Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
19 Mar

Dear Mark: Excess Skin After Major Weight Loss?

questionToday’s Dear Mark topic is a sensitive one: excess, or loose skin after major weight loss. This is a problem for a lot of people, and it can really take the sails out of someone who’s had otherwise seamless success losing weight. I may ruffle a few feathers here, but I assure my intent is merely to give folks who have loose skin the best shot at reaching their desired body composition. So, as you read my response to the reader question, keep that in mind.

With that said, let’s get to it:

Hi Mark,

Excess skin after weight loss is a big topic in most weight loss communities, yet I rarely hear about it in the Primal community. Does the Primal lifestyle prevent excess skin? Are there any tips from either yourself or from the members of the community about avoiding or preventing excess skin after weight loss? I am currently approx 100 lbs overweight so this is something that really concerns me.

Gabrielle

Before getting into potential methods of treating and/or preventing excess skin after weight loss, let’s explore the phenomenon itself. What exactly is loose, or excess skin?

Most cases of loose skin are actually just cases of excess subcutaneous body fat covered by skin. And because subcutaneous fat is “soft” fat, it is looser and easier to confuse with skin. It droops and jiggles and the skin that surrounds it conforms to its shape. That’s not to suggest that legitimately loose skin isn’t a real problem, because it is. But I would wager that many if not most cases of loose skin can be explained by overly stubborn deposits of subcutaneous fat.

Stubborn fat is actually a real thing. As Martin Berkhan explains, adipose tissue is full of alpha-2 and beta-2 receptors. A-2 and b-2 receptors are the major lipolytic receptors in adipose tissue, meaning they interact with the catecholamines (adrenaline and noradrenaline) to cause stored body fat to release. B-2 receptors are associated with “easy fat,” or fat that burns off easily. A-2 receptors are associated with “stubborn fat,” or fat that’s harder to burn. All adipose tissue has both a-2 and b-2 receptors, and the higher the b-2:a-2 ratio, the easier it is to burn the fat. The lower the ratio, the more stubborn the fat. Belly fat has a notoriously low b-2:a-2 ratio, which is why it’s usually the last to go (especially for men). If your belly fat is stubborn, it may resemble loose skin even as the rest of your body has mostly leaned out.

If your loose skin is thicker than a few millimeters, there is residual body fat. And because adipose tissue – which, remember, is actually a major endocrine organ, rather than an inert piece of tissue – remains, the skin has no reason to return to its former size and elasticity. As long as the subcutaneous fat attached to it remains, the skin will appear loose and drape-y. Skin that fills your hand when you squeeze it isn’t just skin.

This isn’t really bad news, believe it or not. It actually means that you’re almost there. It means that your “loose skin” isn’t necessarily out of your control. If indeed it is simply stubborn subcutaneous fat, once you manage to lose the excess fat, the “loose skin” might just disappear along with it. In fact, I’d imagine that most such cases of “loose skin” can and will be remedied in this manner. Men, get down to around 10-12% body fat before you start considering surgery or anything drastic. Women, get down to 15-17% body fat before taking any surgical steps.

Hey, if that sounded harsh to you, at least I’m not as bad as Ron Brown, PhD, who claims loose skin is nothing but a myth. Go ahead and check out his argument, but try to avoid meeting his steely gaze. Lock eyes with Dr. Ron at your own peril; you will be consumed. Despite the intense shirtless photo, he has a point that skin is not a passive slab of flesh. Instead, it is an active organ that should be able to adapt to the body’s “internal and external environment.”

That said, if your loose skin is paper thin, closer to the thickness of your eyelid or the back of your hand (about 1 mm thick), and resembles rolled up papyrus or parchment, you likely suffer from excess skin. What can be done to prevent or deal with actual excess skin?

First and foremost, any weight loss regimen must be accompanied by resistance training. Yeah, I’ve said it before, and I’ll say it again: you have to be lifting heavy things in order for the best things to happen to your body composition. There are a few genetic outliers who can put on muscle as easily as breathing, but those folks probably won’t have the problem of loose skin anyway. For the rest of us, however, we need to lift weights in order to maintain and/or build lean mass during weight loss. If your loose skin is caused by a rapid diminishing of body mass, packing on a bit more mass in the form of muscle can mitigate the problem.

There’s no hard data on this, but I’d imagine that crash diets, ones that consume lean mass and fat mass indiscriminately in the pursuit of rapid weight loss, will be more likely to leave you with excess skin. If you’re losing weight and feeling weaker, disoriented, lazy, rundown, and generally crappy, you’re probably doing it wrong. Weight loss should imbue you with vigor and strength, easy, smooth energy. You should be burning clean body fat for energy, not breaking down your lean tissue. Remember what I wrote last week about fasting preferentially targeting body fat versus lean mass? Yeah, fasting might be just the ticket for ridding yourself of stubborn body fat while avoiding the accumulation of excess skin due to concurrent lean mass breakdown.

Another major cause of loose skin is compromised skin elasticity. If your skin loses elasticity, it will lose its ability to spring back to its former glory. Lost elasticity is usually thought of as a characteristic of growing old, but it can also strike younger people. Besides finding the fountain of youth, what can you do to improve skin elasticity?

One study found that dietary gelatin improved skin elasticity (PDF). Eating real bone broth, fatty gelatin-rich meats like oxtail, poultry feet, or short ribs, or even using gelatin powder as a supplement might be able to restore or preserve skin elasticity. You’re already getting dietary gelatin anyway, right?

Another study found that a proprietary blend of nutrients, including selenium (salmonbrazil nuts, seafood), zinc (oystersred meat), vitamin C (vegetables, fruit, raw liver), and various carotenoids (fruits and vegetables, red palm oil), was effective at increasing skin elasticity.

Vitamin C is important for collagen formation, which is vital for skin elasticity. Make sure to get enough vitamin C.

If weight loss occurs and you’re at a low-enough body fat percentage to determine that you truly have excess skin, give it several months before you turn to the scalpel. My guess is that for Primal eaters who are eating a nutrient-dense diet (including plenty of the aforementioned nutrients), truly excess skin won’t be as big a problem as it might be for the general dieter.

