‘Extreme Weight Loss’: How Body Lift Surgery Can Motivate Weight Loss

VVartanian on 23 Jul 2013 at 9:00am

Dr. Stoker shares how body lift surgery can motivate patients to stay on track with diet and exercise after extreme weight loss.

On last week's episode of Extreme Weight Loss we had the pleasure of meeting Mehrbod Mohammadi, 34, a music producer and DJ from Los Angeles. Mehrbod and his family escaped from Iran during the Iran/Iraq war when he was a child. Unfortunately, this experience caused Mehrbod to develop a full-blown food addiction (as he was taught food was a scarce resource and he should eat despite hunger). 

But, even with these hardships, Mehrbod is happily on the brink of a burgeoning music career and preparing to propose to his lovely girlfriend. The only thing standing in his way is his weight of 434 pounds (and a long-standing history of losing weight and gaining it all back again). That is, until trainer Chris Powell steps on the scene. 

Mehrbod dazzles Chris at his 90-day weigh in -- and loses a startling 137 lbs. And, even though it was tough to keep on track while he's working long nights -- he loses another 47 pounds at the six-month mark. Things start to change, however, when Mehrbod asks his girlfriend's family permission to marry their daughter. They decline saying they don't like his chosen career, and Mehrbod falls back into old habits and stops being honest with Chris.

Finally, Mehrbod gets the courage to confess to Chris that he's been rigging his scale and has gained 46 pounds. But "Mehr" (as Chris affectionately calls him) manages to regain Chris's trust, and at his final weigh-in he comes in at 230 pounds and qualifies for a body lift with LA-based plastic surgeon, Dr. David Stoker.

Which got us wondering... what effect does a lifetime of losing and gaining weight have on your skin? 

RealSelf: Mehrbod has struggled with a lifetime of yo-yo dieting. Is his skin more at risk for sagging because he's had so many cycles of weight loss/gain over the years?

Dr. StokerWith the first weight gain and weight loss, some of the elastin fibers [a protein responsible for skin’s structure and flexibility] in the skin are damaged and never repair.  And with each cycle of weight gain and weight loss, a larger percentage of those elastin fibers are damaged and don't recover.

We see this in mothers who have had multiple babies - that the skin doesn’t snap back as well. With someone who is gaining 100 pounds or more -- the effect is much more dramatic.

RealSelf:  What other ways does yo-yo dieting negatively affect someone's health?

Dr. Stoker: Anyone who has gained and lost weight is always going to be predisposed for gaining the weight back. One of the important things that we do on this show is to help patients who have severe [excess skin after weight loss] achieve a more normal or ideal appearance. Once [a patient] makes the extra commitment of time, effort, and the cost of doing this surgery – they tend to be more committed to keeping the weight off (and have a much lower recurrence rate of gaining the weight back).

Sometimes I will operate on [patients] before they are at their ideal weight – because their skin mass is already so severe that it inhibits their ability to loose more weight and dramatically increases their risk of regaining the weight.

RealSelf:  Exactly how does the excess skin endanger all the gains a person has made after extreme weight loss?  Does the look of the excess skin cause depression?

Dr. Stoker: I think there is a high rate of depression and anxiety in patients who are severely or morbidly obese -- and that doesn’t necessarily dissipate if they still [perceive they look abnormal despite their] lower weight.

For example, in patients whose abdominal and chest skin hang off of their bodies so much that it’s actually on the floor when they are doing a pushup -– or somebody whose abdominal skin is so excessive that when they are on the treadmill (or StairMaster) their skin smacks on their thighs with an audible clap... it’s embarrassing and painful.

[Body lift surgery] is a huge boost in helping reclaim a normal appearance after this huge life transition.

RealSelf: What procedure would you recommend in case like Mehrbod's?

Because Mehrbod is a strong male with a lot of testosterone, he's able to bulk up on muscle and has less need for skin removal surgery on the upper body (than a similar female patient).  Muscle takes up some of that skin laxity.

But the problem is with the way that males gain weight.  Typically, it’s around their midsection and around the waistline where the extra skin is most concentrated.  And, that’s where Mehrbod will benefit most from skin removal surgery.  A body lift is typically beneficial around the waistline. 

A body lift results in a dramatic improvement, and not only removes that extra skin on the waistline -- it also pulls loose skin upward from the thighs and buttocks and pulls downwards on the chest.  It's a much more complete tightening that an abdominoplasty or tummy tuck procedure.  

Do YOU have questions about a surgical body lift? Ask them on RealSelf

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