Methods to mitigate the side effects of weight loss

Scope of the site

This page is about the mitigation of side effects of weight loss. Currently it covers loose skin, stretch marks and gynecomastia (gyno).

Before you read this, make sure to have proper expectations. This is just a page on the internet, written by a stranger without any credentials. Keep that in mind.

There is a reason this page is called mitigation and not prevention. These issues probably aren't completely preventable or reversible once they happened. That's just the reality of the situation.

This page should cover both scientifically proven ways to mitigate issues as well as bro science and hearsay. I'll try to to point out which is which where possible. If possible I will also try to add scientific studies or (less scientific) sources to claims. Probably 1 representative study max per claim though. These are linked and you can mouse over to see the study name.

This used to be called weightloss-side-effect-mitigation.md and was hosted on github, but the repo has since been closed (github dislikes multiple free accounts it seems and my other account is used for actual code and thus has priority). As a result it is now hosted here. If the location ever changes again I will try to keep it at least on this domain or add a link and note about the relocation. If you prefer a markdown formatted file, you can still download that by adding a /source.md to the domain link. A download should start.

IF YOU ARE PREGNANT, MAKE SURE THE METHODS YOU USE CAN'T INTERFERE WITH YOUR PREGNANCY. I DID NOT CHECK IF THEY COULD. This page is work in progress. If you have suggestions or ideas, feel free to give them.

In general the advice given in this page should be gender unspecific and apply to men and women equally, except for where it obviously doesn't (the gyno section). The strength of the effects of the methods might change between men and women, but if it helps one group it will help both.

Lastly a word on the tech side of things: This site has no tracking, ads or similar. It uses some custom written javascript lines to switch between light and dark mode. It also uses the tippy.js library for the mouseovers over links. That is also the only external content loaded for now. The site still works without javascript if you don't want these features.

Loose skin

When someone loses a lot of weight, they can end up with loose skin. The reasons for this are simple; your skin had to grow to accommodate your girth and stretch for that (or tear, which causes stretchmarks). Unfortunately it doesn't really tend to do the same in reverse, at least not to the same degree. As a result people can have this skin that used to be "filled" with fat left over and hang off of them when the fat is gone.

What causes Loose skin?

There are a bunch of factors causing loose skin and unfortunately it is too late to change some important ones of them. Generally speaking if it damages the collagen in your skin, it's bad for you. Here're the factors you can't change anymore or can only change barely:

What can you do?

So now let's cover factors that you can change and methods to mitigate these issues as well as possible.

First let's start with factors that have scientific backup:

Doing strength training

This one helps passively, by building muscle (which strength training helps with), you can "fill" some of that volume that used to be filled with fat with muscle, making the loose skin less obvious and slightly more toned. It also increases blood flow which helps with skin health and might cause more collagen to be present.

Taking Collagen supplements

This one has no direct studies testing them with loose skin, but there have been studies of the effects of collagen supplements on skin collagen. Collagen hydrolysate peptides are found in the connective tissue of animals and can be taken as a supplement or gained by eating broth or soup made with this tissue or bones. This can improve your skin health and thus help combat loose skin.

Staying hydrated

Drinking enough water and staying hydrated helps with your skin's general health and thus might help with loose skin. Either way it won't hurt and it's basically free, so make sure you drink enough.

Wear sunscreen when exposed to the sun

As we already established sun is bad for your skin and it will make it harder for skin to go back to its old size, so wear sunscreen. Make sure it protects from both UVA and UVB well and that it doesn't irritate your skin. At minimum wear it in the face, I'd recommend arms and legs during the summer at least and full body when you plan to not wear clothes / only swimwear.

Getting the right nutrients

Make sure you eat enough protein, get enough vitamin C, which is responsible for collagen synthesis and Omega-3 fatty acids. You can use supplements for all of those or get it just through a healthy and balanced diet.

Surgery (Body-Controuring)

Frankly I don't feel comfortable giving advice regarding this - try everything else first, wait a bit and then talk to a medical professional, preferably one who doesn't profit from advising you either way (so don't ask the guy making a profit from the surgery). If you still want to get it after that, it's your choice.