Now I’d like your help. Did you have excess skin after weight loss? Was it truly just skin, or was there also fat left over? Please, leave a comment and let everyone know what worked – and didn’t work – for you. Thanks for reading!

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. So if I am already lifting heavy things and fasting, but I’m seeing no change in the amount of stubborn fat, what other options do I have? Lift more, fast more, or are there other changes I can make to lose the last couple pounds?

    Brian wrote on March 19th, 2012
    • If you aren’t incorporating sprints in your regimin, now’s the time to start! Good luck, Brian!

      fritzy wrote on March 19th, 2012
    • Perhaps look again for allergens and eliminate them.

      Lauren wrote on March 20th, 2012
    • The last couple pounds? Is that all? How about the option of don’t worry about it? If your goal of losing weight is some arbitrary ideal of relative attractiveness, you’ll never get there. That is a long and frustrating road ending ultimately in dissatisfaction. If your goal was improved health, then you are already there. Continue to live a healthy lifestyle and if your body composition changes, fine. If it doesn’t, fine. If you can’t have what you want, want what you have.

      Joshua wrote on March 22nd, 2012
      • Thanks for the lecture. Exactly the motivation I needed.

        Brian wrote on March 26th, 2012
        • Totally. Well said Joshua. You gotta keep these things in perspective.

          Deuce wrote on March 29th, 2012
      • I get what your saying but don’t knock the guy down. And the fact is that there are real issues that come with the extra flap of skin. Especially if you’re exercising you can get rashes under folds of skin, and finding clothes to fit what would be your normal body plus a sag of skin is difficult and can be uncomfortable. Somethings that seem to be about “attractiveness” can also be about sheer logistics. I would also add there is something to be said about trying to attain a body that makes you feel good. It’s nothing to cry over when it doesn’t happen but there’s no harm in seeking answers when you feel you’re doing everything you can without the success you are looking for. Goals aren’t something to scoff at.

        Manda wrote on March 5th, 2013
        • Well said Manda,I never can understand why people feel they have a right to “lecture” rather than just either be helpful or say nothing.

          peter wrote on August 14th, 2013
    • I tried crossfit, and strength cardio, that did help out a little.

      mark wrote on July 8th, 2013
    • Fasting can send your body into starvation mode making your body store fat cells. Maybe cut your calories, but you should consume at least 1,000 I’d say, especially if you’re lifting and working out.

      Rach wrote on October 23rd, 2013
      • Intermittent fasting will not put your body in starvation mode; your body will need at least, 48-72+ hours to realize it is being starved. If proper fasting techniques are used followed by adequate hydration, there is nothing to worry about.

        Shayne wrote on February 6th, 2014
  2. What an interesting article! I’d also like to hear what people who have lost lots on the Primal diet have found in regards to this issue.

    As for someone just starting on a weight loss program, I think these recommendations are great. IF already sounded pretty good from your last article. Now with the skin benefits it sounds even better.

    I can see an opportunity for making a good weight loss supplement with all the recommendations above mixed in with some gelatin. Maybe you should consider it!

    Joanna wrote on March 19th, 2012
  3. Well, good news and bad news there. Good news is I might be able to wear a bikini again after all. Bad news is yes, I DO have a fair bit of “stubborn” belly fat. Time to start lifting something heavier than my 50-lb son.

    Danielle wrote on March 19th, 2012
    • Just don’t go fattening up your son for the sake of skinnying up yourself;)

      Deuce wrote on March 29th, 2012
      • Try to get the son to 150, 175 pounds before you give up on using him as a muscle strengthener.

        Jeff wrote on March 29th, 2014
  4. I lost a lot of weight but have the problem with stubborn fat at the waistline, it’s not much just enough to be annoying … it’s gradually coming off but I don’t see any easy way to get the job done, have to exercise more and consume fewer calories, it’s not coming off of its own volition, that’s why they call it “stubborn fat.” If it was easy then everyone would enjoy low body fat.

    rob wrote on March 19th, 2012
    • Second that. My face lost weight quickly, as did my waistline. But my stubborn adipose tissue remains. I know what I have to do- totally quit drinking beer/alcohol until my desired physique is achieved.

      Side note: My stretch marks located on my love handles have been slowly disappearing.

      liberty1776 wrote on March 19th, 2012
      • I have to second the comment on the beer/wine. It seems to halt my weight loss completely. Too bad, as that would be my preferred 20%.

        As I lose weight, I notice stretch marks in all sorts of places I had never worried about before. For example, on the bottom of my upper arm. I actually find this post very inspiring–there is no chance that I will ever have surgery to get rid of my belly flap, so it’s going to be fat loss or nothing. Maybe someday I will look good in a bathing suit!

        Louise wrote on March 20th, 2012
  5. I lost a 130 pounds, and I have stretch marks from hell; they look like silver tiger stripes on my belly. I have loose thin skin on the bottom of my stomach, and I doubt it’s adipose tissue; had a dermatologist look at it, and he recomended surgery to get rid of it. It kind of sucks to be honest, every time I look at my stomach I see the indentions of my abdominals, with large stretch marks that remind me of how fat I was.
    I think this may be a larger issue in the paleo community, but people don’t want to fess up.

    Carlos Morales wrote on March 19th, 2012
    • By the way, it’s hard to take Ron Brown’s article seriously, when it looks like an Angel Fire website with no sources, before and after photos, and a general lack of research proofs. He could be right, but he’s not doing a very good job proving it.
      It reads like a rant, “It’s easy, just stop eating” seems to be the mantra with very little science to back it.

      Carlos Morales wrote on March 19th, 2012
      • Absurd. He clearly and thoroughly details why “just stop eating” is exactly the wrong approach through some 4 paragraphs that you obviously didn’t read before coming here to bash him. Nobody is trashing you based on your inane comments. If you’re going to sit at your computer and bash people you don’t know, at least be right about what you are bashing.

        Deuce wrote on March 29th, 2012
        • Hey fruit cake; how can you say, “Nobody is trashing you based on your inane comments,” YOU JUST DID BY SAYING THAT!!! (btw, your name sounds awefully close to what you are with your put down of that poster! lol

          garry wrote on February 24th, 2013
      • Also, Ron Brown’s speciality is psychology… He has no professional training in biology…..

