Loose skin: a side effect of weight loss

You’ve done everything right. You’ve hit your step goals, pushed through plateaus, and watched the number on the scale drop. But as the weight comes off, something else is left behind - a body that no longer fits quite like it used to. Specifically, the skin.

Excess skin is one of the least talked-about realities of significant weight loss. It doesn’t show up in transformation photos or feature in success stories. But for many, it’s a constant, physical reminder that while the weight loss journey is over, a new challenge begins.

The skin doesn’t always bounce back

Skin is a living, breathing organ. It stretches to accommodate growth and expansion, but it doesn’t always shrink back down.¹ When weight is gained, especially over a long period, the skin’s internal scaffolding (the collagen and elastin fibres) stretches too. And like an overused elastic band, sometimes it loses its snap.¹

The more weight you lose, and the faster you lose it, the more likely you are to notice sagging, folding, or loose skin, particularly around the stomach, thighs, arms, and chest. It’s especially common after rapid weight loss with obesity medications.²

And while some wear their excess skin as a badge of honour or proof of the progress they’ve made, others find it distressing, even debilitating. In some cases, people report wishing they’d known it could happen before they started. And for others, it could lead to some issues with self esteem.¹

It’s a biology thing

Genetics play a major role in how your skin responds to weight loss. Some people’s skin rebounds well. Others, not so much. Age matters too: the older you are, the less collagen and elastin your body naturally produces, making it harder for skin to tighten. And where you carry your weight also influences where the skin loosens.¹

You can do everything right and still be left with skin that sags. It’s not about effort. It’s about tissue.

More than just cosmetic

Loose skin isn’t just visual. It can cause rashes, yeast infections, painful chafing, and serious discomfort.^1,3 It can interfere with movement and exercise. It can feel like you’ve traded one kind of limitation for another.

Mentally, it can take a toll. Some people find their self-esteem dips, even after reaching their “goal weight.” The gap between what they expected to feel and what they actually feel can be wide and isolating.⁴

What can you do about it?

There’s no miracle cream. No special supplement. And despite what social media might say, collagen powders won’t magically shrink loose skin. But there are ways to support your body and feel more comfortable in it.

1. Build muscle

Resistance training can help improve body composition by filling out the space where fat once was. Stronger muscles help support the skin and can reduce the appearance of sagging, especially in the arms, thighs, and abdomen.⁵

2. Keep skin clean and dry

Folds of skin can trap moisture and lead to irritation. Use gentle, pH-balanced cleansers and always dry thoroughly. In hot weather, powders or barrier creams can help reduce chafing and prevent rashes.

3. Nourish from the inside

A balanced diet rich in protein, healthy fats, and micronutrients supports skin health.⁶ If you’ve had rapid weight loss as a result of medication or bariatric surgery, you may need supplements to meet your nutritional needs, especially for healing and skin integrity.

4. Moisturise

Lotions won’t eliminate excess skin, but they can improve texture and hydration, making your skin feel more comfortable. 

5. Consider shapewear

Supportive garments can help you feel more comfortable day to day. They’re not just for aesthetics, as they offer structure and support, particularly when skin moves more than you’d like it to.

6. Look into surgery if and when it’s right for you

Procedures like tummy tucks (abdominoplasty) or arm lifts (brachioplasty) are options for some. But they come with risks, costs, and strict eligibility criteria, especially on the NHS. You’ll need to have maintained your weight for a while, and be in good health. 

The emotional side

Excess skin can feel like a betrayal at times. You did the work. You changed your life. And now, instead of feeling like a new person, you’re navigating a new kind of discomfort.

If your body image takes a hit, you’re not alone, and you don’t have to stay stuck. Psychologists and counsellors trained in body image or weight-related issues can help. Ask your GP or weight management provider for a referral. 

The numan take

It’s okay to want more from your health journey. And it’s okay to ask the questions no one talks about. Because behind every before-and-after photo is a body still figuring things out, and a person working tirelessly to be who they want to be.

References

1. ^{Rocha RI, Junior WC, Modolin MLA, Takahashi GG, Caldini ETEG, Gemperli R. Skin changes due to massive weight loss: Histological changes and the causes of the limited results of contouring surgeries. Obesity surgery. 2021;31(4): 1505–1513.}

2. ^{Ashtary-Larky D, Bagheri R, Abbasnezhad A, Tinsley GM, Alipour M, Wong A. Effects of gradual weight loss v. rapid weight loss on body composition and RMR: a systematic review and meta-analysis. The British journal of nutrition. 2020;124(11): 1121–1132.}

3. ^{Derderian SC, Dewberry LC, Patten L, Sitzman TJ, Kaizer AM, Jenkins TM, et al. Excess skin problems among adolescents after bariatric surgery. Surgery for obesity and related diseases: official journal of the American Society for Bariatric Surgery.}

4. ^{Alzahrani KJ, Kattan AE, Ezzat LA, Alsaleh SA, Murad KA, Alghamdi BA. A psychosocial analysis of the effect of body-contouring surgery on patients after weight loss. Eplasty. 2017;17: e12.}

5. ^{Nishikori S, Yasuda J, Murata K, Takegaki J, Harada Y, Shirai Y, et al. Resistance training rejuvenates aging skin by reducing circulating inflammatory factors and enhancing dermal extracellular matrices. Scientific reports. 2023;13(1): 10214.}

6. ^{Assaf S, Kelly O. Nutritional dermatology: Optimizing dietary choices for skin health. Nutrients. 2024;17(1).}