My story was featured this week on popular Primal/Paleo Blog, Mark’s Daily Apple this week and as it always seems to, a few of the commenters noticed that I don’t seem to have any loose skin.  With the advent of extreme weight loss programming, people are more acutely aware of the issue with loose skin following extreme weight loss.

“So what is the deal with loose skin?”

Let’s hit this with 4 Frequently Asked Questions.

1) Do I have loose skin?

Yes.

1.5) But I don’t believe you! I can’t see it in your arms and OMG you’re so dreamy and OMG can you post more videos of you doing squats?

Ok, so maybe no one asks this question exactly that way.

I have a decent amount of loose skin in my lower stomach, inner thighs and underarms. There is a significant difference in definition when you compare my the back of my body where there was less fat accumulated than in my front where my gut used to protrude enough to enter a room 15 minutes before I would.

1.6) I don’t believe you! Show me nude pics.

You’re sick, do you know that?

2) What did I do to prevent loose skin?

Almost nothing. When I noticed it start to become an issue, I decided to do what I had heard anecdotally worked. I might have used cocoa butter lotion 12 times in the 18 months I was heavily focused on weight loss. The problem with cocoa butter is it makes me want to grab a spoon and start eating myself. I smelled like dessert, it was debilitating.

Other than that, I didn’t really do anything to minimize the impact of loose skin.

3) What works?

I could not find a single scientific study to show that something “works” for removal of loose skin other than one obvious thing. So let’s start with a list of stuff that might work and doesn’t have a downside other than spending time and/or money.

• Cocoa Butter: This stuff is rumored to help with loose skin, but I can’t find anything to validate this. Pregnant ladies have been using the stuff for years and like I said, I tried it and there’s an upside: you smell delicious (literally) and you will have moist skin.
• Staying Hydrated: Your skin is an organ drinking water might help? I can’t think of a downside to doing this anyway, so go for it!
• Losing weight slower: this will give your skin a chance to shrink in? I can’t find a single study to prove whether it’s the time you’re waiting that’s tightening the skin or the difference in losing. For example, if I had lost 200 pounds in 2 years instead of one year, would my skin have looked better than if I’d lost 200 pounds in one year (which I did) and waited a year to see what happened? There’s no downside to losing weight slowly, so go for it if it works for you!
• Lifting weights/growing muscle: The idea is that you are filling that skin up with rippling muscles. Again, no downside to doing this.
• Being younger: the younger you are, the better chance you will have to see your skin bounce back. Obviously, we can’t control this, so it’s just the universe’s way of telling you you’re old if your skin doesn’t recover. The universe can be a real bastard sometimes.

So what is the one thing that is proven to remove loose skin?

A knife.

Post weight loss surgery is always an option. It is expensive and typically not covered by insurance with costs in excess of $10,000 depending on what kind of work you have done. Furthermore, like all surgeries it carries with it the burden of risk and recovery. Surgery remains the one virtually foolproof way to remove skin.

At this point, I would be remiss to not recommend listening to my good friend and Tips Alumni J.T. who has also written on his blog about his three body contouring surgeries. He is an incredible resource on this subject and has firsthand knowledge on it which I will not pretend to.

4) So if you have loose skin, why haven’t you gotten surgery?

I always feel compelled to make some strong statement here about accepting the imperfections of my body, but the truth is that sometimes I do feel self conscious about my loose skin. Losing weight is the greatest thing I ever did for myself and I have called my loose skin the badge of honor I will wear for the rest of my life as a symbol of that, but sometimes I am scared of that first moment when a girl I’m seeing gets to see my stomach or legs (when we go swimming or something).

So I guess if you want to know how I really feel, the real question is this:

4.1) If there was zero risk and zero cost, would you get the surgery?

I am so proud of my imperfect body. Why do I need to get surgery. I mean, who cares about having abs and being shredded and having the girls scream every time you walk in the room like it used to happen with Slater on Saved By The Bell?

Of course I would have the surgery if it was risk and cost free. I’m not stupid. I worked my butt off and although I didn’t do it strictly for cosmetic reasons, everyone wants to look as good as they possibly can, right? We all have differing degrees of vanity, but I don’t know anyone whose first name isn’t Jesus, Mahatma or Dalai who doesn’t have even a little bit.

But if we’re talking about $10,000, I would rather take my imperfect body to Tahiti than spend the money on the surgery.

But none of these questions are the real question. Here’s the real question:

If I lose weight, will I have loose skin?

I don’t know. If you have a lot of weigth to lose, the answer is maybe. But let’s not make it maybe. Let’s say it’s yes for now. Let’s be stoic for a second and prepare for this challenge.

Before I go on, I need to prepare you: this might hurt a little bit.

Letting a fear of loose skin hold you back from losing weight is like suffocating because you’re scared of breathing in smog. One might give you lung cancer and the other one is guaranteed to kill you. If we were to weigh this in a different way, it might look like this:

If you’ve listened to more than one episode, you know that for most of us, losing weight was the best thing we ever did for ourselves. It opened the doors to so many new opportunities, experiences and friendships. In my case, all the relationships that mattered improved and I had the strength to cut the fat from areas of my life. Start your journey today. If anything, be afraid of what will happen if you don’t do it, not what will happen if you succeed.

One last thing: Surgery might help keep the weight off

So while doing research for this story, I came across a recent study that presented an interesting idea that I just want to throw out there. They looked at two groups of about 100 patients. Both groups had had gastric bypass surgery to lose the weight, but one group had post weight loss surgery to remove loose skin while the other didn’t. After seven years, the group that had surgery after weight loss only gained back an average of 14 pounds whereas the group that didn’t have surgery gained back on average 50 pounds.

I could totally see that people having this surgery might feel like they have more skin in the game (see what I did there???).

Disclaimer: This study was published in a plastic surgery magazine with an agenda to get this plastic surgery covered as an essential part of gastric bypass surgery.

Do you have any questions about loose skin that we can answer? Let me know in the comments!