QUESTION: “Hi Dr. Neal, I want to ask you about loose or flabby skin. I used to be about 150 lbs. Now I'm around 120lbs and I have a lot of flabby skin and cellulite. Do you think building muscle will help tone it up or is surgery a good option? Your podcast has helped a lot so I wanted to know what you think. Thank you!”
DR. NEAL: Thank you so much for your question. I’m so glad you find the podcast helpful.
First, congratulations on your weight loss efforts. That’s no easy feat and you deserve so much credit for this. As you mentioned, a side effect of weight loss can be having loose skin.
This is very normal. Now, there are fixes for this but unfortunately, most of them have to be performed surgically.
Why Do We Experience Loose Skin After Weight Loss?
First, let me explain why this happens. As we get older, it is very natural to lose the elasticity of our skin. This is because skin’s elasticity is, in part, based on different types of proteins found within the skin.
Collagen and elastin are just a couple of proteins found in the skin and they help keep it elastic. So, as we get older, these fibers tend to breakdown which leads to loss of elasticity. It’s kind of like a rubber band – the more it’s used and the older it gets, the less elasticity it will have.
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When it comes to weight loss and loose skin, we often see this happening when large amounts of weight are lost in a relatively short period of time. We also see this same thing happening with too much sun exposure. But that’s a different topic altogether.
Weight loss that’s a bit more gradual allows the skin to shrink back down as the weight is lost. With rapid weight loss, the skin may have more time to catch up. Also, the longer the weight was kept on the body before the weight loss, the more likely the person will experience loose skin.
I’ll use a different analogy here. Imagine a typical rubber balloon – like the ones used during a celebration. Have you ever added air to a brand-new balloon, but quickly let the air back out? Notice how the elasticity of the balloon hasn’t really changed all that much. It still feels like it’s brand new.
But, what happens to the balloon’s elasticity after the balloon has been inflated and stays inflated for days? When you let the air out, the balloon has pretty much lost all of its elasticity.
Well, our skin behaves similarly.
So, What Can We Do?
Since elasticity is dependent on proteins like collagen and elastin, getting enough protein in the diet is important. But in the Western world, getting enough protein in our diets is usually not a problem.
Most health professionals agree that supplements, skin creams, and even exercise will not make a difference. Here’s why: when it comes to supplements, like collagen supplements – it seems that supplementing with collagen doesn’t seem to actually increase collagen levels in the skin. Meaning, even though we may be supplementing with collagen, the body doesn’t necessarily send that collagen to the skin.
When it comes to skin creams, it turns out that the ingredients in these creams are often too large to actually be absorbed by the skin. Exercise is a great habit to have, don’t get me wrong, but even strength training may not make a difference in tightening up loose skin.
Now, you also mentioned cellulite. Cellulite is basically fat deposits under the skin that leads that dimpling look on the skin’s surface. Unfortunately, there are no effective treatments for cellulite.
So, What Options Are We Left With?
Well, it turns out the most effective way to remove excess skin is through cosmetic surgery. There are many surgical options for removing loose skin. Some are more complicated than others, so it’s best to discuss options with a Medical Doctor that specializes in these types of procedures. A great place to start is to talk to your primary care doctor who can then refer you to someone. Usually, they will refer you to either a Dermatologist (a Medical Doctor that specializes in treating the skin) or a plastic surgeon.
I know that this may not sound like the best news, but all is not lost. There are options available. And, again, you deserve so much credit for reaching your weight loss goals!