        Hailey wrote on May 21st, 2012
    • Congratulations on the weight loss. regarding stretch marks….the tendency to that is very individual. I was pregnant at the same time as a good friend of mine. I got HUGE; think land whale (daughter was 9 lb 3 oz) and had no stretch marks on my stomach, did get some on my legs; weird huh? my friend didn’t get nearly as big and her stomach was covered with them.

      bbuddha wrote on March 19th, 2012
    • I would definitely try the gelatin and vitamin c that mark recommended. I took both of those during and after my last two pregnancies, and got no new stretch marks, and the ones from past pregnancies went away too.

      Katie @ Wellness Mama wrote on March 19th, 2012
      • Will do, just made a big vat of homemade chicken broth and saurekraut so I’ll be jacking up my gelatin and c.

        Carlos Morales wrote on March 20th, 2012
      • That is awesome to hear that the gelatin and vitamin c worked! I am really excited to find out about the gelatin. I plan on incorporating these while during my weight loss regimen. I have two children and a I have a lot of stretch marks in all different areas of my body. I have also just finished my journey with Cancer and praying that losing weight won’t be as hard as it was prior to my cancer knowledge. I had thyroid cancer. Which gave me a hard time losing weight more then 10 lbs never happened. Thank you for the encouragement to possibly see these things disappear!!!

        Kay wrote on January 20th, 2013
    • Carlos you should be proud, losin 130 lbs. shows amazing determination and self discipline!!! The stretch marks…I can see where it would be a reminder of how “fat” you were, BUT you can also look at them and see how far you have come and where you never want to be again! Losin 20 lbs is a major accomplishment for most people…you lost 130 lbs, WOW!!!! My daughter is 17 yrs. old, she lost 10 and was bothered by the stretch marks. I had her use Bio-oil and maderma…they are so faint now that she barely notices them….hope it helps you :))

      Brenda Giacumbo wrote on March 20th, 2012
    • I’ve lost 80 lbs total after gaining 60 lbs with my pregnancy. I had stretch marks all over my body and a horribly shaped body/stomach. I have been doing strength training as well as cardio for about 60 minutes a day, 5 days a week faithfully! And I can honestly say my body has somewhat resumed its shape. I can probably lose 10 or more lbs to be at the 15% body fat, but the “extra skin” has diminished a considerable amount and my stretch marks are almost gone! I’m definitely back in a bikini! This article is completely right ive done so myself, it just takes time! This is my second year and it is not easy..

      Relly wrote on August 28th, 2012
      • I am so glad to hear this- at least you gave me a time frame of hope. I lost 76 pounds and not from pregnancy but a middle age crisis weight gain that I had for a few years.

        After my pregnancy I lost weight with no residuals save a tiny bit of stretch marks/looseness of lower abdominal area. That was a huge adjustment to the skin so I am hoping that I will adjust in time again.

        So sorry I let myself go, but we all make mistakes. Hoping I can look at least decent again though I will never be 25 again I know.

        Carol wrote on September 2nd, 2012
      • Relly,
        How long did it take you to notice that your tummy was getting back in better shape? I’m just curious. I gained 40 pounds with my second child. But have lost it all plus am now back in my sizes from high school but I still have that pooch in my tummy and some extra skin post pregnancy. I work out 5 times a week doing a variety of things – treadmill, yoga, Jillian Michaels Ripped in 30 DVD, etc. I can tell I’ve transformed already but I still have a ways to go. Your story encourages me and would like to know more! Thanks, Mandy

        Mandy F. wrote on March 31st, 2013
        • Just reading all the wonderful success stories of weight loss. Way to go! I work with people who’ve lost weight and struggle with loose skin. I would highly recommend the body wrap from my company. Visible results can be seen with nine out of 10 people in the first 45 minutes! They can be used anywhere from the neck down to tighten, tone & firm the skin. Recently I’ve bred working with a young woman who’s lost 150 pounds. We started wrapping her upper arms. She thought her only hope was surgery until she tried the wraps! Contact me at the website and I’d be happy to assess and coach you!!

          Lorrie wrote on June 27th, 2014
      • I had a child 10 years ago. I was 95 pounds when I had him. I cant remember how much I gained, but I went right back to my original size. Of course, I have excess skin on my stomach. I never paid much attention, I thought I could never lose it, but now I am not okay with that. I havent been in a bikini since and I would really like to. Is this possible after letting it go so long? I have been working out at least 3 times a week and only have been doing it for 3 weeks, but I want to keep at it. I am trying to eat better and the gelatin and vitamin C, I will definitely try. I have to lift as well though? I am so clueless. My main goal is to tighten my stomach back up. I am already at the right size, I believe. I am 5 foot, 104 pounds. Gosh, I just need help and advice because I do not want to loose hope.

        Santos wrote on January 27th, 2014
    • Tanning in the sun with coconut oil, would reduce stretchmark visibility! Works great

      Echo Slow wrote on August 12th, 2013
      • I hope you mean a protective tanning cream with coconut oil, as going in the sun after putting on PURE coconut oil will literally fry you. If you are using pure coconut oil you should use it after a shower and do not dry yourself. This will feed your skin and keep some of the moisture in. And please do not go in the sun for at least 6 hours after using PURE coconut oil.

        alex wrote on September 22nd, 2013
        • alex, I am very fair and use coconut oil (without anything else) as a suntan lotion. I find it works very well and I don’t burn. I find that diet effects my ability to burn (which I used to when I ate grains) more than what I put on my skin.

          Stephanie wrote on September 22nd, 2013
        • Actually, organic coconut oil is used as a natural sunscreen in Asia. I use it while in Thailand and I never burn!

          Tamara Talbot wrote on June 11th, 2014
  6. After losing the bulk of my weight, I didn’t think it was excess skin leftover… definitely belly fat. Apparently there is more than just white and brown fat… Thanks for the breakdown of a-2 and b-2 receptors. And, thanks for the new reading material on Lean Gains.

    Primal Texas wrote on March 19th, 2012
  7. After being so obese my skin is a trophy :)

    Grokitmus Primal wrote on March 19th, 2012
    • Ha! That’s what I say about the loose skin under my chin! ;^)

      Carol wrote on March 19th, 2012
  8. I gained 100lbs with each of my three pregnancies. (Obviously, before my Primal days.) As I always lost the weight quickly following birth it was an abrupt change. I had a lot of extra skin. For other health reasons, I did a ten day water fast. An unexpected bonus at the end of the fast was significantly firmer skin. Joel Furhman has some excellent books on fasting safely for longer than a few days.

