11/03/2024
Worried about sagging skin and what to expect with weight loss medications like Ozempic/Wegovy?
I received a question from someone who has been lifting weights in order to lose weight. They were frustrated because they didn't see any weight loss and was considering starting Ozempic/Wegovy/Semaglutide. Their major concerns were about not seeing any changes on the scale, the possibility of loose skin with weight loss, and whether the appearance of loose skin would get better with time.
This was my response -feel free to comment and add your insights!
First of all, congrats on taking charge of your health. Weight training is essential for gaining lean muscle (especially during weight loss), improving your metabolism, physical strength, and longevity, but by itself, it's not enough for fat or weight loss. Especially belly fat which tends to be stubborn. You first need to be in a calorie deficit for weight loss. Many people struggle with eating less than their norm which is where medications like Ozempic/Wegovy help a lot.
Macros that fit your goals are also important. If you eat a lot of carbs and weight train, water will be drawn into the muscle making them heavier (weight stays the same or goes up) and makes you appear bulkier. The excess carbs will be stored as fat (again, weight stays the same or goes up) and your body composition doesn't appear to change. The right combination of fats, protein, and carbs will keep your muscle lean and the fat at a minimum. Needless to say you want to cut out all beverages that use real sugar (soda and juice) and avoid alcohol and mixed drinks- these are the dream killers!
Getting adequate sleep (at least 7 hours) is something a lot of people overlook and is essential to losing body fat and belly fat in particular.
Steady state cardio, like walking on an incline for 30 minutes (minimum) at a pace that makes it hard (but not impossible) to have a conversation, will utilize more fat stores for energy vs. weight lifting. You want to keep the same pace for the entire 30 minutes and don't have an incline so steep that you need to hold on to the machine. Hands free is best. I recommend walking 7 days per week and weight training 2-3x/week alternating days.
If you lose weight gradually, like 1-2 lbs. per week, you will lower the risk of loose skin and other complications of rapid weight loss. I understand, we all want to be healthy and cute right away lol, but be patient. You don't have to be overly aggressive about weight loss, unless you have an obesity related condition that is life threatening. Even losing just 5% of your body weight will confer metabolic benefits, and reduce your risk for diabetes and heart problems etc. If you're consistent with a plan that's manageable for you (meaning, you could do it for life) and it follows these general guidelines, you will see progress.
Ozempic/Wegovy may hasten your results (it doesn't work for everyone BTW) and as such, loose skin is certainly a possibility. Hydrating with water, moisturizing your skin, and continuing to exercise/weight train to support the skin with muscle, will improve your skin's appearance as you lose weight and after. But the best thing you can do is try to control how quickly you lose the weight. I am a provider in this space and these are some of the things I help my patients do, and they get better results. If excess skin after weight loss is severe, some people do opt for surgery but no one wants to do that if they don't have to.
Hope this helps you, and be well! You're on the right track :-).
