Aside from the health benefits, one of the best things about losing a massive amount of weight from weight loss surgery (bariatric gastric bypass surgery), or successful dieting is the improvement that the previous obese person enjoys in self-image and self-esteem. Many of these previously morbid obese people after achieving their target weights still want to look better. Despite having lost the weight and fat volumes, these previously obese people suffer from a redundant skin and excess tissue (fat) problem. This redundant skin and immediately underlying fat (subcutaneous) may hang on the person's body and cause medical problems and personal hygiene problems.
The redundant skin is typically a result from years of slow expansion of the body shape and form, which occurs secondary to the weight gain of obesity. This type of problem develops with obesity because the skin has been stressed for years and was continually expanded. The expansion or stretching of the skin may stress the skin and even tear the deeper structures of the skin. The skin may appear thin and fragile and even tear easily. When the skin's deeper side (dermis) tears, stretch marks will appear. It is typical for the previously morbid obese person to have large areas of stretch marks and thinned skin. These skin areas may appear worse as the obese person continues to lose their weight.
With the weight loss, the skin and underlying subcutaneous fat will contract to a point; however as the weight loss continues, the skin will fall or hang over other body parts. This has occurred because the skin's ability to contract has essentially reached its limit and all the skin can do is fall or hang. This type of sagging body appearance can be a stigma of a previous obese life to the public. It can also serve as a daily reminder of a different time gone by, to the previously obese person. This may be disturbing to some of the previously morbid obese people. Not only are there the psychological ramifications associated with the redundant skin, there are the more obvious problems with physical appearance; activities of daily living - including hygiene, and the appearance of the ‘new' body in clothes. In short, the redundant skin is very problematic for some of the previously morbid obese people who have lost major amounts by weight.
Some of the determinants of how much redundant skin a previously obese person has, is related to how much their maximum weight was, and how much weight the obese person lost. Their height is also a determinant. Genetics also play a role in how elastic a person's skin will be. Younger obese people's skin will recoil better, than older obese people's skin. Social issues like sun exposure and smoking are also associated, because both have been shown to have detrimental effects to the collagen of the skin. Obese people with fair complexions tend to have more problems with stretch marks than obese people of darker complexions.
The redundant skin areas that may be problematic after massive weight loss from successful dieting or weight loss surgery (bariatric gastric bypass surgery) can include the face, neck, arms, breasts (men and women), skin folds of the back, bra strap areas, abdomen, flanks, buttocks, pubic areas, thighs, and knees. Which of these redundant skin areas that are involved depends upon the previous obese person genetics and body shape. These fatty areas may be generalized or focal areas of skin and fat. The extent to how much the redundant skin actually bothers a previously obese person is subjective. It is also probably associated with how many of these problem areas the person may have and how severe the areas are involved.