Oil your skin with Argan Oil

Argan Oil does a few of the things other methods in this page do too, like protect from sun damage. Apparently you can choose between applying it to your skin externally or consuming it orally. It moisturizes your skin and helps with would healing. But most importantly it has anti aging effects and can increase the elasticity of the skin. As a positive side effect it may help heal stretch marks.

A word on time

Skin retracting and going back to (more) normal takes time. Despite seeing the claim that loosing skin too quickly can cause more loose skin I have not been able to find any studies supporting this. That being said, loosing weight very quickly means the skin had less time to do its work. Obviously a person that lost some weight over some time looks better (as in has less loose skin) than a person that lost the same amount of weight over half the time, which is what I assume caused the saying. If you have any proof one way or the other, feel free to suggest it, it's greatly appreciated.

The thing to thus keep in mind is that skin going back takes time. If you lose your weight fast you should wait a good amount of time to give your skin time to retract before making any rash decisions like going and getting surgery. Give it time.

Now let's move over to the less scientific methods and approaches (ranging from random hearsay, over stuff that I just couldn't find a study for, to glorified snake oils):

Skin moisturization

Especially if you have dry skin, but even if you have medium skin, consider using a moisturizer. There are various ones out there, but given the fact that you are using it on your body you will use more, so I'd recommend getting a cheaper one. Essentially the cheapest one that isn't bad, which I know means nothing to you. You might have to try a few, but having a cheap moisturizer makes it easier to liberally apply on your belly, chest, legs and arms. Apply in the morning to protect your skin from drying out. It might be worth getting a slightly more high quality one for your face, but it's probably fine to use the same for your face too.

Use pregnancy creams / oils

The logic here is rather straightforward - pregnancy creams and oils are used to help reduce damages of pregnancy, which is a big belly and stretched skin. Issue is that a lot of these creams are pseudoscience themselves or have no proven effects, because it's a big market. So if you do this, expect low returns (if any) for high monetary cost. But if you want to, go ahead.

Skin exfoliation

Another method with relatively straightforward logic is to exfoliate your skin, removing dead skin cells and helping with blood flow. The latter part especially is supposed to help with skin health and collagen and estastin production.

Cold showers

Same logic as skin exfoliation - encourage blood flow, which then helps skin health. You don't need to have your whole shower cold, you can have a normal enjoyable shower, but you would/should end it with a cold blast to get the blood flowing. Again it doesn't have to be so cold it feels like someone rammed a kitchen knife into you, just enough to get your blood flow going.

Retinol or Tretinoin creams

Don't use if you are pregnant If you want a more in depth read about these read this healthline article. For the sake of this article they are the same, except Tretinoin is stronger and needs a prescription. It can heal sun damaged skin, exfoliate it and there are claims that it can help boost collagen production. Unfortunately these are very expensive, so use cautiously and try to get cheap ones that don't irritate your skin.

Skincare creams containing "collagen" and "elastin"

These are a waste of money. They might help make skin feel nicer for a short time, but these molecules are too big to enter your skin.

Don't drink caffeine, consider taking hyaluronic acid

There are links between caffeine consumption and lowered collagen synthesis in human skin.Consuming hyaluronic acid can help protect your skins collagen.

Data sources

A lot of these studies were found on / by healthline, especially this link on loose skin by healthline. Healthline seems like a generally trustworthy source, since they tend to link their sources.

Gynecomastia (Gyno)

Gynecomastia is a medical condition in men that causes larger breasts. It can be caused by having a hormonal imbalance (primarily by an increased circulating estrogen to androgen ratio), or by roiding (taking steroids), as well as some prescription drugs. There's reason to believe that a good portion of men who think they have gyno don't actually, they have pseudogynecomastia, caused by fat tissue. If you have moobs, it's very possible that it's not gyno. Thus, this following section covers both how to fight gyno and how to get rid of (non gyno) moobs as well. Those things being said, being overweight (or obese) can lower your testosterone levels so being overweight sadly increases your chances of gyno, even if it's not necessarily the cause. Even if you do have real gyno, know that you are not alone. It is estimated that above 30% of males will be affected during their lifetime.

