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I have a theory about loose skin, which I haven't been able to test out because I am still in the process of losing my excess fat, and I am curious to see what others have experienced in this department. My theory is that if we are working with our bodies natural processes - getting complete nutrition, eating when our appetite tells us to rather than restricting calories and going hungry, staying in some degree of ketosis - our bodies will rearrange themselves in such a way that there won't be any loose skin after weight loss. The most prominent example I know of of this is Jon Gabriel. He never comes out and says he did paleo since he has his own weight loss book to sell, but my impression is that this is basically what he did. He lost a staggering amount of weight and had no loose skin after. Google him if you want to see the pix. Of course, I am sure there are factors that will limit the ability of the body to snap back - age, etc. - but I think we have a much better chance of not having loose skin if we allow the body to want to get thinner through proper nutrition rather than pushing it by starving ourselves and working against our body's hormonal signals.

So, if you've lost quite a bit of weight through paleo, what have been your experience with loose skin? And, the most important factor I am looking for is were following your appetite and hunger signals during the process or did you restrict calories and "force" the weightloss?

ETA: Jon Gabriel's before and after: alt text

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I am going to try to remember to add my after pictures when I finally get here. Give me a year or so, LOL! – turkeytyme Jul 3 2011 at 12:49
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 This story impressed me more: marksdailyapple.com/the-unconquerable-dave ...and for men it seems to be a different story. – Kikilula Jul 3 2011 at 13:43
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 Yes men have thicker skin and they do seem to have less of an issue with skin post weight loss than most women. Plus they lose much more easily. I hate them, lol. – Shari Bambino Jul 3 2011 at 14:08

17 Answers

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I've read anecdotal evidence that drinking collagen-rich bone broth regularly can improve skin elasticity - reducing wrinkles and improving the look of cellulite. Dr. Cate Shanahan and Luke Shanahan, authors of Deep Nutrition: Why Your Genes Need Traditional Food, claim that this is the case, and I know people who swear that bone-broth cured their cellulite. It makes sense to me then, that if consuming collagen improves the elasticity of your skin, then it could also help it to bounce back after extreme weight loss.

It certainly couldn't hurt anything! Seems like cultures who eat a lot of gelatin i.e. Koreans (bone broth soup bases); Asians (agar-agar) have terrific skin.

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 Interesting! Something tells me there is some truth to this. I've run across a source indicating that starvation (which traditional dieting pretty much is) reduces collagen production, possibly decreasing tissue elasticity. Of course the book I saw this in was talking about lung tissue, but I would think the same would apply to other tissues. – turkeytyme Jul 5 2011 at 9:59
I've also read somewhere that Asians tend to have thicker, oilier skin than other people which is why they have a slower rate of wrinkling and damage... – ImRotu Jul 10 2011 at 21:43
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Sorry to burst your bubble but I don't think your theory holds water. The skin is damaged on the way up not the way down. You damage it getting fat. It's all over with at this point. Your fate has been determined. If you lose it quickly you may want to give it some time because sometimes there will be further retraction but this one dude seems to give a lot of people some false hope that they will be bikini models once they lose their extra 100+ lbs and that simply is not the case for 99% of the people who ever actually do lose the 100+ lbs. Yes age and genetics play a part so hope you got some good genes. Yes some peoples skin is in better condition and there will be some retraction. But there is nothing anyone can do about it diet or otherwise IMO. I've talked to at least a dozen plastic surgeons about this subject and they all are in agreement on this and I believe them based on what I have seen of many others out there who have lost massive amounts of weight. I should also add that there has been quite a bit of speculation over that man's photos over the years. I am certainly not convinced they are not retouched especially given that he now sells his diet secrets online.

