When “Muscle Loss” is Really Fat Loss with GLP-1s

My Skin Drips as Fat Melts

I have lost over 200 pounds. Twice. Once in 2001-2002 (Roux-en-Y Gastric Bypass) and this time from 2022-2024 (Trulicity and Mounjaro). I was 40 years old the first time and am 63 years old this time. I also lost 111 pounds in 1996 on Fen-Phen. I was 35 years old.

Not only did I lose those huge amounts of weight, I also regained more each time. Those three experiences don’t take into account the other 50 years of dieting… losing and regaining, losing and regaining again.

I mention these experiences because, here at 63 years old, I have very little elasticity left in my skin. I’ve really given my skin some work-outs! It’s not surprising she is rebelling with the drips and sags.

See What I Mean?

I’m really saggy baggy. I mean, I have a lot of hanging skin. I’m going to be brave and show you parts of my body.

First, my belly. It looks like I have vertical blinds for a stomach now. If you squint, it looks like a tree trunk.

The girls and I decided it was a variation on Skin Art. I have many tattoos, which are considered standard skin art, but can’t I call art “art” if I think it is art?

I’ve decided my artistic hanging skin is a tattoo’s naked sister.

If this picture weren’t me, I would be fascinated by it. But looking at it in the mirror is, at the very least, jarring. Almost my entire body has these vertical blind-like folds.

My “Muscle Loss,” Is Not Muscle Loss

I put “muscle loss” in quotes because I was told by many folks, and the press, that my weight loss was really muscle loss. At least half of it was.

“About 20% to 50% of any type of substantial weight will be from muscle,” explains Caroline Apovian, M.D., the co-director of the Center for Weight Management and Wellness at Brigham and Women’s Hospital in Boston, MA.

I finally decided to get a Body Composition Dexascan done in March 2024. The results made me proud! My weight loss was not because my muscles were melting, but because I was losing fat. Looking at the images and seeing the percentages of muscle compared to fat (each in different colors), I surprised the X-ray technician who expected me to have lost a great deal more muscle than I have, too.

My muscle (Lean Mass) weighs 114.4 lbs. and my fat weighs 96.7 lbs. So far so good!

I had not yet done a lot of walking and no lifting, except for my own giant body, until right before I did the scan. Now I walk like crazy and am lifting hand weights and using bands. When I get the next scan in September, I really look forward to seeing my progress.

My Dermatologist Tells Me…

I see my Dermatologist every three to six months because I have a history of malignant melanoma. I saw him a couple of weeks ago when he did two biopsies that, I found out yesterday, came back negative. Yay! It was the first time I’d gotten naked in front of anyone since starting Mounjaro. It was challenging for me to move the gown so he could check my skin. He’s seen me throughout the weight loss, but this was very different than six months ago. I was very concerned that starting Mounjaro was what was eating my muscles, why I had so much dragging skin.

The Dermatologist was very kind and patient with me. I started crying with embarrassment, but he did his best to put me at ease. He went as slow as I needed him to. Why was I not ever embarrassed to wear sleeveless dresses without bras and undies at 350+ lbs. but being 188 lbs. was freaking me out? I just look so different! I’m used to seeing my puffed-up-with-fat skin. This was such a change. Will I ever get used to it?

He said that what was happening was the first 100+ lbs. emptied the deeper-in fat. The last 91 lbs. lost, the ones since I have been on Mounjaro, were emptying the fat closer to the surface. That these last remnants of fat are the ones that are going to sag the skin the most because there is nothing more to fill it. I don’t have one clue if that is true or not. I have not researched it yet, but it sure made me feel better. The idea that the skin is sagging because the fat is disappearing made the drapes seem more palatable.

In another post, I will talk about having the skin removed/tightened, but that is just too much to think about for now.

I am sure I’m not finished mourning my smooth skin, but I’m thinking smooth skin for me equals fat, and unhealthy, body, whereas all the creases represent better health and a longer life.

Here’s to a longer life!