Q & A: I’ve recently lost weight (good), but I don’t like the loose skin I have.

Q & A: I’ve recently lost weight (good), but I don’t like the loose skin I have.  Do I have this loose skin because I’ve lost weight too fast, or lost too much muscle?  Can I do anything about this?

A: Great questions. The loose skin that you (and most people) have after weight loss is not there because you did something wrong. You have loose skin because you’ve gotten to a healthier weight and because skin only expands.  (Meaning skin cells multiply to make room for a bigger body, but it doesn’t shrink back when you get smaller.) Yes, there are definitely some things you can do about it.

Skin Size
Our skin is remarkably stretchy.  You see this every time you open and close your hands, or bend your knees.  However, it is only stretchy to a point – eventually the tension on it triggers the expansion of the skin.  Expansion in terms of more total surface area/more skin. The sustained tension can come from getting taller as a child, or from gaining enough weight (for whatever reason). 

Plenty of articles will blame you for the loose skin because you lost weight “too fast” which, they claim, “doesn’t leave time for the skin to shrink.”  This is bullsh*t because skin that has expanded does not go in reverse.  (Have you ever seen the ear lobes on someone who has purposefully stretched them out? Even if they removed the hardware years ago they still have huge ear lobe holes – it does not shrink.) If you lose 70 pounds in 7 months or 7 years, you will end up with exactly the same quantity of loose skin.

Actually, the longer you take to lose weight the looser your skin will appear, because our skin is less elastic as we age.  10 years ago I thought that the skin on my stomach hadn’t really been stretched out that much after losing 60-ish pounds.  I was wrong.  My tummy skin from a decade ago looked smaller because it was younger and had more and tighter collagen underneath. 

What can you do?

Muscle up. Adding muscle in and around the places where there is loose skin will be the most important non-surgical intervention.
·     Example: For many women the back of the arms is a place that collects loose skin with weight loss.
·     You need to train more than just your triceps (muscles on back of upper arm) because the triceps can’t really grow enough to fill up the loose skin.  The loose skin is shared by your whole arm (front and back side of upper arm), back and shoulders, so you want to work it all.

Exercise.  Besides adding (or at least keeping) muscle, exercise also increases collagen production everywhere. 
·     Will it make your skin look 20 again?  No. Is it the best weapon you have? Yes.
·     Exercise also makes your cells younger by adding (or maintaining) length to your telomeres. Telomeres are the bits on the ends of DNA that get shortened each time a cell divides.  When the telomere gets too short the cell can no longer divide, meaning it will not be replaced and you accumulate very old cells.

Hydrate: do I need to explain that drinking enough water makes your skin look better and improves joint health?

Skin supplementation: supplementation is last on the list of “to do” because it is the least important.  It’s not unimportant.  The most important supplements would be a high quality multi-vitamin, fish oil, and a hydrolyzed collagen supplement. (Aside, collagen has benefits, however it’s a very poor protein supplement 

Low hanging fruit: The 2 most basic things to avoid are smoking and getting sun burns for skin health, and I assume these don’t need an explanation.  (The reduction in smoking in Americans has done more to increase life expectancy that all of the medical technology invented in the last century.)

Common sense: if it sounds too good to be true, it is.  We wish there was a magical skin cream that would make excess skin go away, but there’s not.  Some active ingredients can cause slight and temporary improvement in appearance, but that’s it.

Embrace it: even if you chose to get some loose skin removed you’ll still have some left elsewhere. Total body skin removal surgery is way not safe.  Also, surgery is expensive, painful, risky, and leaves scars, so it’s unlikely that the risks + costs to reward ratio will make sense for your entire body. Meaning we (everyone who has lost a substantial amount of weight) will be left with some loose skin, and that’s OK. We don’t need to be “perfect.” 

Lastly, anyone who has a problem with the loose skin you’ve worked very hard to earn can have a seat on a pole with splinters. 

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