    Kelly wrote on March 19th, 2012
    • Huh…I wonder what the science is behind that? Good to know though :)

      Agi wrote on March 19th, 2012
    • My nutrition professor told us if obese people drink a lot of water during their weight loss phase they will avoid getting loose flesh / stretch marks. He recommended very low carb with a half hour of walking per day ( to start). Once the goal weight is achieved add more fruit and veg.

      My weight gain has been completely stress related. When I did yoga I was so fit ( and calm).

      Jen wrote on March 20th, 2012
  9. This post was absolutely what I’ve been wondering. I have major belly fat/loose skin left that just hangs there. I’ve lost 100 pounds since July but strength training hasn’t been in my regiment a lot. I’ve been factoring in fasting and cutting back on dairy/starchy vegetables but now I need to get some strength training in. I was hoping for an easier solution but if this is the way to go, so be it. I’m at 23% BF and I need to get that down. Thanks for the answers Mark, even if it wasn’t exactly what I was hoping. :)

    trekfan wrote on March 19th, 2012
  10. I have lost 40 pounds so far, and am looking to lose about 40 or 50 more I’m not at a place to say if I’ll have excess skin or not. However I’ve had stretchmarks on my stomach and hips since I was 9 years old and have yet to learn to love them.

    Excess skin is really not a big issue with me at the moment, as I’m still working to reach a goal of primal living, although my opinion may change once I’m closer to reaching it!

    Caleigh wrote on March 19th, 2012
  11. no solutions here, but this is definitely on my mind because of age – 47 and shifting through that phase of life where everything wants to change. Somewhere long ago, I heard 70lbs over ideal weight is where you start to get into skin problems. I’ve hit that mark at the end of a couple of pregnancies. And stablized at about 35lbs overweight. Primal + leptin reset has taken care of all but the last 15lbs. That is definitely more central obesity where the bumps, bulges, muffin tops still hang out. But skin on face/hands/feet/forearms/lower legs all look good. Other than the Leptin reset, been running short distance and doing CF for 4 years. I’m trying some cold thermogenesis to work off the last of the stubborn fat, but I’ve had to put it aside since I’ve been sick. Would love to annihilate some more fat, but killing fat releases toxins, so I’m taking that slow.

    cgk wrote on March 19th, 2012
  12. I’ve gained and lost the same 40-50lbs throughout my adult life (currently in the lower end of that range), and the weight loss has always been very quick, and at the expense of lean muscle tissue. At my thinnest, I’ve always had very “jiggly” loose skin on my belly, buttocks and thighs. It was bad enough last time (two years ago) that I felt very self-conscious wearing a bikini on vacation, because while I was slim, the skin puckering and folding was quite noticeable. After reading this blog post, I can appreciate that I definitely still had a lot of fat beneath my skin during those times.

    In the last two months I’ve started incorporating primal workouts (slow walking, bodyweight strength training, sprints) into my life, and I’m excited by the thought of replacing fat with muscle, rather than trying to reach a certain “ideal” weight on the scale…

    Thanks for the post…

    MLG

    Michelle Lynne Goodfellow wrote on March 19th, 2012
  13. Mark,

    When advising us to consider a body fat percentage of 10-12% (men) before considering plastic surgery, did you factor body frame type? I’m an ectomorph with about 6% and have a bit of a lower belly pooch that has been difficult to get rid of. Most likely because of diet. I still consume about 15% of junk food, i.e., ice cream and the occasional weekend wheat treats.

    Thanks,
    Steve

    Steve wrote on March 19th, 2012
  14. One thing I would add is that, for those who are formerly obese, extra adipocytes created via hyperplasia may store water for a while.

    This is speculation on my part, but I suspect that the extra adipocytes are eliminated after a certain amount of time at a low body fat level. The body seems to be good at getting rid of tissues that are not used.

    It is not uncommon for formerly overweight athletes, who need to dehydrate themselves to make weight, see the loose skin “disappear” as they lose a significant amount of water.

    I don’t recommend that for non-athletes, as severe dehydration can be lethal.

    Ned Kock wrote on March 19th, 2012
  15. I think an important point people miss is that fat is not just human lard. It is adipose tissue with a blood supply and nerves. Would you cut off part of your liver or any other organ? No, and shouldn’t cut off skin or fat tissue.

    Mike wrote on March 19th, 2012
  16. Okay, this post was written for me, LOL. I discovered I am gluten intolerant just before Halloween; I dropped not only wheat, but as a result of studying the new world I inhabited, I also dropped nearly all carbs and started researching paleo diets. The change agrees with me and I feel great. I lost about 30 pounds but I’m really too skinny now and I don’t want to lose any more. I’m 5’ 10 and I now weigh 136, which should tell you how low I am. Now, I’ve been able to work out through all this, and that for the first time in I don’t know how long; I apparently had the gluten issue for decades, only nobody thought to look into it and I sure as hell didn’t know to. In fact, it wasn’t a doctor that found it – it was the book “Wheatbelly”.

    Anyway, during the year before dropping wheat I had a whole host of problems caused by the gluten, including joint pains, extreme fatigue, eczema, and the actual loss of my ability to play the guitar (and I’m a musician – this is not trivial!) because of a thumb injury that refused to heal and re-injured itself regularly. All of this got better without the gluten, but the thumb issue is still not resolvd, probably because there was so much actual injury done during that time.

    Anyway, I write all this because thanks to the messed up thumb, I can’t lift heavy weights and squats are out. So I have been doing pullups, chinups, and inclined pushups (interestingly, none of these seem to light up my thumb) and nobody would EVER guess from looking at me in a tank top that I weigh what I do. I walk and run every day (something else I couldn’t do before – the lifestyle change has been dramatic, I kid you not) and my legs are in good shape although I have a typical runner’s body – that should be obvious from my weight.

