Sagging skin can be a serious physical and cosmetic problem after significant weight loss. Seventy percent of people who undergo weight loss surgery, for example, suffer from excess sagging skin, reports a study in "Obesity Surgery" in 2013. Sagging skin can make you feel self-conscious, cause uncomfortable chafing and even be a barrier to physical activity. Whether or not sagging skin happens depends on how much weight you have to lose, your age at the time of weight loss and how quickly you've lost it. You can minimize the amount of sagging skin you develop with certain weight-loss strategies, but some loose skin is inevitable with extreme weight loss.
Speed of Weight Loss Affects Skin Elasticity
Skin sagging almost inevitably occurs when you lose a large amount of weight quickly, such as with bariatric surgery or a medically prescribed, very-low-calorie diet. The compounds that help promote skin elasticity -- elastin and collagen -- become stressed in the process of extreme weight loss. The faster this stress happens, the less able elastin and collagen are to bounce back and provide skin firmness.
To minimize the stress on the skin, aim for a slow, gradual rate of loss. When you lose weight at a rate of 1 to 2 pounds per week, you give elastin and collagen time to adapt. You may still have a fair amount of sag when you reach your goal weight if you lose 50 or more pounds, but it will be less severe than if you lose the weight at a faster rate.
Yo-yo dieting also encourages skin sag. When you repeatedly stress the skin with quick weight loss and gain it back, your skin's elasticity wears out and eventually, can't bounce back. Don't crash diet or try a plan with unsustainable tactics, like juice fasting or banning entire food groups. Instead, adopt a weight-loss plan that teaches you how to moderate portions. Choose healthy, whole foods so you lose weight once and for the long-term.
Take Care of Your Skin
As you age, collagen and elastin naturally lose their strength. The younger you are when you lose weight, the easier it is for skin to bounce back. Genetics also play a role in how elastic your skin is. You can't change your age or genetics, but remember that losing weight greatly reduces your risk of chronic disease and early death -- regardless of what your skin looks like afterward.
How you treat your skin can affect how well it tolerates weight loss without sagging. Sun damage and smoking can make your skin less elastic. Use sunscreen if you spend time outdoors, especially at the beach or pool, and make it a priority to quit a tobacco habit.
Exercise as You Lose Weight
Exercise is a critical strategy in losing weight. It burns calories and enhances your overall well being. Strength-training as you lose weight can help tighten muscles so they look firmer as you lose excess fat. This reduces the appearance of sagginess -- but tauter, tighter muscles can't make loose skin go away. Strength training will be most effective in reducing the appearance of loose skin in people who've lost a moderate amount of weight, such as 20 to 30 pounds.
Go for at least two sessions per week that address all your major muscle groups: arms, legs, glutes, abs, shoulders, back and chest. Do at least one set of an exercise, for each muscle group, that consists of eight to 12 repetitions with a weight heavy enough to fatigue you by the end. When 12 repetitions is easy to complete, add more weight and possibly additional sets.
Some Sagging Skin Is Inevitable
If you start with a body-mass index greater than 30, especially 35 to 40, excess skin is inevitable after losing weight. When you're significantly overweight, obese or morbidly obese, skin stretches out to accommodate your larger body size; when you lose weight, the skin remains.
The "North American Journal of Medical Sciences" published research in 2013 noting that this loose skin often negatively affects people's satisfaction after weight-loss surgery. The researchers suggested that body-contouring surgery be made a regular part of obesity management because of the impact the loose skin has on people's feelings and self-image after weight loss. If you've lost a large percentage of your body mass and loose skin is affecting your quality of life, discuss medical treatment options with your doctor.