If you are asking about this for yourself then I say don't worry about it. Just focus on losing the weight you need to lose because the odds are very much stacked against you that that will ever happen. Lose the weight and then you will see what you get in the end. Eat a healthy diet and optimize your chances but to insinuate that people left with puddled of skin somehow did it wrong is really unfair. While I wasn't strictly paleo through my entire weight loss I did eat a low carb whole foods diet with very little grains, no legumes and almost no bad oils and I ended up with 15 extra pounds of skin that had to be cut off. I dry brushed and slathered myself with all kind of goop trying to avoid it. I did NOT lose quickly at all. Turns out my years of yo yo dieting took its toll and there was nothing that could have been done to get a different outcome and avoid the 10 ft of surgical scar I now wear on my body.

I'm happy to show my before pics (I looked like a melted candle) and my battle scars to anyone who's going to LA in August for the symposium. Well you might have to get me drunk first, lol. Otherwise I don't post those online as it's just too personal for e but for some reason I have little difficulty showing my scars in person so if anyone wants to verify in person I'm happy to oblige, lol.

To the OP, I think I may sound negative here and I don't mean to. This is definitely a sore subject for me. I just don't like false hope and honestly you just cannot possibly know what your own skin and body will do so speculation seems futile to me. I think you should just focus on the job at hand -the weight loss - and let what ever else will be, be.

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No, I understand it's a hard subject for us all and you've got a good attitude about it, I think. No matter what happens, it's still a much better place to be in getting healthy. – turkeytyme Jul 3 2011 at 12:33
Absolutely. I will say that exercise which builds muscle goes a long way in helping any extra skin drape a little better. That is one thing you can do to look much better no matter the skin situation. Plus it does so many other good things. What's not to love. You may or may not be ready to go there just yet depending on where you are in your journey but something to think about for when it's less about the scale and more about what the body actually looks like. – Shari Bambino Jul 3 2011 at 14:00
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 I do think it works if your hormonally optimal. Most aren't – The Quilt Jul 3 2011 at 16:29
Yeah, I agree Shari. Good points. – sherpamelissa Jul 5 2011 at 15:42
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 Hormonally optimal? If you are saying I ended up with a ton of excess, damaged skin because I wasn't hormonally optimal I'll have to call bs on that one. Hormonlly optimal can get you places but it doesn't cure skin that's been stretched beyond capacity. All this blame the victim stuff really irks me. I gained a lot of weight and my skin tore and mended as best it could. My hormonal optimization or lack thereof had nothing to do with it. My skin was damaged physically to the point it simply couldn't rebound. End of story. – Shari Bambino Jul 11 2011 at 1:40
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I got those answers on my similar question:

http://paleohacks.com/questions/16579/did-time-have-any-effect-on-your-loose-skin-after-losing-a-lot-of-bodyfat#axzz1R1Vn6fJn

On me the loose skin is getting gradually better but will never be perfekt again. I started to develop striae on my arms and brests and legs during rapid growth in puberty without being overweight. Can't imagine that up to finger wide scars can vanish...

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True about the scars, although they do lighten in time. – turkeytyme Jul 3 2011 at 12:39
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I just hit 140 lb. weight loss and have done it right - mostly Paleo and slow. I've been working at it since May 2010. Yep, quite a bit of loose skin, especially in the abdominal area. I've had folks tell me that they can't believe I don't have loose skin, but they aren't seeing the "full" me - the one I see in the mirror after a shower. I think exercise has helped a lot as I can tell I've developed decent muscle tone. I have another 30-40 pounds to go, so I don't know if I'll need to have some corrective surgery or not. I'm 55 years old and not too vain, so maybe I'll just be happy to have my life back and forget about the surgery!

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 If other people don't see it perhaps you are judging yourself too harshly? I'd also suggest that perhaps things will look differently once you take off the additional pounds. It sounds like you are a still a work in progress. You should definitely be proud of all you have accomplished so far though. – turkeytyme Jul 3 2011 at 12:37
Rhonda wow great job on the loss! I got the same thing from people. Of course they weren't seeing me butt nekid either. I agree about exercise. It does help with shaping and draping, lol. You have a great attitude! – Shari Bambino Jul 3 2011 at 14:03
Without knowing your height its hard to tell, but you say your 140 now and have another 30-40 go. You may be aiming to low. – Ryan H Jul 3 2011 at 15:11
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 She says she's lost 140 lbs., not that she weighs that much. – Rogue Nutritionist Jul 3 2011 at 17:06
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 Is it also possible that the skin will tighten over time after you've reached your goals? – Ambimorph Jul 5 2011 at 4:09
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At my highest weight, I was around 165lb. I lost about 40lb doing slimming world, mostly "green" days which was lots of rice & pasta etc. veg & litre meat/fish. I felt great, but my tummy was still really flabby!

