Losing weight is an incredible achievement, often resulting in improved health and enhanced well-being. However, many people who experience rapid weight loss with GLP-1 medications like Ozempic® and Wegovy® face an unexpected challenge-loose, sagging skin. While these medications help individuals shed pounds effectively, the skin does not always retract, leaving behind excess folds on the face, neck, arms, abdomen, and thighs. Even without medical intervention, embarking on a weight loss journey can lead to various changes in the body, including changes in skin elasticity due to subsequent weight loss. This common occurrence can affect both physical appearance and emotional well-being related to body image, prompting individuals to seek solutions for managing and addressing loose skin after weight loss.
Why Does Skin Sag After Weight Loss?
Weight loss-especially rapid weight loss-does not always mean a tight and toned appearance. Many patients using Ozempic, Wegovy, or similar medications find that certain areas of their body lack firmness even after reaching their goal weight. Even a person who appears thin or athletic can have loose skin due to weight loss. Skin may loosen or sag as people age due to changes in the molecules that keep it elastic, firm, and hydrated. Here’s why:
Loss of Collagen & Elastin: Skin relies on these proteins for elasticity. Rapid weight loss can outpace the skin’s ability to contract, resulting in sagging. Collagen provides the skin with its structure and firmness, while elastin allows it to stretch and return to its original shape. As we age, our older skin naturally loses elasticity due to a decrease in existing collagen and elastin production. As you age, your body produces less of this essential protein, which can also cause skin to sag. During weight fluctuations, the skin stretches and contracts to accommodate changes in body size. When skin has been significantly stretched and remains that way for a long period of time, collagen and elastin fibers become damaged. As a result, they lose some of their ability to retract.
Muscle Loss Factor: GLP-1 medications can cause muscle loss along with fat loss, making the skin appear even looser due to the lack of support. An increase in muscle mass may help improve the appearance of loose skin. Building muscle beneath that skin can help fill the gap.
Stubborn Areas: Loose skin is especially noticeable in areas where fat loss was significant, including the jawline, arms, abdomen, and thighs.
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Age: Age is a crucial factor in determining how the skin responds to weight loss.
Amount of Weight Lost: The amount of weight lost and the speed at which it is lost can also impact the skin’s elasticity. Rapid weight loss, especially through crash diets or extreme calorie restriction, can lead to excess loose skin because the skin doesn’t have enough time to adapt to the changes in body size. This phenomenon is particularly common among individuals who undergo bariatric surgery or other forms of weight loss surgery.
Genetics: Genetic factors play a significant role in how the skin responds to weight loss. Some individuals may be genetically predisposed to have more resilient skin that retains its elasticity even after substantial weight loss. Genes may affect how your skin responds to weight gain and loss.
While some people experience mild skin laxity that improves over time, others may need treatments to help tighten and restore their contours.
Natural Strategies to Manage Loose Skin
Dealing with loose skin after weight loss can be challenging, but there are natural, evidence-based strategies that can help. Several strategies can be implemented to manage loose skin through natural means:
Read also: Is Natural Skincare Effective?
Resistance Training
One of the most effective ways to improve the appearance of loose skin is to fill the space with muscle. When it’s possible, exercising away loose skin requires time, so you don’t have any to waste. Engage in regular strength training. Performing resistance training, also known as strength training, helps build lean muscle mass, which can create a firmer, more toned look. While research isn’t currently available, it’s possible that an increase in muscle mass may help improve the appearance of loose skin. A groundbreaking 2023 study published in Scientific Reports found that resistance training can rejuvenate aging skin by improving skin elasticity and increasing dermal thickness. This research suggests that the benefits of resistance training go beyond just building muscle; it can have a direct, positive impact on the skin itself. The Physical Activity Guidelines for Americans recommends engaging in strength training exercises that target all major muscle groups at least twice a week. When performing strength training exercises, proper form is very important. You will get more out of each exercise if you do it properly, and you are less likely to suffer an injury if you do the exercises correctly. The internet is full of instructional guides and videos that can help if you’re unfamiliar with a certain exercise. Start with lighter weights and less resistance until you build your strength. Then gradually increase the amount of weight you lift. Remember that exercising to lose excess skin is a long-term commitment. It’s important that you pay attention to your body when weight training, Soreness is a sign that you’re overdoing it, so do fewer reps or cut back to lighter weights. And don’t skip rest days. It‘s your body resting and repairing the tiny muscle tears exercise causes that make your muscles bigger.