    BUT…I’ve got grotesque wrinkles on my stomach – it’s really awful. Now, one problem (I assume) is my age – I’m 61. So fine, I’ve got to live like this for the rest of my life – wonderful. And I’m starting to think that’s the truth, because I don’t dare lose any more weight and that wrinkly flab, while it thins somewhat as I lose weight, is far thicker there than anywhere else on my body. I am hoping that some of this will tighten up as I continue to eat well and work out, but it is depressing to think that while for the very first time in my life I’m actually in good enough shape to want to show off my body, I don’t want to look like a deflated Jabba the Hut.

    I’m already eating pretty much the way your advice would have me do, I’m exercising to the extent that I can given the hand problem, and I’d sure appreciate any other ideas you could throw my way.

    Ben Boom wrote on March 19th, 2012
    • “Squats are out”… why is that? You don’t need your thumb for squats using a proper overhand grip. And especially not front squats. You can probably even get away with deadlifts using a mixed grip without the hook grip to preserve your thumbs, though you’ll be limited a little. There’s also resistance bands, box jumps, sprints, burpees, lunges, weight vests, dip bars, gymnastic rings and a hundred other things that can be combined in various ways to provide some form of resistance training.

      David wrote on March 19th, 2012
      • Guys, please credit me with trying everything I can think of before telling me I can do squats. This thumb problem has been a nightmare, nothing like any physical problem I’ve evr had. I’ve seen two hand surgeons, two physical therapists, my family doctor, an acupuncturist, a rolfer, and a naturopath and not one of them has a clue what is going on, except perhaps the naturopth who suspected I might have I wheat issue. Well, we confirmed that! All my other symptoms disappeared with the removal of the wheat, but the thumb injury , while much better, has remained.

        The problem is that ANY form of squat that requires me to use my left hand to lift a weight of more than about 30 pounds messes up my left thumb. I know it doesn’t seem logical but trust me, it happens. Since squats aren’t much use if you only do them with your body weight I can’t see the point of doing them. I don’t have access to a gym so I can’t use a machine of any kind.

        Ben Boom wrote on March 20th, 2012
    • Try offset squats, shrimp squats or pistol squats–bodyweight squats that will really shred your legs!

      fritzy wrote on March 19th, 2012
      • Thanks, LOL. I really need the regular kind of squats for the core strengthening. The ones that just work with body weight alone don’t do that much for your core; they do work your legs but it’s my center section that’s weak. That’s where I really need some improvement.

        I appreciate the suggestions; thanks.

        Ben Boom wrote on March 20th, 2012
        • You absolutely need to use your core muscles when doing bodyweight squats, or you simply are doing a correct squat.

          Arielle wrote on March 20th, 2012
        • how about a weight vest?

          kristina wrote on March 20th, 2012
      • I’m very curious about your comment that bodyweight squats are not good for your legs. Could you elaborate? I’d appreciate it.

        Steve wrote on March 28th, 2012
    • Hello Mr. Musician,
      I have a sister who had renards disease and she went to a rumatoligist. she had lost two fingers going to several different doctors who said she had burgers disease and they amputated them. Well in the end she had reneards disease and her rumatoligist gave her some type of cream to put on the sore spots on her finger and they healed. I don’t suspect that you have renards disease but I do think you would do well to go to a vascular specialist or a rumatoligist. My heart goes out to you at this time…Take care and I pray that your thumb gets well so you can bless others with your beautiful music…thank you ms vee

      msvee wrote on June 24th, 2012
    • You should try wrist wraps. Valeo has the best ones. They take the pressure off your hands and forearms and let you focus on pulling with the muscle group you’re training.

      Leila wrote on April 12th, 2013
  17. Thanks for this article. I had been somewhat concerned about ending up with lose skin, as I have already lost a decent amount of weight with a decent amount more still to lose. Maintaining or building muscle while losing the fat, looks to be the key to tightening up the skin. I have kept my protein intake up fairly high as I try to eat at least 1 lb. of grass fed beef and/or 1 lb. pork/fish and/or 8-12 pastured eggs per day to help maintain my muscle mass. Looks like I am probably doing the right thing. Thanks again.

    TJ wrote on March 19th, 2012
  18. I was just thinking about last week. My wife has turned away from pasta and bread at last and joined me on this, but isn’t seeing a change as quickly as I did. She worries, after two children, she’ll never have the abdomen she wants. I can’t wait to see the comments here.

    ioelus wrote on March 19th, 2012
    • Too many women (& men) look at pictures in magazines, on the internet, etc. & want to have the same body as they see. There is absolutely nothing wrong with having an “imperfect” body. Don’t set unrealistic goals for yourself. Being fit & healthy are priority one.

      peggy wrote on March 19th, 2012
      • And PhotoShop does wonders :)

        ALL pictures in ALL magazines are done via Photoshop. You can make a 600 lbs couch potato look like a gazelle.

        Arty wrote on March 21st, 2012
        • That was by far the best mental image I have ever gotten on this site, thank you.

          Dani wrote on May 15th, 2012
    • I have the same problem after 3 children. One of my issues is a bit of abdominal diastasis. Tell her to consider looking into the tupler technique to help bring the abs in a bit. It’s really common in women who have had babies, even years later. Aside from that, though, I have stretch marks up over my belly button… I have very little hope on that one, so I hope that’s not her problem :-/

      Jenna wrote on March 19th, 2012
    • must check out leangains, its amazing.

      lisa wrote on March 19th, 2012
  19. This is a very good topic and one that’s been on my mind for a while. You validated what I was wondering; a layer of sub-Q fat around my waist. Being 62 might be a factor, but I’m not budging it. I lift heavy things, eat fat, cut the protein, count calories and IF. I also curse hormones. :P I guess I’ll ramp up everything.

    Carol wrote on March 19th, 2012
  20. The same guidelines go for keeping skin tight during pregnancy. Skin stretches out a lot and if nutrition isn’t great, then the belly will just hang postpartum. The nutrients Mark listed are all great for keeping skin taut.

    Peggy The Primal Parent wrote on March 19th, 2012
    • I was very unhealthy during my pregnancy, knew nothing about nutrition back then, and I threw up constantly until 5 months, at which point I was 15 lbs lighter than I was when I got pregnant. And I was thin to begin with. After 5 months they fed me nothing but massive amounts of carbs to fatten me up. It worked and I was huge, gained almost 50 lbs by the time the birth happened. That gave me toximia, so was hospitalized for two weeks before the birth. After the birth I lost every pound and never had a single stretch mark. I think there’s some genetics in there somewhere!