I have type 2 diabetes & after two pregnancies using insulin (why didn't I know about low carb then???), my tummy is not a very nice sight. I'm a complete apple shape.

Anyway, I've lost about 20 (I went up to 140ish when pregnant) since my last pregnancy doing low carb on and off (still breastfeeding). But, I'm stuck at 126lb ATM & have been for about the last six months.

However, what I have noticed is my overhanging fat tummy is receding - without any further weight loss. It's very slight, but I'm pretty sure that it will recede some more. I don't think it'll be perfect - I have a lot of stretchmarks (which appeared with a sudden increase of weight, possibly when diabetes took over?) that do look a lot better and no longer feel sore like they used to. So, things can change but I don't think it's a process that happens overnight and I don't think it will work for everyone. I'm hopeful though!

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Just thought I'd add... At 165lb and 4ft 10, I was clinically obese, so although my weight doesn't sound high, I think I ought to weigh around 100-110lbs (ish). – Efaitch Jul 3 2011 at 8:13
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 You've got a good point that what you have at first isn't necessarily what you'll have months down the line. It's easy to arrive at your goal weight and say oh my god this looks awful, but your body may not be finished rearranging itself. – turkeytyme Jul 3 2011 at 12:42
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I lost 125lbs all Paleo following hunger cues. Ain't no magic gonna undo this stretchmark saggy BS I got goin' on, other than plastic surgery.

There is NO way that guy's photos are real, unless he was fat at 16 for 5 minutes.

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I've wondered if he is for real too, but he sure seems to be. I've read a lot of his stuff and he seems really sincere, even going so far as to put a whole lot of information out there for free rather than trying to sell it. He could just be lucky I guess. – turkeytyme Jul 3 2011 at 12:47
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 Amen Stacy! I was trying to be diplomatic but I agree. If you look at his progression of photos he clearly had excess skin and there is no way it could have retracted enough for him to look like his supposed finished product. I think he's a big sleaze, lol. – Shari Bambino Jul 3 2011 at 14:05
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Everyone's skin is different. It mostly depends on the elasticity of your skin. Muscle building exercise while losing the weight definitely helps. If you are doing all cardio and not building muscle you will probably have more loose skin. I have lost over 80 lbs. and only have a small amount of loose skin in my lower abdomen. I have also given birth to 2 large babies. I am now Paleo, but did not loose the weight on the Paleo diet. I did however eat low carb with the exception of oatmeal and whole wheat bread. I agree with the others that have said you really can't know until you lose the weight and find out and it really doesn't matter just lose the weight. If you have a few pounds of loose skin it's a whole lot better than having 100 or more pounds of FAT!

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 Your last comment is so true! – turkeytyme Jul 3 2011 at 12:44
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Lost 80 lbs. In 8 mos. Eating zone paler and I have loose skin....I especially call my stomach pooch my battle scar and I can act like elastic woman when I pull skin from my trices. Thank goodness im not vain!

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Obviously I haven't seen you, but I'm wondering could the stomach pooch simply be the last little bit of fat that hasn't gone yet? – turkeytyme Jul 3 2011 at 12:45
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I have some lose skin and stretch marks around my stomach and somewhat around my butt. I went from around 210-220 to 140 in a year doing a couple different regimens(whole foods, raw food etc.), I never starved myself and basically lost it all with little effort(it basically melted off once I stopped eating mcdonalds). There is definitely still small amounts of fat where I have the stretchy skin and I have read that once you lose all this fat the skin will start to tighten up but who knows.