Proper Nutrition
Proper nutrition is crucial for skin health and its ability to repair and regenerate. Diet plays a significant role in skin health. Don’t get in your own way by coming home from the gym and then engaging in unhealthy habits. Adequate water is essential for maintaining optimal skin moisture and delivering essential nutrients to the skin cells. It helps to replenish skin tissue and increases its elasticity, making it more pliable and likely to tighten up after you lose weight. Adequate protein is vital for healthy skin. The amino acids proline, hydroxyproline, and glycine play a direct role in collagen production. Vitamin C is needed for collagen synthesis and also helps protect skin from sun damage. The omega-3 fatty acids found in fatty fish and plant sources, including walnuts, chia, and flax, may help increase skin elasticity and have anti-aging effects. Staying well-hydrated may improve the skin’s appearance.
Protein: Your skin is made of protein, so consuming an adequate amount is essential for building and repairing tissues. Plant or animal protein is essential for the maintenance and repair of skin tissue and helps build muscle. Your body turns protein into building blocks called amino acids and reuses them to make other proteins, including the collagen that is essential for the elasticity of skin.
Vitamin C: This powerful antioxidant is a vital cofactor in collagen synthesis. Without enough vitamin C, your body cannot produce collagen effectively. Vitamin C is needed for collagen synthesis and also helps protect skin from sun damage.
Omega-3 Fatty Acids: The omega-3 fatty acids found in fatty fish and plant sources, including walnuts, chia, and flax, may help increase skin elasticity and have anti-aging effects.
Water: Water is essential for maintaining skin health and elasticity. A 2015 study found that increasing daily water intake significantly improved skin hydration and function. Since skin cells are 64% water, it’s essential for healthy skin. Drinking 2 or more liters of water per day may significantly improve skin health. Getting enough water can be tricky, but remember that it doesn’t have to come solely from your water bottle.
Collagen Supplements
Collagen supplements have gained popularity for their potential skin benefits. Taking collagen hydrolysate may have a protective effect on skin’s collagen. Collagen hydrolysate, a form of collagen that has been broken down into smaller, more easily absorbed particles, has been the subject of several studies. A 2019 controlled study demonstrated that a liquid collagen supplement significantly improved skin elasticity, texture, and hydration after 12 weeks of use. It comes in powdered form and can be purchased at natural food stores or online.
Gradual Weight Loss
Losing weight naturally and effectively can help minimize the occurrence of loose skin. Aim for a sustainable approach with moderate weight loss of about 1-2 pounds per week. This gradual weight loss helps minimize the risk of developing loose skin or excess skin folds. Maintaining a relatively stable weight can help minimize the risk of developing loose skin, as it allows the skin to adapt gradually to changes in body composition. Slow and steady wins the race, and experts agree that’s the best strategy for weight loss, too, especially if your goal is to trim down by 100 pounds or more. Slow, gradual weight loss gives that all-important collagen and elastin in the epidermis time to retract. Gradual weight loss is also considered better for your general health. The CDC recommends trimming down at a rate of 1-2 pounds per week. Tracking your weight loss weekly can prompt you to pace yourself when necessary so that your skin can keep up. Try keeping a journal to document your nutrition, exercise, skin care, and other health habits.
Topical Creams and Lotions
Use topical firming creams and lotions with collagen-boosting ingredients like retinol, hyaluronic acid, and vitamin C. Apply these products regularly to areas prone to loose skin to support skin elasticity and create the appearance of tighter, younger skin. Lotions, serums, and creams that contain retinoids may have some positive effects on saggy skin, as retinol promotes the skin’s ability to make collagen. But creams containing collagen don’t seem to have much benefit for the skin’s natural collagen production. Lotions that contain vitamin C or hyaluronic acid may help reduce sun damage to skin and skin discoloration, but they won’t improve the tightness or elasticity of skin over the long run.
Massage
Massage may improve blood flow and stimulate fibroblasts. Fibroblasts are cells that help produce connective tissues, such as collagen and elastin, that keep skin firm.
