Losing a lot of weight is an impressive feat that significantly reduces your risk of disease.
However, people who achieve great weight loss often have a lot of loose skin, which can have a negative impact on appearance and quality of life.
This article takes a look at what causes loose skin after weight loss. It also provides information on natural and medical solutions that can help tighten and get rid of loose skin.
What causes loose skin after weight loss?
The skin is the largest organ in your body and forms a protective barrier against the environment.
The innermost layer of your skin is made up of proteins, including collagen and elastin. Collagen, which makes up 80% of your skin’s structure, provides strength and firmness. Elastin provides elasticity and helps your skin stay firm.
During weight gain, the skin expands to make room for increased growth of the abdomen and other body parts. Pregnancy is an example of this expansion.
Skin expansion during pregnancy occurs over a period of several months, and the expanded skin typically retracts within several months after the baby is born.
In contrast, most overweight and obese people carry extra weight for years, often beginning in childhood or adolescence.
When the skin has been significantly stretched and remains that way for a long time, collagen and elastin fibers become damaged. As a result, they lose some of their ability to retract (1).
Consequently, when someone loses a lot of weight, excess skin hangs off the body. In general, the greater the weight loss, the more pronounced the effect of loose skin.
In addition, researchers report that patients with weight loss make less new collagen and the composition is poorer compared to collagen in young, healthy skin (2, 3, 4).
Skin that is stretched during significant weight gain often loses its ability to rebound after weight loss due to damage to collagen, elastin, and other components responsible for elasticity.
Factors that influence the loss of skin elasticity.
Several factors contribute to loose skin after weight loss:
Length of time overweight: in general, the longer someone has been overweight or obese, the looser their skin becomes after weight loss due to elastin and collagen loss.
Amount of weight lost: weight loss of 100 pounds (46 kg) or more typically results in a greater amount of sagging skin than modest weight loss.
Age: Older skin has less collagen than younger skin and tends to be looser after weight loss (5).
Genetics: genes can influence how your skin responds to weight gain and loss.
Sun exposure: Chronic sun exposure has been shown to reduce collagen and elastin production in the skin, which can contribute to looser skin (6, 7).
Smoking: Smoking leads to a reduction in collagen production and damage to existing collagen, resulting in loose, sagging skin (8).
Several factors influence the loss of skin elasticity with weight changes, including age, genetics, and the length of time someone has carried excess weight.
Problems associated with excess loose skin.
Loose skin due to massive weight loss can cause physical and emotional challenges:
Physical discomfort: Excess skin can be uncomfortable and interfere with normal activity. A study of 360 adults found that this problem was most common in people who had lost 110 pounds (50 kg) or more (9).
Decreased physical activity: in a study of 26 women, 76% reported that their loose skin limited mobility. In addition, 45% said they had stopped exercising altogether because their fluttery skin caused people to stare (10).
Skin irritation and breakdown: one study found that of 124 people who requested plastic surgery to tighten their skin after weight loss, 44% had reported skin pain, ulcers, or infections due to loose skin (11).
POOR BODY IMAGE: Loose skin due to weight loss can have a negative impact on body image and mood (12, 13).
A number of problems can develop due to loose skin, including physical discomfort, reduced mobility, skin loss, and poor body image.
Natural remedies to tighten loose skin.
The following natural remedies can improve skin firmness and elasticity to some degree in people who have lost small to moderate amounts of weight.
Perform resistance training
Regular resistance training is one of the most effective ways to build muscle mass in both young and older adults (14, 15).
Increasing muscle mass not only helps you burn more calories, but also improves the appearance of loose skin.
Collagen hydrolysate is very similar to gelatin. It is a processed form of collagen found in the connective tissues of animals.
Although it has not been tested in people with loose skin associated with severe weight loss, studies suggest that collagen hydrolysate may have a protective effect on skin collagen (16, 17, 18).
In a controlled study, collagen strength increased significantly after four weeks of supplementation with collagen peptides, and this effect persisted for the duration of the 12-week study (18).
Collagen hydrolysate is also known as hydrolyzed collagen. It comes in powder form and can be purchased at health food stores or online.
Another popular source of collagen is bone broth, which also offers other health benefits.
Consume certain nutrients and stay hydrated
Certain nutrients are important for the production of collagen and other components of healthy skin:
Protein: adequate protein is vital for healthy skin, and the amino acids lysine and proline play a direct role in collagen production.
Vitamin C: Vitamin C is needed for collagen synthesis and protects the skin from sun damage (19).
Omega-3 fatty acids: A small study found that the omega-3 fatty acids in fatty fish can increase skin elasticity (20).
Water: Staying well hydrated can improve the appearance of your skin. One study found that women who increased their daily water intake showed significant improvement in skin hydration and function (21).
Use firming creams
Many “firming” creams contain collagen and elastin.
Although these creams may temporarily boost skin tightening slightly, collagen and elastin molecules are too large to be absorbed by your skin. Generally, collagen must be produced from the inside out.
Some natural remedies help tighten loose skin after pregnancy or small to moderate weight loss.
Medical treatments to tighten loose skin
Medical or surgical treatments are usually necessary to tighten loose skin after severe weight loss.
Body contouring surgery
Those who have lost significant weight through bariatric surgery or other weight loss methods often request surgery to remove excess skin (22).
During body contouring surgery, a large incision is made and excess skin and fat are removed. The incision is sutured with fine stitches to minimize scarring.
Specific body-contouring surgeries include:
Abdominoplasty (tummy tuck): removal of skin from the abdomen.
Lower body lift: removal of skin from the abdomen, buttocks, hips and thighs.
Upper body lift: removal of skin from breasts and back.
Medial thigh lift: removal of skin from the inner and outer thighs.
Brachioplasty (arm lift): removal of skin from the upper arms.
Multiple surgeries are usually performed on different parts of the body over a period of one to two years after a major weight loss.
Body contouring surgeries usually require a hospital stay of one to four days. Recovery time at home is usually two to four weeks. There may also be some complications from the surgery, such as bleeding and infection.
That being said, most studies have found that body contouring surgery improves quality of life in formerly obese people. However, one study reported that some quality of life decreased in those who had the procedure (23, 24, 25, 26).
Alternative Medical Procedures
Although body contouring surgery is by far the most common procedure for removing loose skin, there are also less invasive options with a lower risk of complications:
VelaShape: This system uses a combination of infrared light, radiofrequency and massage to reduce loose skin. In one study, this resulted in significant loss of abdominal and arm skin in overweight adults (27, 28).
Ultrasound: a controlled study of ultrasound treatment in people who had bariatric surgery found no objective improvement in loose skin. However, people reported relief of pain and other symptoms after treatment (29).
It appears that although there are fewer risks with these alternative procedures, the results may not be as dramatic as with body contouring surgery.
Body contouring surgery is the most common and effective procedure for removing loose skin that occurs after severe weight loss. Some alternative procedures are also available, but are not as effective.
Take home message
Excess loose skin after weight loss can be distressing.
For people who have lost small to moderate amounts of weight, the skin will likely eventually retract on its own and can be helped by natural remedies.
However, people who have suffered major weight loss may need body contouring or other medical procedures to tighten or get rid of loose skin.