It feels great to lose weight, not to mention the benefits for your blood sugar, blood pressure, and cholesterol[*].
But unfortunately, some people who lose a significant amount of weight find themselves dealing with loose skin around their neck, abdomen, arms, legs, or buttocks (or all of the above).
Psychologically, loose or sagging skin can affect your self-esteem, comfort, and mobility. And physically, it can lead to rashes and infection resulting from trapped sweat in your skin folds.
In this guide, we’ll explain everything you should know about loose skin and the ketogenic diet — whether you’re concerned about the possibility of loose skin in the future, or already dealing with it. Learn what causes sagging skin, whether keto helps, and strategies to solve it.
But first, let’s start by knowing the difference between loose skin and stubborn fat.
Just because your body feels soft and jiggly doesn’t necessarily mean you have loose skin. So before you assume you’ve got loose skin due to losing weight, here’s what to do.
The easiest way to identify loose skin is through the “pinch test.” To do it, you’ll have to pinch the skin on your “problem areas” like your lower abdomen.
If you don’t have loose skin, there should be very little skin between your fingers during the pinch test. It’s the same amount of skin you get when pinching skin at the back of your hand.
And if you do the pinch test and grab some subcutaneous fat, your fingers would be a few millimeters apart and possibly even more — that would indicate you’re holding onto additional fat as opposed to loose skin left over from weight loss.
In contrast, loose skin that remains after fat loss is more likely to be inelastic and saggy. During the pinch test, you’d find it’s thin and doesn’t have much rebound (unlike tissue that contains stubborn fat).
A visual assessment can help you decide, too. You’re more likely to be dealing with stubborn fat (a.k.a. the “subcutaneous fat” that lies beneath your skin) if your problem areas look flabby but not wrinkled. And conversely, a wrinkled visual appearance is more likely to be loose skin.
Another way to confirm whether you’re mainly dealing with excess fat or not is by getting your body fat percentage tested professionally, which can tell you whether you still have more fat to lose. For men, essential fat is 2-5% and obesity is >25%, while for women, essential fat is 10-13% and obesity is >32%. (You can refer to the American Council on Exercise’s Percent Body Fat Norms table.)
The most precise and accurate methods for body fat testing are DEXA (dual x-ray absorptiometry) and water weighing (also called hydrodensitometry)[*]. Skinfold caliper measurements — a service some personal trainers offer — and bioelectrical impedance, a feature found on some household scales, are not as reliable or accurate.
The ketogenic diet doesn’t cause loose skin in and of itself. However, large amounts of weight loss can sometimes cause loose skin, regardless of which diet you used to lose weight (even including keto).
In some cases, a person decides to go very low carb in hopes of attaining massive weight loss in a short period — which can happen by doing too much at once. Initial “water weight loss” occurs from glycogen depletion, followed by fat loss as ketosis is sustained.
But one problem with losing weight quickly is that it doesn’t give your skin enough time to contract back to its original shape. As a result, excess skin may hang on the areas previously occupied by body fat.
According to the CDC and National Institutes of Health (NIH) recommendations, “people who lose weight gradually and steadily (about 1 to 2 pounds per week) are more successful at keeping weight off”[*][*].
It’s also the case that setting these types of realistic and sustainable goals can help prevent loose skin on the keto diet. While you might lose weight more quickly at first, it’s best to allow your body to settle into a steady rhythm of weight loss.
Also, know that not everyone experiences saggy skin after weight loss. So don’t let potential worries over loose skin keep you from achieving a healthy weight!
Various factors affect your chances of getting loose skin such as your age, lifestyle habits, and diet quality. Read more on these factors below.
- Age. Collagen is essential for maintaining skin firmness and elasticity. However, your body produces less collagen as you get older — about one percent less collagen each year when you reach the age of 20[*].
- Rate of weight loss. A healthy weight loss rate is about 1-2 pounds per week[*]. Going beyond this for extended periods would mean rapid weight loss, which puts you at increased risk of saggy skin. Additionally, the more you have to lose, the greater the amount of loose skin you can potentially expect.
- Lifestyle habits. Smoking, too much sun exposure without protection, chronic stress, and a lack of sleep all cause poor skin health and may contribute to sagging skin[*][*][*].