Symptoms:

Symptoms of gyno are enlarged breast tissue around the nipple area with a firm, symmetrical rubbery mass that extends concentrically from the nipple, swelling of the breasts, breast discharge and tenderness of the breast.

Steps 1 and 2 are good to do either way, but if you have reason to strongly believe that it is real gyno, you could skip to Step 3. If it turns out not to be real gyno in the end, return to step 1.

Prevention

Real gyno means your body created breast tissue. At that point, this tissue will not go away unless you have surgery. There are supplements marketed to reduce the chance of getting it in the first place, but little decent research has been done regarding their effectiveness. Any supplement claiming to get rid of it after it has appeared is almost certainly lying to you. If you live in the US, the FDA does not regulate supplements the same way as it does presciption drugs, so claims about their efficacy can be made without real proof.

If you do not roid, you should not need to take any of these and hope they work. If you do, it's still a cointoss if they help at all. Some supplements claiming to help include: vitamin E, white button mushroom extract, choline, indole-3-carbinol. Decide for yourself if you want to use any and which ones.

Apart from supplements the usual stuff applies, do not get fat (lowers your testosterone), eat healthy, if you have very low t-levels get them checked by a doctor.

Step 1 - Lose weight.

If you have gyno or not, you want to get rid of the fat tissue in your breasts. It makes up most of the tissue in your breasts and is responsible for most of the bad aesthetics. So get rid of it. To do so you need to lose general weight, because spot reduction is a myth. This means that you can not lose fat only in a specific place. You need to get your general bodyfat% down. So do that first. Breast fat doesn't go very early, so you need to get to a decently low bodyfat% before seeing results unfortunately.

Step 2 - Build muscle in the chest area

Building muscle under your moobs can help with their appearance and stretch them out a bit. Note that this is not spot reduction, it's building muscle in a specific area for cosmetic reasons.

If you don't have gyno at this point your moobs should be gone or barely there (depending on how low your bodyfat% got).

Step 3 - If it's still not gone, you may have real gyno.

Go to your doctor. Tell them that you think you might have gyno and try to get a hormonal screening. If you roided, you already know what you did. If you did not, your Testosterone levels should be uncharacteristically low. Trust your doctor in regards to possible treatments, which might be raloxifene (Evista) or tamoxifen (Soltamox) (both are off-label uses). While gyno is a cosmetic thing (and you don't really need to fix it from a medical POV) you probably want to treat your low T because that is linked to a bunch of medical issues in men. Consult your doctor for treatments, T supplements or advice.

Sadly if it's real gyno, while you can get rid of the fat tissue in your breasts, you can not get rid of the breast tissue. It's not tissue getting reabsorbed by your body when you lose weight. If these conditions are met: (real gyno, low bodyfat%, some muscle on chest, If possible low T is treated) and you are still unhappy with how it looks, surgery is the last option. Liposuction is the surgical removal of the fat tissue, but what you want is surgical removal of the breast tissue. Consult a cosmetic surgeon for that.

A final word before you decide to do surgery

Sadly, a lot of people who lose weight develop even more of a self-conciousness after getting to a better weight, because they imagined that once they lost weight they'd have the perfect body of a greek god. Being faced with the reality that this doesn't happen and the results of their time overweight do not magically dissapear can make them be substantially harsher on themselves than necessary. Please try to introspect and observe that you do not develop body dysmorphia. Even if there are small signs left of your weight loss, try to accept it and learn to live with it (if possible. I am generalizing a lot of body types here and sometimes excess skin might even cause medical problems). And if you can't and decide to go for surgery, remember that while surgery will remove that excess skin / those moobs, it will not give you that greek god figure you wanted either. You will have scars and they will still be a reminder of what used to be there. I won't pretend that everything can go away and lie to you, so you should mentally prepare for that.

