File under “Physical Changes That Are Totally Normal”: If you’ve lost a significant amount of weight, you may have noticed that some areas of skin appear looser on your smaller body than they used to. Some people view loose or sagging skin as a fierce symbol of strength; others may find themselves frustrated by excess skin after weight loss. Maybe you relate to both feelings! Whatever your personal thoughts about your skin, we asked experts to give us the facts on what causes loose skin after weight loss, whether loose skin poses any health concerns, and what works and doesn’t work in terms of tightening loose skin—if that’s an avenue you wish to explore.
What causes loose skin after weight loss?
In general terms, the tautness of skin is a function of collagen fibres, elastin fibres, and other structural components, says New York City-based plastic surgeon David Shafer, MD. Here are two aspects of weight that affect those structural elements.
- Duration of starting weight: Skin is elastic to some extent, meaning it can stretch and contract. That being said, skin’s structural fibres may not reshape over a smaller area once they’ve been stretched for a long period of time, Dr. Shafer explains. The longer a person spent at their starting weight (say, 10 years vs. one year), the more loose skin tends to be left when weight drops significantly, he says.
- Amount of weight lost: Kilos come off subcutaneously—in other words, beneath the skin’s surface. That means weight loss leaves skin with less surface area to cover, which can produce a sagging or drooping effect. In general, the greater a person’s weight loss, the more loose skin may be present afterward, Dr. Shafer says.
Does rapid weight loss cause loose skin?
Some weight-loss experts once theorised that speedy weight loss—think: Fad diets—could cause sagging by not allowing skin sufficient time to contract. This theory hasn't quite panned out though. While there are plenty of reasons that gradual, sustained weight loss is better for health than a fad diet, a 2021 review by WeightWatchers®’ Science Team found no strong evidence that the rate of weight loss is a factor in whether someone develops loose skin.
Other factors that may contribute to loose skin
- Age: Our bodies naturally produce less of the proteins collagen and elastin as we grow older, says New York City-based dermatologist Julia Tzu, MD. “When we lose that collagen and elastin, it decreases the ability of our skin to be as elastic as it used to be,” she says. Eating an array of protein sources—including meat, poultry, seafood, tofu, tempeh, eggs, nuts, pulses, and dairy—can help provide the diversity of amino acids your body needs to synthesise collagen and elastin to the best of its ability, Dr. Tzu notes.
- Sun exposure: Research shows that long-term exposure to the sun’s ultraviolet rays can reduce skin’s collagen and elastin levels. In this way, UV damage may heighten the likelihood of loose skin following weight loss, Dr. Tzu says. Consider that one more reason to slather on the sunscreen going forward.
- Smoking: Research has found that tobacco smoke—even in secondhand form—can lead to premature ageing of skin by impairing collagen synthesis.
It’s important to know that skin appearance can vary widely from person to person. “Everybody has an environmental component, nutritional component, anatomical component. How much each one plays for each person is going to be a little different” Dr. Shafer says
Is loose skin bad for your health?
In most cases, loose skin poses no medical concerns, Dr. Tzu says. Skin irritation can sometimes occur if moisture and sweat become trapped between the folds. If you experience skin discomfort, it’s best to see a dermatologist for personalised treatment. Some people find moisture-absorbing powders helpful.
Dr. Tzu stresses again that having loose skin is a normal human experience: “Most of us currently have or will develop loose skin during our lifetimes,” she says. “Skin is the interface between our bodies and the environment, and this fortress will naturally weather and change over time.”
Can lifestyle measures tighten loose skin?
The Internet abounds with DIY ideas for tightening loose skin. While some of those measures are good for health in other ways, there’s no strong evidence that exercise, nutrition supplements, or skin creams can make a major difference in the appearance of sagging skin associated with weight loss. Here’s a closer look at the claims:
- Strength training: Pumping iron is great for muscles but can’t tighten skin directly, Dr. Shafer explains. At most, building muscle mass beneath skin can produce a slight de-sagging effect. “It can stretch out the skin a little bit so it doesn’t look so loose,” he says. Still, given that resistance training is proven to support heart health and bone strength, it might make sense to add some reps to your regular fitness rotation.
- Topical creams: You can save your money on pricey peptide creams and collagen lotions that claim to increase skin firmness. Topical creams generally aren’t formulated to make a meaningful difference in tautness or elasticity. “The molecule size is way too big to be absorbed where it’s needed,” Dr. Tzu says.
- Dietary collagen: To date, there’s no definitive evidence that taking a dietary collagen supplement directly results in higher collagen levels in the body’s tissues—or significant differences in overall skin firmness. As Dr. Tzu mentions above, eating an array of protein-rich foods is a more reliable bet (not to mention good for your overall health).
Medical and surgical options for tightening loose skin
If you are interested in exploring medical options for tightening loose skin, it’s best to consult with a specialist who can advise you on which of several available procedures might be best for your needs. Today’s procedures range from noninvasive to surgical, Dr. Shafer says, with less invasive options generally recommended for people with small areas of skin to address.
- Noninvasive procedures: Performed on the surface without necessitating incisions or leaving skin raw afterward, these procedures use forms of energy such as radiofrequency or ultrasound to heat skin and spur collagen production. Studies are promising, although research is still limited and focused largely on facial skin. You may need multiple treatments for best results.
- Minimally invasive procedures: Minimally invasive procedures can produce more noticeable results than noninvasive options. Patients undergoing treatment for larger areas of loose skin may be sedated during these procedures, with most needing at least a few days’ downtime afterward. Examples of minimally invasive skin-tightening procedures include laser resurfacing, and radiofrequency targeted to specific areas through small skin incisions.
- Surgical procedures: During skin-removal surgery, a surgeon uses incisions to remove larger amounts of loose skin in areas such as the midsection, breasts, thighs, and arms. Surgical skin-removal procedures include lower-body lift, panniculectomy, breast lift, and neck lift. Depending on the extent of surgery—and the area being addressed—recovery could take anywhere from a couple of weeks to more than a month.
The upshot: Loose skin is normal after weight loss
In most cases, skin that sags or appears loose after weight loss poses no health risks and does not require medical treatment, experts tell WeightWatchers. Though diet and exercise generally won’t make a major difference in terms of tightening skin, measures such as getting regular physical activity, eating a variety of nutritious whole foods, and avoiding unprotected sun exposure can support your overall health and the general integrity of skin. If you are interested in addressing excess skin for cosmetic reasons, consult with a certified dermatologist or plastic surgeon to explore which options might be best for achieving the results you desire.