People may not always include it in their before/after photos, but loose skin is a pretty common byproduct of significant weight loss. While you can’t prevent it altogether, there are ways to manage it. Here’s what you can to minimize the amount of loose skin you end up with in the weight loss process:
Why our skin does this
First, let’s take a look at the anatomy of your skin and the surrounding area. Two layers of tissue reside underneath your skin: adipose tissue (or fat) followed by muscle tissue directly beneath. Both fat and muscle push up against the adjacent layer of skin, keeping it relatively taut before you lose weight.
The issue of loose skin actually starts when a person gains weight. When this happens, your skin’s surface area increases to accommodate the new fat tissue (which is why stretch marks sometimes occur).
While your fat cells shrink when you lose that weight, you still retain the same surface area. This space under the larger surface area creates a layer of skin that may “hang,” because there is less tissue underneath taking up space. This is what’s known as loose or “sagging” skin.
The amount of loose skin that remains varies by individual. In fact, not everyone’s skin sags afterwards, and it depends on several factors, including the total weight gained and lost, age, total muscle mass and genetics.
Some people have a massive amount of loose skin that only surgery can fix. Others have none at all, despite significant weight loss.
Then there are those in the middle, where there’s room to prevent loose skin during weight loss, and potentially even improve it afterwards. I have personal experience with this. After going from 230 to 150 pounds, my skin was loose and even (apologies in advance for the visual) “pullable” away from my body. I looked like a cross between a Shar-Pei and some Silly Putty. My skin is no longer loose—suggesting that in non-extreme cases, it can be improved to a degree—but it could have been prevented using the methods below.
Muscle tissue is key
Maintaining or increasing muscle tissue is the key to minimizing loose skin. Remember, the phenomenon occurs when the underlying layers of tissue shrink under a much large surface area. If muscle mass is lost in addition to fat, it creates an even larger void under your skin’s surface. On the other hand, increasing lean tissue fills the area underneath the skin, keeping it taut.
There are a few ways that you can go about retaining or even increasing your muscle tissue during a diet.
Lose weight at a healthy pace
There’s a correlation between how quickly one loses weight and the amount of loose skin they end up with.
In order to lose weight, you must create a calorie deficit. When the deficit is reasonable and you’re losing one to two pounds per week, a majority of the weight lost is fat. While a more aggressive deficit will result in faster weight loss, there’s a higher risk that this weight loss will come from muscle tissue, especially when done over a prolonged period of time.
Keep a slow and steady pace and a healthy caloric deficit (which varies from person-to-person, depending on a number of factors, including how much your workout). You’ll retain much more muscle tissue, thus keeping your skin “tight.”
Don’t skip the strength training
Similar to the reasons above, incorporating strength training will allow you to maintain more muscle mass, or even build muscle if you’re relatively new to this type of exercise.
A hypertrophy (muscle building) regimen may yield better results over one that optimizes strength or endurance. Hypertrophy training specializes in increasing the overall size and volume of your muscles, allowing your skin to cling tighter to the underlying tissue.
Bodyweight routines are fine too, if that’s more of your jam, so long as they are implemented correctly.
Lastly, make sure to keep protein intake high. During caloric deficit this will not only prevent the loss of lean mass (or “muscle catabolization”), but also ensure that you have the optimum amount for building muscle. You can use the “Alan Aragon” rule to find your minimum daily protein target.
In some cases, it might not be skin at all
Personally, I’ve observed that loose skin is less of an issue for those who get down to lower levels of body fat. Of course, this could simply be due to survival bias. For example, perhaps folks without loose skin issues in the first place are more motivated to keep continuing their progress. But Dr. Ron Brown, author of The Body Fat Guide doesn’t think so, and has a compelling explanation: what many perceive as “loose skin” is actually excess fat.
Measuring the thickness of these hanging folds of skin provides evidence that there is still a substantial amount of body fat underneath the skin. The skin is not so much “loose” as it is flabby due to excess body fat. Even if some areas have completely thinned out, excess body fat is likely to be stored in adjacent areas that contribute to the overall flabby condition.
Still, there are certainly cases where nothing short of surgery will help. But at least there are techniques at our disposal during the weight loss process that could help control the amount of loose skin you end up with.