- Sugar consumption. Too much sugar accelerates skin aging by forming cross-linking collagen fibers. Cross-linking prevents your skin from properly regenerating[*]. Unfortunately, sugar hides in many foods, and many people eat sugar daily without realizing it.
The answer is yes. Following a low-carb and high-fat ketogenic diet can address loose skin as long as you do it right. That said, you need to make sure you’re getting all the nutrients you need from keto-friendly foods that promote healthy skin.
These important “skincare” nutrients include vitamin C, collagen protein, and omega-3 fatty acids[*][*][*][*]. In a little while, we’ll explain each nutrient in detail so you can appreciate its role in preventing extra skin.
It’s helpful to remember that your skin is highly responsive to what you eat and anything else it’s exposed to. So, aside from a well-formulated keto diet plan, strategies like collagen supplementation, intermittent fasting, regular physical activity, and focusing on overall wellness will actually improve the elasticity of your skin.
Before turning to surgical or non-surgical skin tightening procedures, do these first:
1. Give Your Body Time to Adjust
Your skin can shrink back when you lose weight, but it’s important to give it enough time to catch up.
We’ve all heard the saying, “Patience is a virtue.” It’s key to a healthy and sustainable weight loss journey. In fact, it lowers the chances of extra skin so you can feel good about how you look when you reach your goal body weight.
Aiming for significant weight loss in such a short time has other negative consequences apart from loose skin. For example, severely restricting calories to lose weight quickly can slow further weight loss since your body adapts by conserving energy — a phenomenon called adaptive thermogenesis. Moreover, calorie-restricted diets increase your risk of losing lean muscle mass, which could also contribute to skin loosening[*][*][*].
Forcing rapid weight loss may also cause you to miss out on important nutrients, including vitamins and minerals. Common micronutrient deficiencies include sodium, potassium, magnesium, vitamin A, C, and B vitamins.
2. Follow a Keto Diet Meal Plan That Focuses on Whole Foods
One of the key characteristics of following a well-formulated keto diet is focusing on whole foods for your nutritional needs[*]. Choosing foods in their natural or minimally processed state (as opposed to junk foods and ultra processed foods) helps to maximize your intake of nutrients that support skin elasticity, such as:
Protein is a major component of your skin; therefore, dietary protein is necessary for skin repair. Two proteins responsible for your skin’s structure are collagen and elastin. Collagen provides strength to your skin while elastin keeps it flexible[*].
Besides that, protein supports lean muscle mass. Preserving or increasing muscle helps to lessen the appearance of saggy skin. As an added tip, do resistance training to replace lost fat with healthy, lean muscle. More on that later in this guide.
So, make sure you’re eating adequate amounts of protein to support collagen and elastin production and maintain muscle mass. On a keto diet, you should aim to consume 1 gram of protein per kilogram of body weight (or your target body weight).
Tip: Use our keto calculator to determine your protein needs and other macros.
Examples of high-protein foods that support weight loss are eggs, beef, salmon, chicken, cottage cheese, and Greek yogurt.
Our skin normally contains high concentrations of vitamin C, which points out its importance in skin health. Vitamin C stabilizes the collagen molecule and stimulates collagen production[*].
Based on several reports, vitamin C levels are low or depleted in aged skin or skin exposed to pollutants or UV irradiation[*]. This is vital information for older adults and those frequently exposed to the sun who are worried about possible loose skin after weight loss.
The good news is that you can increase your vitamin C intake by including these foods in your diet:
- Fish roe
- Beef liver
- Bell peppers
- Cruciferous vegetables (broccoli, brussels sprouts, cabbage, cauliflower)
According to one double-blind nutrition intervention study, a 90-day oral supplementation with a fermented papaya preparation or an antioxidant cocktail (with 50 mg of vitamin C) improved skin elasticity and moisture in healthy, non-smoker male and female subjects[*].
If your current diet lacks adequate amounts of vitamin C, then you can take a vitamin C supplement for additional support. Just make sure it’s keto-friendly and has no added sugars.
Omega-3 Fatty Acids
Consuming omega-3 fatty acids through fish oil or krill oil supplements or oily fish like salmon, mackerel, and sardines may support your body’s collagen production.
In a 2008 randomized controlled trial, researchers noticed a 10% increase in skin elasticity among female participants who took a supplement rich in natural fish oil for three months[*].
Omega-3 fatty acids also protect the skin from sun damage, which is known to cause skin wrinkling and a loss of elasticity[*].