A small study in 2025 asked women ages 20 to 50 to use either a facial roller or gua sha facial massage for 10 minutes, 5 times per week for 8 weeks. Both groups showed improved facial contours but through different mechanisms. The facial roller group achieved this through increased skin elasticity and the gua sha group’s results were due to changes in muscle tone.
Another small study found that performing a 3-minute massage routine every day for 2 weeks lead to improvements in skin plumpness, fine lines, and radiance.
Avoid Harmful Habits
Research shows that tobacco smoke and the intake of nicotine have a toxic effect on skin and increase the chances of premature aging. The effects are caused both by the smoke and the breathing in of toxins. In a study comparing smokers with nonsmokers, hydration and firmness were lower in the smokers’ skin. Like nicotine, alcohol is a toxin that can damage the skin on a cellular level. Alcohol is a diuretic, which means it makes you pee more. So drinking it can lead to dehydration. Since the skin is 64% water, dehydration can have a visible impact and can affect skin health beneath the surface. Drinking too much alcohol can also deplete the body of beneficial vitamins, like A, B, and C, that are essential for skin health.
Non-Surgical Skin Tightening Treatments
For mild to moderate skin laxity, non-surgical treatments can help firm and tighten the skin while improving muscle tone and skin texture. Dermatologists and cosmetic surgeons can perform nonsurgical procedures that may help reduce loose skin. However, these procedures are not useful for severe cases of loose skin as the results tend to be subtle. These treatments require little to no downtime and can provide natural-looking, gradual results. Nonsurgical procedures do not involve cutting or puncturing and typically only cause temporary swelling and redness. They also often take only a short amount of time to perform. Most procedures are safe for use on all skin colors and are suitable for any body part. Many nonsurgical procedures treat loose skin by boosting collagen and elastin production in different layers of the skin, usually by using various devices to send heat under the skin.
VirtueRF Microneedling for Collagen Stimulation: Uses radiofrequency energy and microneedling to stimulate collagen production, tightening loose skin. When microneedles are combined with Radiofrequency energy as described above, the term is called Radiofrequency Microneedling. Helps restore elasticity and improve skin texture on the face, neck, arms, and abdomen. Best for patients with mild skin laxity who want firmer, smoother skin without surgery.
Emsculpt® NEO for Muscle & Skin Firming: Helps counteract muscle loss from weight loss, rebuilding muscle tone while tightening skin. Uses high-intensity focused electromagnetic energy (HIFEM) and radiofrequency to strengthen muscles and reduce fat. Ideal for toning the abdomen, arms, thighs, and buttocks.
CoolSculpting® for Refining Contours: Targets small, stubborn fat pockets that may remain after weight loss. Helps smooth and refine areas like the lower abdomen, flanks, and arms. Works best when combined with other treatments for a more sculpted look.
Radiofrequency (RF) therapy: Radiofrequency (RF) therapy is a non-invasive procedure that uses radiofrequency energy to heat the deeper layers of the skin. This controlled heating stimulates collagen production and lifts loose skin over time. RF therapy is commonly used on areas such as the face, neck, abdomen, and thighs. A dermatologist will place a device against the skin to heat the tissue underneath. Most people who use this method see results after one treatment. The treatment takes about 6 months to take full effect, but some people notice tightening shortly after the procedure. With the right skin care, the results may last for 2 to 3 years.
Surgical radiofrequency: The minimally invasive form of radiofrequency involves inserting tiny tubes through small incisions in the skin to send heat to the areas that require tightening. Doctors often perform this procedure on the neck or upper arms, and it may produce results within 1 month. This procedure usually takes place under local anesthesia, and most people need to wear compression bandages for 4-5 days afterward. People often undergo treatment with intense pulsed light (IPL) in combination with radiofrequency to more effectively treat the skin at different levels. A person may require a series of IPL treatments to see results, and it is sometimes unsuitable for those with darker skin tones or tanned skin.
Microneedling: Microneedling is a minimally invasive procedure that involves creating tiny punctures in the skin with a device containing fine needles. These micro-injuries stimulate the body’s natural healing response, leading to increased collagen production and skin lifting. Microneedling can be used to treat a variety of skin concerns, including fine lines, wrinkles, acne scars, and loose skin. The procedure is safe for all skin types and requires little to no downtime. Patients may notice improvements in skin texture and firmness after a few sessions, with continued enhancement over time.
