personal trainer.
If you have undergone bariatric surgery and have had rapid weight loss, it is essential to pay attention to the vitamins and nutrients that you are consuming on a daily basis. Because you are physically restricted with what you can eat, each bite is crucial in giving your body the vitamins and nutrients it needs to function and keep your skin healthy. Even those who have not undergone surgery may have diets that are lacking in much needed nutrients. Infact, it is believed that as many as 92% of American adults have vitamin deficiencies. To ensure that your body has all of the nutrients and vitamins it needs, consider taking supplements. While a general multivitamin will do the trick, there are also ones designed specifically to support the functions and health of the skin.
The health consequences of smoking cigarettes or vaping are endless. Each year 480,000 people die from the effects of tobacco use. Many more struggle with heart disease, stroke, lung cancer, breathing difficulties and more. While these are all severe and dire consequences, one of the first noticeable signs of damage from tobacco use lies in the appearance of the skin. When a person uses tobacco, the nicotine within it restricts the blood flow throughout the body. This includes the skin and affects the production of collagen and elastin. With an inadequate amount of these proteins, the skin becomes dry, less elastic and is prone to sagging.
When all else fails, it is important to remember that losing weight is important for your overall health. While it can be disappointing to experience sagging skin after working hard to lose weight and improve your body image, keep in mind that the amount of stress your body is under has been significantly reduced. Even if you do not receive the exact results that you had in mind, losing weight is a huge achievement that should be celebrated. That being said, those who have excessive amounts of loose skin after weight loss may find that the skin causes pain, leads to skin infections or prevents them from participating in certain activities. In this case, it is important to consider all of the treatment options that are available.
Collagen Supplements: Boosting the amount of collagen your body produces can be helpful in mild cases of sagging skin. The results will vary but you may notice slight improvement after several months of taking the supplements.
Build Muscle: For moderate cases of sagging skin after weight loss, building muscle in place of the lost fat can decrease the appearance of loose skin.
Firming Creams: Although there are varying reports of success with firming creams, some believe that they are helpful in temporarily tightening loose skin.
Body Contouring Surgery: Body Contouring Surgery consists of a number of specific procedures. All of these procedures focus on surgically removing the excess skin to improve the function and appearance of an area of focus. Some of the most common forms of these surgeries include brachioplasty which removes skin that hangs from the arm and abdominoplasty (or tummy tuck) to get rid of sagging abdominal skin and strengthen the muscles. Other procedures such as a panniculectomy removes the skin that hangs beneath the belly button, while an overall lower body lift aids in removing skin from the hips, thighs and backside.
Chemical Peels: Chemical peels are less invasive than a face lift surgery but can be helpful in improving the appearance and sagginess of skin on the face or neck.
Botox: Most commonly thought of in the case of avoiding wrinkles, Botox can be an option for decreasing the appearance of sagging skin in certain areas of the body.
Radiofrequency or Lasers: Although radiofrequency devices or laser procedures can sound intimidating, they offer promising results and are good options for those who do not qualify for weight loss surgeries due to health concerns.
In order to qualify for one of the many surgical procedures to remove skin after weight loss, the patient will need to meet a number of requirements. First and foremost, they must be in an overall healthy state. For those with certain health conditions, cosmetic surgeries may be too much of a risk for doctors to perform. From there, they must also be non-smokers who are committed to continuing a healthy diet and lifestyle after the procedure. Those who have lost a significant amount of weight (usually 100 pounds or more) must also maintain this weight loss for a period of at least six months before they are deemed eligible for excess skin removal surgery.
Although there are surgeries available and other methods to remedy sagging skin due to weight loss, prevention is key. Those who are embarking on a weight loss journey naturally should ensure that they do not lose weight too rapidly. Aim for a weight loss of 1-2 pounds per week to give your skin the chance to properly contract throughout the process. In some cases, dietary supplements may be used to help maintain this pace over time.
Keep in mind that losing a large amount of weight is an ongoing process and requires extreme lifestyle changes to achieve and maintain goals. Along with gradual weight loss, be sure to eat a well-balanced diet and hydrate regularly. For those undergoing bariatric surgery, you can help minimize the amount of sagging skin by implementing muscle building activities into your daily routine even before surgery takes place.
If your BMI classifies you as clinically obese and you need to lose 100 or more pounds, it can be intimidating. You may have a variety of concerns with excess and sagging skin being one of them. While losing this amount of weight can cause some cosmetic issues when it comes to skin, keep in mind that by losing this amount of weight, you are likely adding years to your life. You are preventing health conditions linked to obesity, such as Type 2 Diabetes, heart disease, high blood pressure and a number of other diseases and disorders. Despite this, if excess or sagging skin begins to affect your physical capabilities or your mental state, be sure to speak with a doctor to discuss the best options for your specific needs.
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This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your physician about the risks and benefits of any treatment. Nu Image Medical may not offer the medications or services mentioned in this article.