What has worked for me is gaining muscle and correct posture. I've gained back up to ~175 and the stretchy skin has decreased especially on my butt. My goal weight is 190-200 and I figure once I hit that mark most of the skin will stretch to the point where it doesn't sag anymore. Regarding posture if I don't stand correctly my stomach flab sags and creates a roll which looks rather weird, if I hold my posture right I look like a normal person(I actually looked pretty ripped lol). Search Esther Gokhale on google for some posture tips.

I wouldn't really expect the skin to magically disappear but as long as its not to severe I think you can negate the stretch with more muscle.

The stretch marks are less visible the more tan I get.

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I've seen that little stomach roll when bending over even on celebrities who have never been fat so I tend to think that's not really loose skin at all, just normal. Sounds like you have made some awesome progress and I agree with you that a tiny amount of loose skin can be canceled out with muscle. – turkeytyme Jul 4 2011 at 4:05
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This is an interesting take on "The Myth of Loose Skin." I'm not sure I'm on board with him 100% but it's interesting nonetheless.

http://www.bodyfatguide.com/LooseSkin.htm

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Might be some truth to what he says. I mean how many people who loose mass amounts of weight truly do get down to that point where they would ever see if his theory is right? Especially those who starve themselves, which most do. People who do paleo are much more likely to follow through to lower body fats IMO so if his theory is true they would be most likely to arrive at that point. – turkeytyme Jul 4 2011 at 4:12
That makes a lot of sense. Never thought of it that way. Glad I read that article (even though it was selling something rather than bring just an informative article) – miked Jul 4 2011 at 14:48
That is a very interesting perspective. He is a bit misinformed about gluconeogenesis, and appears not to know that different macronutrient ratios effect the composition of weight lost (LC is muscle sparing to the greatest extent). Still, that doesn't really affect his argument much, and the argument is compelling. – Ambimorph Jul 5 2011 at 4:51
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I lost 100 pounds and the only thing i have left is belly skin. time has helped but it still sagging. the man in the picture still has an upside down frowning belly button he isn't facing the camera for a reason. if you look closely you can see it

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If you have to look closely to see it though it's just not that much loose skin. I know I'd be ecstatic if you had to look closely to see any loose skin that I had. – turkeytyme Jul 4 2011 at 4:14
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Well, I don't have any real experience with this, but I do have a theory: One of the good things about bone broth is that we're getting all of that cartilage in the broth that goes straight to our joints. I.e., we let the chicken do all of the work to make the cartilage from their food and we just use it. I imagine that eating skin of the animal is good for our skin, at least in some way. So maybe people who lose weight slowly on a animal based paleo diet could have a better time having their skin recover versus people losing weight on a low-fat (also bad for skin) grain-based diet. But I'm sure there are still tons of variation among people. I guess the only real thing I could argue is that paleo can't hurt.

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Interesting theory and one that I'd agree with as being plausible. It makes sense that if we are eating all the parts of the animal then those parts would be incorporated into our bodies. I think people who eat low fat/low cal may just be prone to loose skin because they are missing some of the good building blocks of healthy skin by eating in that fashion. People on a paleo diet tend to be better nourished, in my opinion and should be building healthier tissues that don't sag. – turkeytyme Jul 4 2011 at 4:08
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I had three children over a 15 month period (twins then a singleton). I had a hard time losing the last 20-ish pounds of pregnancy weight and started doing Paleo and Crossfit and it came off quickly.

I have horrific stretch marks and hanging skin. The lower my body fat, the flatter my stomach and the longer my flap of twin-skin hangs from my belly button. My belly button is no longer "tight", rather, it looks as if it is "wrapped" in skin, if that makes sense. This skin is NOT going to retract. It actually looks a bit better if I'm carrying a little extra belly fat, but when I'm at my leanest, it's at it's loosest. I can grab a handful of skin and pull it away from my belly. The doc tells me my only recourse is plastic surgery.

And - just as a reference, I am 6"0, 165 lbs, a size 6-8. Pretty lean.

