That Nagging, Sagging Skin
I got fat between the ages of 18 and 21. No real excuses. Busy with college, blah, blah, blah... The real problem was food. Crappy food and truckloads of it. I slacked off, suffered from a bout of temporary stupidity, and got fat.
There were no "body acceptance" enablers around back then or I might be dead by now. I just got sick of being sloppy and socially invisible, dropped the excuses, and lost around 70 pounds. Years passed, I rediscovered the gym, and made a career in the fitness biz. Only one problem: loose skin.
What Is Loose Skin Exactly?
It's when you get fat and your skin expands to hold in extra adipose tissue. The skin stretches out, gets damaged, and loses some (or a lot) of its elasticity. When you lose the fat, the skin looks saggy, like someone let the air out of your love handles or lower belly.
It doesn't happen to everyone who loses weight, but for some it occurs even with relatively minor fat loss. Usually you see it in those who lose roughly 100 pounds or more, but some people may notice a little sag losing just 40 pounds or so. Other factors play a role: genetics, age, where you tend to store excess fat, how long you stay fat, etc.
It's kinda like pregnancy. Some women spring right back into shape even after popping out a few carpet crawlers, while other women never wear a bikini again even after one pregnancy where they avoided excess fat gain. Former fat boys and moms weirdly have a lot in common.
In extreme cases where a morbidly obese person drops a couple hundred pounds, the saggy skin can be seen on the chest, arms, thighs and just about everywhere else. But we're not talking about that. We're talking about the average person who drops 40 to 70 pounds and keeps it off – the person who's lost the fat and is left with some bothersome loose skin. Can anything be done about it?
If You're Fat Now
First off, lose the fat anyway. Better to have some loose skin than be unhealthy. Remember, fat LOSS doesn't cause loose skin; it just makes it more noticeable. And rapid fat loss (vs. slow fat loss) doesn't cause it either – a common myth.
Fat GAIN causes the loose skin, and that damage is already done. It's just usually harder to see because, well, it's puffed up by globs of fat. Don't let the worry of having some loose skin keep you from losing fat. Hell, consider it a trophy or a battle scar.
If You Already Have Loose Skin
1 – Accept this: Loose skin cannot be dieted off, trained off, or drugged off.
There are many products on the market claiming to get rid of loose skin, or if the product manufacturer wants to avoid the stamping foot of the FTC, "reduce the appearance of" loose skin. Some just contain local diuretics, others contain hopeful sounding things like collagen or elastin, but all that basically means is temporary water loss and skin that "feels" tighter but really isn't. No cream or noninvasive laser or light therapy is going to make a few inches of your body's largest organ disappear.
If you are just looking for some localized fat loss and temporary tightening, here's a trick. Get a fat burner that uses a self-emulsifying gel delivery system (such as Hot-Rox® Extreme), break open a few capsules and rub it into the problem area. You'll need to already be relatively lean to notice the effects, but bodybuilders and figure/bikini competitors have successfully used this method right before contests. But again, this doesn't remove excess skin obviously.
2 – Stop trying to low-carb it off.
Most of that isn't fat, it's skin. Some people don't realize this, assume the problem is pockets of fat, and diet themselves into a metabolism-wrecked pile of bones. Yeah, don't do that.
A test that plastic surgeons use is to have you bend over at the waist, like a deep bow. See how it looks from that angle. If it's more of a deflated, empty flap that could be described as "pull-able" then it's skin. If it's a full-looking roll, it's fat. And it is possible to have excess skin AND fat deposits. Cruelly, the more ripped you get the more the damaged skin is noticeable.
3 – Ignore the never-been-fat armchair experts.
You may also hear advice on the internet like "just build more muscle and fill that skin in!" This advice comes from people who have never had the problem. They are, for the most part, idiots. Yes, build muscle. Muscle is awesome. But it's doubtful that you can "fill in" several inches of deflated love handles with obliques. Heck, try anyway. Obliques are awesome too. But you probably won't be satisfied.
4 – Loose skin can only be cut off.
In the belly and flank areas, this is often called a "tummy tuck." The medical term is abdominoplasty. Basically, a long strip of excess skin is surgically removed and the remaining skin is put back together, tightening the abdomen. This surgery is usually accompanied by a little liposuction and sometimes other procedures depending on the extent of the damage.
The docs are pretty good at it these days, but you're still getting a knife stuck into your body, there are risks, the recovery time is tedious for an active person, and you'll have a long scar. This will run you 6,000 to 12,000 dollars once you add up all the costs (anesthesia, drugs, etc.).
Consider surgery if you've lost roughly 100 pounds or more and you find the damaged skin unsightly. Realize that you're trading some flappy skin for a pretty gnarly, hip-to-hip scar. Outside of extreme cases, there are no health problems caused by non-elastic areas of skin. It's just cosmetic. But if it bugs you and you've got the funds, do what makes you happy after weighing the risks and rewards.
Although my loose skin wasn't bad, it had always been annoying. I decided to get a free consultation with a surgeon. He said there was some damage but not enough to justify the procedure. I could've doctor-shopped and found one of those guys who'll do anything you ask, but I decided that a bit of loose skin was okay. I probably wasn't going to get a Calvin Klein underwear contract anyway. I can live with a five-pack and a bit of skin that my wife says she can't even see.
If You Don't Have Loose Skin
Don't get fat. Really, it sucks. If you're under the false impression that you need to get fat to build a lot muscle – or plowing through the menu at Taco Hell just sounds fun and "I'm bulking, bro" is a convenient excuse – consider moisturizing with pregnant-lady lotions designed to minimize stretch marks. They won't help that much, the skin may still lose elasticity, but it's probably better than doing nothing.
The best plan: Get a better understanding of effective training, nutrition, and supplementation. The goal is big biceps, not a big gut and a weird-looking bellybutton.