The Truth About Loose Skin After Weight-Loss Surgery

Will I have loose skin? How much? Can clothes hide it? Will it change my personal life? These are some of the most common questions people ask before weight-loss surgery, and they are fair ones. For some people, surgery to remove skin is the right answer later on. For many, regular strength training is part of the picture too.

Loose skin is expected

When you lose a lot of weight, skin that was stretched for years does not always shrink back. How much loose skin you have depends on your age, your genes, how much weight you lose and how long you carried it. It is common, and it is nothing to be ashamed of.

What strength training can do

• Build and keep muscle while you lose fat, which can make arms, legs and shoulders look firmer.
• Make you stronger, with better posture and balance for everyday life.
• Support your weight loss and fitness. In a review of controlled trials, people who exercised after weight-loss surgery lost a little more weight and fat, and gained strength and fitness.

What it cannot do

Muscle sits under the skin. It can fill out the shape of an area, but it cannot tighten skin that has been stretched a lot, especially on the belly. If loose skin causes rashes, gets in the way of movement or bothers you, surgery is the only way to remove it.

Why compound exercises

Compound exercises work several muscle groups at once. A squat, for example, works your thighs and buttocks, and also your core, the backs of your legs and your lower back.

Think of building a house. A few workers on the windows finish the windows, but the rest of the house waits. A full crew working on the whole house gets more done. Compound exercises are the full crew.

Seven common compound exercises, each with a gentler way to begin:

• Squat: start by sitting down to a chair and standing up again.
• Deadlift: start with a light kettlebell, lifted from a raised surface.
• Romanian deadlift: start with light dumbbells and a small range of motion.
• Bench press: start with push-ups against a wall or a counter.
• Shoulder press: start seated, with light dumbbells.
• Barbell row: start with a resistance band, or one dumbbell at a time.
• Pull-up: start with band-assisted pull-ups or an assisted pull-up machine.

When to start after surgery

Healing comes first, and every plan is personal, so follow what your surgeon and team tell you. As a general guide:

• Walk from the day of surgery, and build up week by week.
• From about 4 to 6 weeks, more vigorous cardio, such as running or swimming, can usually be added if your team agrees.
• Avoid exercises that strain your belly, such as sit-ups and crunches, for the first 3 months.
• Weights are usually added from about 6 months. Start light and add weight slowly.
• Over time, aim for at least 150 minutes of activity a week, with strength training at least twice a week.

Give your muscles what they need

• Protein first at every meal, usually 60 to 80 g a day or as your dietitian advises.
• Fluids through the day, in small sips, especially around workouts.
• Your bariatric vitamins every day.
• Rest days, so your muscles can recover and grow.

Moisturizer, sunscreen and not smoking can help your skin feel more comfortable and stay healthy. They will not tighten loose skin, but they are worth the habit.