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How long ago did you have your last baby? I ask because right after mine was born I had a LOT of loose tummy skin, but it really did tighten up a lot over time. I had a flap hanging down at first, but that went away. I don't remember exactly how long it took though. I started doing Atkins right away to lose weight and by the time the excess 40 lbs. were gone my stomach looked pretty good. Of course, I regained that weight and more, but the pregnancy stretching really did recover. I think it might have taken like a year though. – turkeytyme Jul 10 2011 at 6:03
My youngest will be 3 this month... I wish my tummy would recover more but I think this is where it will be.... :( – Sara Jul 16 2011 at 4:05
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I started getting fat young. In pictures of me, at around 7 or 8, you really start to see me chubbin' up. I remember being 14 or 15, flirting with 200lbs, and my mother telling me that I need to not go over that. I'd tried different diets over the years, and sometimes it worked, but stress and depression wasn't good on me and I really put on a massive amount of weight. By 20 I was up to at least 250lbs, possibly more as I'd stopped weighing myself.

Very slowly I started to lose it. At first just through what I thought was a good diet and exercise, and then through paleo. I did the first 30 or 40 pounds by just eating the typical lower calorie diet and avoiding sugar. It was hard and took a long time to get there, and I spent a lot of time working out. I did the next 30 or 40 pounds through off-and-on paleo, eating what I wanted, when I wanted and minimal working out. I'm down to about 180 now, a weight I haven't seen in close to ten years. I have stretch marks, though they're now faded and less obvious, more like old scars. However, I don't have any loose skin. I attribute this to three things:

1) I'm young (23).

2) I wasn't afraid to lay in the sun all throughout summer to tan up a bit. I don't know about you, but by the end of winter my skin just looks gross and unhealthy. Small amounts of a tan just seems to make skin look and feel happier with improved elasticity.

3) I lost weight slowly. Three years to drop down from roughly 250 to 180. This has had many benefits, one of which I suspect is no loose skin.

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I really think age is the predominant factor here. In my 20s, 30s and 40s I gained and lost the same 50-60 pounds. The first 2 times I had no loose skin, but in my 40s if I curled my torso I had a "6-pack" of loose skin folds.

Now in my 60s, I'm losing on Paleo. My skin is shrinking, but there's no doubt I'll have some loose skin on my arms and torso. I don't really care, my personal joke is I'm going from Hippo to Rhino (where I am now) with hopes of reaching Bloodhound.

If you don't want loose skin, lose your extra weight by your early 30s and don't smoke. But no matter how old you are, losing your extra weight will give you increased energy and a lightness of motion that makes it worthwhile.

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 Age doesn't have anything to do with it. I did most of the damage to myself around 16-18 – cliff Jul 10 2011 at 16:36
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after my patients lose their weight we use a few things to tighten skin over about 12 months.....high dose Vit K2 and teprenone Oral and topical caprylic acid and high dose dietary palm and coconut oil. It does amazing things to adipocytes and the skin once the weight is gone.

We also add a couple of high dose supplements too....NAC and R-lipoic acid and resveratrol.

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Have any of your patients tried Fraxel lasers? It seems to me these would help, esp with the supplementation. – Marie Jul 10 2011 at 19:43
They have with mixed results......I usually dont advocate surgery unless there are skin infection issues. – The Quilt Jul 10 2011 at 20:47
Can you say more about this? I'm in my 50s and want to tighten some skin as I lose weight and thought maybe this would be next to impossible due to my age. – Deborah105 Jul 11 2011 at 2:02
What type of doses are we talking? – dubpluris Aug 31 2011 at 17:11
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Speaking from someone who has lost over 100lbs, and although still overweight, has knocked 20" off his waist... I can tell you...

I've not been 440lbs since 2003. However, I still have "issues" of skin folds from being 440lbs. Because these issues are now starting to interfere with my physical fitness (cannot run comfortably) as well as my healthy (having very loose skin around the belt line results in painful sores from belts and waistlines of clothing) I am going to inquire about a medical solution. I'm pretty sure they will want me much lighter than even my personal goal weight, as I am very large-framed, still want to pursue strength athletics, and still want to compete in the middle/heavyweight arenas (230-260lbs). I think I can do that AND keep my waistline under 36".

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