      It’s only in recent years (my daughter is now 30) that I realized why I craved fish so much during pregnancy. Had to sneak out of the house to get it, was told it was bad for me. What crazy things we’ve been taught these last 30 or 40 years.

      My doctor says it should be a criminal offense to tell people to be vegan, or to eat a “whole” grain-based diet.

      Amy wrote on March 19th, 2012
      • Who’s your doctor, and is he/she taking new patients?

        Wenchypoo wrote on March 20th, 2012
  21. Being a trainer I have had a handful of clients lose a lot of weight and noticed that whether or not they have tons of excess skin or stretch marks was more or less random. Some of them did bounce back and have their excess skin tighten up over time as you mentioned.

    Gary Deagle wrote on March 19th, 2012
  22. On a similar note, any suggestions on how to eliminate stretch marks from previous rapid weight gain?

    Gerry wrote on March 19th, 2012
  23. “Go ahead and check out his argument, but try to avoid meeting his steely gaze. Lock eyes with Dr. Ron at your own peril; you will be consumed.”

    HAHAHHAHAHAHAHAHHAAHHAHAHAHAHAHAHAHAHA!

    cTo wrote on March 19th, 2012
    • Didn’t he play the American in Enter the Dragon?

      Michael C wrote on March 19th, 2012
  24. Well, I’ve lost around 80-90lbs at this point since taking up Paleo/Primal around a year ago.

    I’m not down to my goal weight quite yet and even though I’m down 8 inches on my waist I still have the option to shall we say “tuck” my belly in my belt or have a overhang. ;)

    It’s getting less and less though, so I’m confident given time it will fade away as I lose the rest of that stubborn fat.

    It’s kind of odd, I have veins I can easily see now on my hands/arms, my face is thinner, but I’ve still got the gut of a fat guy (though with a shirt on it’s not really that pronounced though).

    Kevin wrote on March 19th, 2012
    • Keep at it Kevin! Eventually you’ll see veins on your stomach (and from that point there’s not much further to go ;)).

      Cal wrote on March 19th, 2012
    • May I humbly suggest going with the overhang? Front-butt is not good for anyone’s look.

      Joshua wrote on March 22nd, 2012
      • HAHA!!! Front butt!!!

        caroline wrote on April 13th, 2012
  25. The best thing that I have found for loose skin is exercising on a rebounder. Hope that helps. Grokkin roll.

    Craig Danner wrote on March 19th, 2012
    • What is a rebounder? You know I was on HCG diet 500cal. a day diet/with appetite suppressants daily for 6 weeks, would give myself injections pregnancy hormone that helps to burn the body fat within us, and I went from 225 to 174 and I feel great. Although I am 45 years old mom of 6 kids and grandma of 5 going on 6 grandkids, I’m more energetic than what i was before. Now i’m on the lipo diet 1000 cal. have to watch my carbs only or less than 15 carbs in whatever i eat. Plus injections that have vitamin B-12 as well as the hcg had too. I have lost all this weight and I have saggy skin, my breast have gone down extremely, I can see my belly button now, my butt well I lost my butt, went from a size 14 in pants to a size 8 and they still fit me loose. I do exercise everyday for 25 min. with weights, I walk alot as well everyday at work and sweat my butt off. /but this diet does work you just have to want it. But yeah i have alot of work to do, not worried about stretch marks just the sagging skin. What can I do, is there a cream or something that I can afford to buy to put on my body?

      jeanette wrote on May 29th, 2012
      • I am researching the hCG diet for potential use by one of my adult children. I am looking for practitioners in Southern California (especially Orange County). You commented that the hCG diet worked for you, would you recommend your doctor to me?

        Frank Walker wrote on January 13th, 2014
  26. I have a very saggy, extra-skin look to my belly, mostly due to the state of gestational diabetes I was in for nearly five years. I have lost 80 lbs over the past two years, and as I continue to get recover my abdomen strength and pre-baby body I can palpitate the muscle through the saggy, soft fat that remains. I’m just discovering the primal/paleo lifestyle, after dismissing years of casual comments from my doctors that I’m probably allergic to wheat and corn. I’m seeing a difference after just a week of moving toward the grain-free, low carb ideals and confident that by this time next year I’ll only have stretch marks as a reminder of the tremendous transformation my body went through to become a Mommy.

    Julie A. wrote on March 19th, 2012
  27. I have lost 30 pounds since the fall, and though everyone keep saying “you don’t need to lose more” the terrible fat on my stomach really bothers me. I was wondering if it was the result of 6 pregnancies. I don’t know my body fat percentage, but I am 5’8″ and weigh 125 lb and train with Cross Fit 6 days a week. Even still I can grab a huge handful of belly fat! I am not totally paleo, but I eat VERY LITTLE carbs (and yes, I do know what this means). I also have been incorporating IF for about 2 months. Not sure what else I can do, but this post definitely makes me think it is not “excess skin!”

    AJ wrote on March 19th, 2012
    • having 6 kids will definitely do some damage…i have 5, and there is no getting rid of my stretch marks or loose skin. its not fat, and its not excess, but DAMAGED skin from pregnancy IMHO. i’m thin and have good muscles, but that ruined skin is just a badge of motherhood.

      HopelessDreamer wrote on March 19th, 2012
      • Its some decades since I had children. After 5 pregnancies I had lots of stretch marks and a flabby tummy. My stretch marks are now all gone and the flab has come and gone depending on my diet. I can’t blame my still too large gut on babies as I lost it at one point.

        I’m going to look into the skin elasticity – gelatine idea and trial that. I’ll go and buy some soup bones and put them in the slow cooker and have some of that each day.

        Harriet wrote on March 19th, 2012
    • “Not totally Paleo” is probably the kicker. Are you eating brown rice, or some other whole grain? Alcohol?

      In my experience, either of those can prevent the loss of belly fat.