3. Supplement with Collagen Peptides
On top of eating foods that support collagen production, collagen protein powder supplements can firm up loose skin.
A 2019 randomized, placebo-controlled study revealed that subjects who received 2.5 grams of collagen peptides orally for 12 weeks experienced improved skin hydration, elasticity, and density[*].
An article published in the Journal of Cosmetic Dermatology also revealed additional evidence showing that taking daily oral collagen peptides supported skin hydration and collagen density. This intervention also reduced collagen fragmentation — a prominent feature of aging skin[*].
When considering a collagen supplement, be sure to look for a brand that uses the fewest ingredients and carbs. That way, you’ll reap the benefits of collagen while also maintaining ketosis.
Perfect Keto offers grass-fed keto collagen with MCTs in convenient powder form to support the health of your connective tissues, including skin. It’s free of artificial ingredients, sweetened with stevia, and comes in six delicious flavors.
4. Intermittent Fasting
Autophagy is a process by which cells digest themselves to remove its components that are no longer necessary. Autophagy doesn’t just help with skin health, but it’s also required for skin cells to function correctly during aging[*][*].
Research shows as we age, autophagic activity decreases, and our dermal fibroblasts become less capable of producing collagen[*].
This is where intermittent fasting may help — it’s proven to activate autophagy, which should support healthy fibroblasts[*] . Beginners can do intermittent fasting by skipping one meal a day (breakfast, for example) or doing the 16/8 fast.
A word of advice: While intermittent fasting has benefits, be careful not to overdo it to the point where you’re sacrificing proper nutrition, as we already discussed previously in this article. Also, avoid fasting or seek a professional opinion from a doctor or counselor if you have an eating disorder (or have dealt with disordered eating in the past).
5. Engage in Physical Activity
Another great solution to prevent or deal with loose skin is to build healthy, lean muscle through strength training. Replacing lost body fat with muscle not only makes you stronger and appear more toned, but it also comes with these amazing benefits:
- Muscle is metabolically active and burns more calories at rest than fat[*].
- Lean muscle mass is associated with reduced insulin resistance[*].
- Resistance training enhances bone strength, decreasing your risk of fractures[*].
If you’re ever worried about bulking up with weight lifting, don’t be. It usually takes years of heavy lifting to achieve a chiseled physique, and you don’t have to take it to that level.
You can also incorporate cardio exercise into your routine for even better results. Brisk walking, running, and cycling help keep the weight off and boost your cardiovascular health. By combining cardio workouts and strength training, you get the best of both worlds.
6. Other Skincare and Wellness Strategies
Along with the tips above, definitely don’t ignore good habits such as getting proper sleep, reducing stress, protecting yourself in the sun, and quitting smoking.
These things may seem insignificant in and of themselves, but combined with a quality keto diet, fasting, and physical activity, they significantly impact your skin health and can have a noticeable effect on skin elasticity or looseness.
You might be a good candidate for skin removal surgery if you’ve reached your goal weight but still have a lot of extra skin. In some cases, it would actually be necessary to remove loose skin if it’s causing you rashes and infections. However, it’s important to consult with your doctor first to determine if you’re qualified.
One invasive procedure would be a body-contouring surgery, in which a plastic surgeon removes sagging skin and remaining body fat[*]. Then, they improve the shape of that area. Examples of body-contouring surgeries include a tummy tuck, arm lift, and thigh lift. Keep in mind that surgery carries risks and side effects. Plus, they require more recovery time.
Less invasive options carry a lower risk of complications, such as radiofrequency, infrared light, and liposuction. Your doctor should be able to help you decide which one may be best for you.
A ketogenic diet that fulfills your nutritional needs enables you to shed pounds while preventing or minimizing loose skin. Be sure to emphasize skin-boosting nutrients like protein, vitamin C, and omega-3 fats.
While you’re at it, work on losing body mass slowly and steadily (as opposed to as quickly as possible) to give your skin ample time to snap back, especially if it has been stretched out over the years. But if you’ve lost a lot of weight already, don’t fret. Try natural remedies such as taking a quality keto-friendly collagen supplement.
However, if you’ve done everything right, including waiting several months to a year for it to tighten up, but you’re still dealing with lots of loose skin — then surgery or a non-invasive medical procedure might be worth a try. In that case, you need to speak with your doctor.