Ultrasound therapy: Ultrasound therapy utilizes focused ultrasound energy to target the skin’s deeper layers, promoting collagen remodeling and lifting loose skin. The ultrasound energy penetrates the skin without causing damage to the surface, making it a safe and effective treatment option. Ultrasound therapy can be used to address various concerns, including wrinkles, sagging skin, and cellulite. A high intensity focused ultrasound (HIFU) facial works on the deepest layers of the skin. Most people notice subtle lifting and tightening within 2 to 6 months of their first treatment and report more significant results with additional treatments. The effects of the treatment can last for up to 1 year.
Laser treatments: Laser treatment may be recommended for individuals seeking to address loose skin. They involve using laser energy to heat the skin’s deeper layers, stimulating collagen production and improving skin elasticity. Different types of lasers may be used, depending on the specific concerns being addressed and the patient’s skin type. Laser treatments can target specific areas of the body, such as the face, neck, arms, and abdomen, to lift loose skin and improve overall skin tone and texture. Laser treatments focus on the outer layer of the skin, which is called the epidermis. Most people need between three and five treatments to see results, and changes are usually visible 2 to 6 months after the last treatment. Laser treatments are especially useful on the upper arms and belly.
Laser resurfacing: Laser skin resurfacing is the most effective nonsurgical procedure for tightening loose skin. It can also reduce wrinkles, fine linkes, and age spots. Most people require 5 to 7 days of rest after the procedure and typically notice results 2 weeks after they heal. Laser resurfacing carries a small risk of scarring.
Who is a Candidate for Non-Surgical Skin Tightening?
- Mild to moderate skin laxity
- Good skin quality with some elasticity remaining
- Looking for a non-invasive approach with gradual improvements
- At or near a stable weight
When Surgery is the Best Option for Loose Skin
If you have significant loose skin that forms folds or hangs away from the body, non-surgical treatments may not be enough. People who have lost a significant amount of weight via bariatric surgery or other weight-loss methods often request surgery to remove excess skin. In these cases, surgical body contouring can remove excess skin for a smoother, firmer appearance.
Tummy Tuck (Abdominoplasty): Removes excess abdominal skin and tightens the underlying muscles. During a tummy tuck, an incision is made along the lower abdomen, excess tissue is removed, and the abdominal muscles are tightened and sutured into place. Best for patients with loose, stretched skin after major weight loss. Abdominoplasty, commonly referred to as a tummy tuck, is a surgical procedure that removes excess skin and fat from the abdomen and tightens the underlying muscles. This procedure is ideal for individuals who have excessive loose, sagging skin in the abdominal area, often resulting from weight loss, pregnancy, or aging.
Arm Lift (Brachioplasty): Eliminates loose skin on the upper arms, often called “bat wings.” An arm lift, or brachioplasty, is a surgical procedure that removes excess skin and fat from the upper arms, resulting in a more toned and contoured appearance. This procedure is commonly sought by individuals who have experienced significant weight loss or have excess skin due to aging or genetics.During the procedure, incisions are made along the inner arm, and excess tissue is excised before the skin is tightened and reshaped. Ideal for patients with significant skin laxity despite toning exercises.
Thigh Lift for Smoother, Tighter Legs: Targets excess skin on the inner and outer thighs. Helps reshape and contour the legs after weight loss. Medial thigh lift: Removal of skin from the inner and outer thighs.
Body contouring surgeries: Body contouring surgeries, also known as body lifts, are comprehensive procedures designed to remove excess skin and fat cells from multiple areas of the body. These surgeries typically target areas such as the abdomen, thighs, buttocks, and breasts, providing overall body sculpting and lifting. Body contouring surgeries may involve a combination of procedures such as abdominoplasty, upper body lift, thigh lift, and breast lift to achieve desired results.
- Abdominoplasty (tummy tuck): Removal of skin from the abdomen.
- Lower-body lift: Removal of skin from the belly, buttocks, hips, and thighs.
- Upper-body lift: Removal of skin from the breasts and back.
Who is a Candidate for Surgical Skin Removal?
- Significant loose or hanging skin that won’t retract naturally
- Looking for more dramatic, long-lasting results
- At a stable weight for at least 6 months
- In good overall health for surgery