      Amy wrote on March 19th, 2012
  28. I’m currently in the lots of loose fat skin phase… ugh. I used to be up around 310lbs at one point in my life and 2 pregnancies… Losing these last 25lbs has been the absolute hardest thing to conquer but I’ll do it! I love feeling strong and encourage everyone to strive for strength first. I’d rather be in this last stage with the knowledge that I can repair my body with food or use S.A.D. food to destroy it.

    Andrea L wrote on March 19th, 2012
    • Andrea, are you on F/B? I’m at the last 5-10 lbs, have lost 115 and am about 18% bf, believe it or not, still a little loose “fat skin” on my lower belly…the rest is actual fat fat in the form of cellulite (yay-not!) under my but and inner thighs…I really can’t see losing more than ten pounds and still be healthy (not even to get on stage)….any way, if you’re on F/B, find me! Would love to stay up to date on your transformation…look me up @ cookie bigness – Hope to hear from you!

      lisa wrote on June 5th, 2012
  29. About eight years ago, I was nearly 300 pounds. I lost 100 pounds through caloric restriction, better (but still SAD) food choices, and lots of exercise, over the course of six months or so. I had “loose skin” even though I was just starting to see shades of a six pack in good light. From there, I yo-yoed between 200 and 240, struggling with a SAD prescription to health. Last year, I went paleo (Thanks Mark!!!) and reintroduced resistance work in place of much of my cardio. Now, I’ve EASILY leaned out to 193 with no caloric restriction, have a legitimate six pack and just a touch of sub-cutaneous fat around my belly. I noticed that as I dropped below 200 lbs, what I thought was “loose skin” slowly went away. I guess the bottom line is, many times you’re not as lean as you think. I’m sure if I introduced a more strict, IF approach, I could lose a couple more pounds of fat, but I’m not sure it’s worth it or not.

    Jim Sifferle wrote on March 19th, 2012
  30. I have lost about 110 pounds of the 120 I want to lose; I have a sagging belly. However, I recently saw a picture of myself naked from 5 years ago when I was very heavy and 40 weeks pregnant and realize its not so bad. All in all, I didn’t do bad at all – no neck skin and very little excess looseness in my arms and legs – you’d only know it if you went looking for it. I also notice that despite having what appears to be no collagen left some areas are very slowly firming up and changing shape. I take msm daily and good supplements and fish oils. While I wont be posing for playboy anytime soon it’s nothing a one piece bathing suit won’t hide. I’ll be 40 this year; my highest weight (not pregnant) was 242 and I now bob between 128-132.

    Michelle wrote on March 19th, 2012
    • These responses are great; they give me hope I can rid of the lump of useless flesh that is the remainder of my fat guy days. I don’t have anyone to blame but myself for my condition, but all you good folks are coming back from pregnancies and decades on the SAD; me, I’m just 23 and ate myself to death for years on end. I was 266 as of late July and now I’m 166. If you guys can get rid of that stubborn body fat, I can do it too. Primal rocks. :)

      trekfan wrote on March 19th, 2012
      • Trekfan, I feel confident enough to *guarantee* you will lose any sagging skin, up through about age 32 I had no trouble with that (there were several weight losses in there lol).

        Michelle wrote on March 19th, 2012
        • I’ll take that guarantee to the bank, Michelle. I sincerely hope it goes away because I desperately want it to. Thanks for the support :)

          trekfan wrote on March 19th, 2012
  31. Interesting read. I’m a 27 year old male, 5’11, and I recently lost 215lbs in just ONE YEAR through a VLC paleo diet, going from 375lbs to around 160lbs. (I was recently featured in Time Out Chicago magazine, as well: http://timeoutchicago.com/shopping-style/sports-fitness/15061307/fitness-paleo-diet)… I was eating more than ever, walking around 5 miles a day (leisure and exercise), and eventually doing some lifting (small weights, loading up duffle bags with books or shoes and carrying/swinging while walking, etc). Come 4/1/12, I will have maintained around 10lbs of this weight for two years, staying gluten/wheat/soy/grain/alcohol and sugar-free for my routine diet (besides the occasional get-down, you know what I’m sayin’?). My body fat has not been over 12% since, either.

    Looking at me, no one can tell that I am being taunted every day with excess skin. It has absolutely been an awful thing to live with; a shell of who I used to be and a constant reminder of past mistakes. More than anything in my life, I want it gone. I want to finish this final chapter. After all of this work that will continue forever (and so thankful that “forever” will last longer), I should be able to go to the beach without a shirt, or wear something a bit more fitted, or not worry about everything expanding after every meal. It is just as tough to live this way as it was being 375lbs.

    While I agree with things in this post, and I can understand and literally feel spots where there’s just stubborn fat to be lost, I truly can’t believe that after losing 215lbs, it’s ONLY stubborn fat and a tiny bit of skin. I mean, I lost the equivalent of a 1st-grade class! When I’m burning fat like wild and everyone is telling me I look too skinny, should I really just keep on truckin’ to lose a little bit of fat that’s leftover from my man-breasts? If I could afford surgery and had the means to do it, I would. This is all very disheartening and I feel that this post just can’t be the answer for everyone.

    I will keep doing what I do, but after two years and staying clean, it’s hard to want anything other than surgery.

    Anthony D'Amato wrote on March 19th, 2012
    • If I can make you feel better, and I hope I can, it can truly take a bit… I gave birth at age 37 to a large baby (9 pounds, 11 ounces), and I’m very tiny and short-waisted. I didn’t gain much fat, but my belly stretched out VERY fast and huge. The belly skin draped, and stayed droopy for several years even though I was quite trim… My baby is 9 now, and I’m approaching 47, and the skin on my tummy looks really great compared to when I was a 30 something. It should only have gotten worse at my age, but it didn’t. It got way better!

      Now, if I bend over, there are minor folds and whatnot, but it’s SUCH a substantial improvement over 6 years ago. I don’t mind this, and the “before” was, as you say, taunting. I thought nobody would ever be attracted to me. Now, I feel quite presentable.

      I hope you find the solution with time, or whatever step you end up taking if you feel you need to. But you’ve got youth on your side, for sure, and it does take a while. If a graying, thin-skinned, almost-50-yo Irish mum can tighten up substantially, you probably can.

      But I don’t blame you for feeling discouraged–I’ve been there. I wouldn’t have believed my skin would recover once those first 3 years had passed without much progress, but it did.

