| If you're overweight or if you've been overweight | | | | even then, only if you are measuring body fat |
| in the past, then you know that getting rid of | | | | and you're certain it's fat you're losing, not lean |
| excess pounds is only one of the challenges you | | | | tissue). |
| face. Once the fat is gone, you are often | | | | 8. There are exceptions to all of the above; i.e, |
| confronted with an equally frustrating cosmetic | | | | people who gained and then lost incredible |
| problem; Loose skin. | | | | amounts of weight quickly at age 50 or 60, and |
| I know this is a big problem because I receive a | | | | their skin returned 100% to normal. |
| ton of e-mail from people who have loose skin or | | | | 9. There are many creams advertised as having |
| from overweight people who are concerned | | | | the ability to restore the tightness of your skin. |
| about having loose skin after they lose the | | | | None work - at least not permanently and |
| weight. Just recently, I received this email from a | | | | measurably - and especially if you have a lot of |
| reader of my syndicated "Burn The Fat" Q & A | | | | loose skin. Don't waste your money. |
| column: | | | | 10. If you're considering surgical skin removal, |
| "'Tom, I began a fat loss program using your Burn | | | | consult a physician for advice because this is not a |
| The Fat program and it worked so well I got | | | | minor operation, but keep in mind that your plastic |
| down to 15 1/2 stones (from 19). However, this | | | | surgeon may be making his BMW payments with |
| has caused me a problem: Excess abdominal skin. | | | | your abdominoplasty money. (It's possible that |
| I didn't crash lose this weight, it came off at the | | | | surgery may be recommended in situations |
| rate of about 2 lbs. per week just like you | | | | where it's not 100% necessary). Surgery should |
| recommended. Now I'm unsure of whether to | | | | be left as the ABSOLUTE FINAL option in |
| carry on, as my abdomen has quite a lot of | | | | extreme cases. |
| excess skin - I feel like I've turned into a bloody | | | | 11. Give your skin time. Your skin will get tighter |
| Shar-Pei! (You know, that 'wrinkly' dog!) | | | | as your body fat gets lower. I've seen and heard |
| Does everyone go through this? Will the skin | | | | of many cases where the skin gradually tightened |
| tighten up? I was overweight for more than 12 | | | | up, at least partially, after a one or two year |
| years. Am I going to end up needing surgical skin | | | | period where the weight loss was maintained and |
| removal? Can you offer me any advice? I'm a | | | | exercise continued. |
| medical student in the UK and my colleagues | | | | 12. Know your body fat percentage before even |
| seem determined to proffer surgery as the only | | | | thinking about surgery. Loose skin is one thing, but |
| option." | | | | still having body fat is another. Be honest with |
| There are 12 things you should know about loose | | | | yourself and do that by taking your body fat |
| skin after very large weight losses: | | | | measurement. This can be done with skinfold |
| 1. Skin is incredibly elastic. Just look at what | | | | calipers or a variety of other devices (calipers |
| women go through during pregnancy. Skin has the | | | | might not be the best method if you have large |
| ability to expand and contract to a remarkable | | | | folds of loose skin. Look into impedance analysis, |
| degree. | | | | underwater weighing, DEXA or Bod Pod). |
| 2. Elasticity of skin tends to decrease with age. | | | | Suppose for example, a man drops from 35% |
| Wrinkling and loss of elasticity is partly the | | | | body fat all the way down to 20%. He should be |
| consequence of aging (genetic factors) and also a | | | | congratulated, but I would tell him, "Don't complain |
| result of environmental factors such as oxidative | | | | about loose skin, your body fat is still high. Press |
| stress, excessive sun exposure, and nutritional | | | | onward and keep getting leaner." |
| deficiency. The environmental parts you can fix, | | | | Average body fat for men is in the mid teens |
| the genetics and age part, you cannot. Advice: | | | | (16% or so) Good body fat for men is 10-12%, |
| Get moving and change the things you have | | | | and single digits is extremely lean (men shouldn't |
| control over... Be realistic and don't worry about | | | | expect to look "ripped" with 100% tight skin on |
| those things you don't have control over. | | | | the abs unless they have single digit body fat, and |
| 3. How much your skin will return to its former | | | | women low to mid teens). |
| tautness depends partly on age. The older you | | | | Except in extreme cases, you are very unlikely to |
| get, the more an extremely large weight loss can | | | | see someone with loose skin who has very low |
| leave loose skin that will not return to normal. | | | | body fat. It's quite remarkable how much your |
| 4. How long you have extra weight and stretched | | | | skin can tighten up and literally start to "cling" to |
| skin has a lot to do with how much the skin will | | | | your abdominal muscles once your body fat goes |
| become taut after the weight loss: For example, | | | | from "average" to "excellent." Someone with |
| compare a 9 month pregnancy with 9 years | | | | legitimate single digit body fat and loose skin is a |
| carrying 100 excess pounds. | | | | rare sight. |
| 5. How much excess weight was carried has a lot | | | | So... the key to getting tighter skin is to lose more |
| to do with how much the skin will resume a tight | | | | body fat, up to the point where your body |
| appearance. Your skin can only be stretched so | | | | composition rating is BETTER than average (in the |
| much and be expected to "snap back" one | | | | "good" to "great" category, not just "okay"). Only |
| hundred percent. | | | | AFTER you reach your long term body fat |
| 6. How fast the weight was gained also has a lot | | | | percentage goal should you give thought to |
| to do with how much the skin will resume a tight | | | | "excess skin removal." At that point, admittedly, |
| appearance. Your skin can only be stretched so | | | | there are bound to be a few isolated cases |
| quickly and be expected to "snap back." | | | | where surgery is necessary if you can't live with |
| 7. How fast weight is lost also has a lot to do | | | | the amount of loose skin remaining. |
| with how much the skin will tighten up. Rapid | | | | However, unless you are really, really lean, it's |
| weight loss doesn't allow the skin time to slowly | | | | difficult to get a clear picture of what is loose |
| resume to normal. (yet another reason to lose fat | | | | skin, what is just remaining body fat and how |
| slowly; 1-2 pounds per week, 3 pounds at the | | | | much further the skin will tighten up when the |
| most if you have a lot of weight to lose, and | | | | rest of the fat is lost. |