Stretch marks

Stretch marks are parts of your skin that have a different texture and color from your normal skin, caused by a bunch of factors. Some people get them from growing up too quickly, or lifting (and gaining muscles quickly), but most commonly they appear from quick weight gain / your skin being needed to stretch sufficiently. The two issues causing this are pregnancy in women and rapid weight gain in men or women. There's a bunch of factors causing stretch marks and how likely you are to get them is dependant on your genetics and skin elasticity. To prevent stretch marks, you want to limit weight gain or skin stretching, which should be possible in all the mentioned cases except for normal growth and pregnancy. Additionally, all the mentioned methods in the loose skin sections that help with a more healthy skin are good prevention methods, as they help build your skin's collagen. I won't go into factors that make you more or less likely to get stretch marks and that you can't influence here, but things making you more likely to get them include: Being female, having pale skin, pregnancy etc. But let's cover ways to mitigate and heal them as far as possible.

Stretch mark mitigation and healing

As mentioned before, anything mentioned in the loose skin section helping with a healthy skin is good for mitigation, look especially into argan oil and having a nutrient rich diet. Here're additional methods to mitigate stretch marks:

Coconut oil

The scientific evidence for this is weak, so be warned ahead of time. But there have been studies suggesting that virgin coconut oil can help with wound healing in young rats. Since stretch marks are wounds (or scars from wounds), this might help with healing.

Tretinoin and Vitamin A application

Don't use if you are pregnant A study from 1996 states that applying Tretinoin on early stretch markes helps with their appearance.. If you read the loose skin section you know that Thretinoin is for our purposes stronger Retinol (and needs it a prescription, while Retinol does not). It stands to reason that applying either of these to add vitamin A to your skin can help. You can also take vitamin A orally.

Microdermabrasion, Laser therapy and needling

These are the methods that you don't do by yourself. You need to contact a dermatologist to get that done (and pay of course). In general talking to a dermatologist about other methods or remedies might be a good idea anyways. There's a study showing that microdermabrasion helps mildly to moderately with collagen density and stretch mark appearance. Similarly there are studies suggesting that needling (a form of microdermabrasion) also helps. Lasering does a similar thing.

Massage

If your stretch marks are less than 2 years old, the MOFFITT cancer center suggests scar massages (for scars). The link also covers how to do these.

Vitamin E supplementation

There is reason to believe that Vitamin E can help heal skin with severe damage. While not strictly relating to stretch marks, it's worth taking note of. Remember that you can always get more of any vitamin through changing your diet instead of buying supplements too.

Chemical peels / Glycolic acid peels

A study from 1998 found that glycolic acid peels can help with stretch mark appearance. There is also more recent studies done on the subject, albeit about scars in general, not stretch marks specifically.

Radio frequency treatment

This might sounds like absolute pseudoscience, but it is a (not very well researched at this point) legitimate treatment method. Here's a small scale study claiming that "14 of the 16 participants agreed they noticed visible improvement" but notice that there is no comparison with placebo done. This study from 2013 seems slightly more promising.

Time

Over time, stretch marks tend to get less and less obvious, both in terms of texture and color (They tend to go from dark red to less red, to white). Unfortunately the time frames we are considering here are very long (we are talking many months to even years). Also since they are scars after all they don't really go away completely. You should be aware of that.

Ending words

Keep these things in mind and try to mitigate the "issues" caused by weight loss as much as possible, but remember that having lost all that weight is, even with some signs of it having been there, massively better than being overweight. It's better medically, aestheticall and quality of life related. Don't ever think that weight loss caused your gyno or loose skin, or get discouraged from weight loss because you won't have that 100% perfect body after. Both the gyno and the loose skin were caused by you having been overweight. And stay vigilant even after you have lost that weight. It might seem now like you will never let things get that bad again, but the stats are against you: The chance to lose a meager 5% of weight for a obese person is 1 in 12 for men and 1 in 10 for women. That's insanely low. You did much more than that, granted, but 53% of these people regain their weight in 2 years and 78% in 5 years. So stay vigilant. Make sure you do not gain that weight back. I truly hope you can live a better, healthier life and hopefully with the methods described in this page you can do so with minimal signs of having been overweight in the past.