      Joy Beer wrote on March 19th, 2012
      • Thank you for posting this response. Just what I needed! :)

        Kim wrote on March 24th, 2012
      • hi
        I have been attracted by your note
        it was really hopeful
        I have a problem with my breast skin.Unfortunately it became stretched.and there are so many stretches on them. do you think that if I become fat, it helps to disappear those stretches?
        I am suffering so hard
        and ur answer soon
        Thank u so much…

        saba wrote on August 28th, 2013
    • Hey Anthony, I checked out the article and you look great! I can totally feel your pain and I hope that Joy’s post was an encouragement. Keep hanging in there.

      alicat wrote on March 20th, 2012
      • Oh! That’s right alicat, I need to check out the article now… Yes! You are no longer the “funny fat guy” but a VERY handsome young man. Keep nourishing yourself, body and mind, and please forgive your past self. The funny fat guy was doing the best he could with what he knew. I comfort my own self with that mantra, for things QUITE worse than being overweight. :-)

        Joy Beer wrote on March 20th, 2012
        • Joy Beer and alicat, you two are so sweet. Thank you for the great compliments. I’ve been going back and forth with a few people on MarksDailyApple Facebook page, and they have been very encouraging. I know that 25 years of bad habits isn’t going to fix itself in 2-3 years, it’s just discouraging and another road block.

          It’s never been about “looks” for me, either. I just want to live longer and experience as much as I can with what I’m given. I would never have fantasized that I’d look the way I do now. I absolutely can’t afford any kind of surgery, but if it ever presented itself, I would accept the gift. Until then, I will always be keepin’ on!

          Anthony D'Amato wrote on March 20th, 2012
    • I read somewhere that your skin completely replaces in 7 years. Anyone else hear/read this?

      TomD wrote on May 12th, 2012
  32. “Lock eyes with Dr. Ron at your own peril; you will be consumed.”

    Ahhhh…thanks for that hearty laugh. What a picture!

    I have stubborn fat on my butt and thighs, and as I slim down it becomes more noticeable. Now I’m being more diligent about lifting heavy things and sprinting, and next week I’ve planned my first IF.

    I’m trying to keep my focus more holistic, and remind myself that if I keep doing what I’m doing, I’ll feel great and a year from now I’ll probably look like a freakin’ rock star. Sounds like a great way to celebrate my 40th birthday!

    Maggie wrote on March 19th, 2012
  33. I lost weight by counting points (you know the program), and my weight loss looked like i had deflated. Extra skin, sagging. On primal, everything seems to tighten up. I’ve found that pull-ups (or partial pull-ups) are the best tonic for abdominal & tricep areas.

    fitmom wrote on March 19th, 2012
  34. Losing fat may cause icky feelings if excess lipid-soluble toxins, such as phthalates and dioxins, are in an individuals fat stores. Dioxins are present in much of the food chain, and phthalates seem omnipresent.

    Megan wrote on March 19th, 2012
  35. My name is also Gabriele (with only one “L”) and i lost a lot of weight and ended up with plastic surgery. I was older, though, and had had 3 kids. If you are young, and haven’t given birth, you might not need it. It depends on how fast you lose it and how elastic your skin is. Gabrielle, if you would like to email me i’d be happy to answer more questions! I’m at gabrielenesta@hotmail.com.

    Gabriele wrote on March 19th, 2012
  36. Oh no! I got lost in his steely gaze and blacked out for 20 minutes.

    But seriously, this article is awesome. I have definitely related to the belly fat issue since having a baby. My body fat is no where near that 15%, but this gives me a lot of hope!

    Cassandra wrote on March 19th, 2012
  37. I lost 100 lbs going low-carb first. (Now mostly strict-paleo due to gluten allergy and an autoimmune disease – still have about 50 – 70lbs to go for my liking.) While pool-side on vacation last year, my mom pointed out it was amazing that I didn’t have extra skin after dropping that initial weight so fast. I thought it had something to do with eating well and good fats (primarily whole foods, mostly home-cooked meals). I’ve been lifting (very) heavy weights since that 100 lb mark. I have had 1 child (almost 10 years ago) and I am 31. My stomach has a pooch but I’ve witnessed it (slowly) disappear and shrink into its own – like it’s some kind of disappearing alien. The excess skin was something I was worried about for a while, and it was a growing fear the closer that I get to my goal. It appears that I will be able miss out on that and only have pictures, a ton of recipes, and one very large pair of pants to show for my weight loss. And who knows – I have no intentions of wearing a bikini… but I’m not opposed to the idea… in the future! :)

    Holly J. wrote on March 19th, 2012
  38. I wonder if the stubborn fat (loose skin) also has to do with inflammation… lack of sleep, stress, recovering from our years of self-abuse, that sort of thing. I don’t have a photographic memory but I do recall Mark talking about something like that in a previous post.

    Mary wrote on March 19th, 2012
  39. I have already lost at least 35 pounds of fat with the Primal lifestyle. I say ‘at least’, because I know I’ve gained muscle as I’ve dropped fat. I didn’t do my body fat percentage when I started this a year ago, so it’s really hard to tell. I have the flabby skin thing going on right now, but I’ve always been aware that, as long as I can feel fat in the skin, my problem is that I need to reduce my body fat. I’m not in a hurry for this to happen, and I figured it would eventually, as long as I keep at it. I’m just taking it s-l-o-w, my own choice. It took me a year to give up foods like peanuts and ice cream. My bad, but I’ve eaten clean for the past month, and the weight is dropping again.

    Sanctus Real wrote on March 19th, 2012
  40. Hi Mark,
    Thanks so much for addressing this issue. I’m now into my 7th year of maintaining a 122 lb loss and am 5’8″ tal. I was 54 yrs old when I started out almost 8 yrs ago and am now 61 yrs old.
    I have lots of loose skin and subq fat. I’m convinced that for me, surgery is my only option.
    I remain grateful to have not only lost the weight but to have kept it off too. I can only hope and pray that I find the money to have my surgery ff my waist.as I find it very depressing.
    I’ve been doing Pilates twice a week for the past couple of years. Lost 1″ off my waist…so far.
    best
    Judy K

    Judy wrote on March 19th, 2012

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