Excess body fat

Question
Hi Ms. Jacques,

I really hope you can answer my question. First, here are some basic facts about me. I am a 22 year old female, weighing at 200 lbs. I have polycystic ovarian syndrome, which makes it harder for me to lose weight. But I am now committed to living healthy by dieting and exercising. My concern is excess body fat. Is that a definite factor when I lose weight. I am scared I will have loose skin in the arms and belly area. Can I prevent that from happening? I was under the assumption that it only happens if you lose weight too fast. If excess body fat is will happen as I lose weight, is surgery to tighten the arms and stomache dangerous, or is it a common procedure? Thank you.

Answer
Hi Caroline,

It's great that you are asking these questions in advance.
With large amounts of weight loss, it is in at all uncommon for the shape of the body to change. This includes excess skin, changes in the shape of breast and buttocks and other possible things.
Unfortunately, there is no way to predict what these changes will be before the weight loss occurs. The is a pretty large influence of genetics - the genetics of you body shape, the genetics of your fat distribution and the genetics of skin itself. You young age give you an advantage and may make it less likely that you have problems with skin integrity, but it is not a guarantee.

On the other side, there are an increasing number of cosmetic surgeons specializing in reconstruction after massive weight loss. You can find some good information on the website for the American Society of Plastic Surgeons: http://www.plasticsurgery.org/cosmetic-procedures/body-contouring-after-major-we

Often a bariatric surgery office will have one or more plastic surgeons they refer to who have done a good job with patients in your area.

Finally, one thing people do not think about is cost. While bariatric surgery may often be covered by insurance (although your state, Florida, does not always cover it), reconstructive surgery is covered less often. So it's good to make sure that if you think you are going to want reconstruction that you think a little bit about what that might cost and plan for it.

I hope this helps. For you, with PCOS, successful weight loss will be very good for your long term health. While the emphasis with young women tends to be on fertility, PCOS can lead to an increased risk for many other health problems in the future. You are wise to be thinking about this while you are young.

Best luck and kindest regards.

Dr Jacques

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