I can't speak about the GBS but I can speak of getting reconstructive surgery after massive weight loss. I can tell you it is NOT a "quick fix" but indeed the only option if you are unsatisfied with your skin following massive obesity.

When it comes to massive obesity, it is a myth that exercise will do anything to fix it. Skin is an organ separate from muscle; building muscle will just help "fill out" skin. Needless to say, if you've been pretty morbidly obese, it's likely your skin will be such that "toning up" is hardly adequate. That may work if you were only a little bit overweight.

Basically if the skin is just "loose and flabby" toning will work - but it if it's like redundant from the extent of loseness... building muscle isn't going to help that much.

Furthermore, age, length of time overweight... while they will help improve skin quality IMO the primary determinate are genes, degree of obesity, and rate of gain.
Genetically my skin is like my mother's: english, scars easily and is thinner. Therefore my skin took more damage than, for example, my cousin who has very thick skin even though her high weight was similar to mine (considering her height). I'm amazed at how she only has stretch marks on her stomach; her arms and thighs are pristine.

Degree of obesity and rate of gain are important. If you gain weight very very slowly over a long period of time, the skin is less likely to sustain permanent damage than if you gained in a couple of big spurts. The damage occurs when stretching of skin exceeds ability to grow - this causes scars and damage which results in lose skin. Obviously, gaining weight very very slowly will preserve skin better than if you suddenly gained.
Speaking personally, I gained weight pretty rapidly AND it was at a time that I was growing into adulthood.

While it's true my age probably helped lessen the damage... it's also true my age helped contribute by putting a greater strain on the need for skin to grow combined with dramatically increasing weight.

Plus there's perception.
Some people aren't as perfectionistic as others and may find it easier to live with excess skin.

Like all problems it's a multifactored issue. Some people will find their skin isn't that bad, others will. Either way, it is indisputable that surgery really is the only option for extreme loose skin. I can grab my skin in handfuls in some areas. I am intending on getting it done, for sure.

Do you have a reference for this Woo. I've always wondered about the difference folks exhibit in skin/flab issues.

I personally thing age and rate of loss would have more to do with skin elasticity, along with heredity. I know women who gained more, and more quickly than I during pregnancy, and yet they had NO stretch marks...where my skin unraveled at about 6 months gestation.

My skin is bad. The skin is very stretched and delicate and crepey and wrinkly on my upper arms, stomach, upper thighs. My breasts were really, really bad, but I had a breast reduction in 2000.

I don't know what caused the poor skin, heredity, fast gain or fast loss, I've done both, fast gains & fast losses, more than once for both. I'm not sure that it was age in my case because my skin was bad in my early 30s. Heck, my breasts were sagging in my teens. I generally have exercised when I was losing weight before so I don't think (at least for me) that exercise has anything to do with saggy skin.

So, I'm more inclined to think heredity has more to do with the skin issues than age, but this is just my experience.

wow...i just noticed something.

i am watching ER and i know that a few years back an actress that plays a nurse on the show had gastric bypass. she looked like a completely different person. well...i am watching now and noticed with shock.....she GAINED a lot of weight back!!! what a shame.

Actually, if I remember correctly, she didn't have a gastric bypass, she did a liquid diet. http://www.yvettefreeman.com/ww.html

oh wow....i had heard she had surgery. i guess that goes to show you that when someone loses a lot of weight, the surgery rumor spreads.

A problem with the diets, such as the liquid diet, used by Yvette is that you cannot stay on them for the rest of your life. Drinking 700 calories worth of shakes a day will definitely cause a weight loss, but at the end of the loss, you are at a loss as to what to do to keep the weight off. You just can't keep drinking shakes the rest of your life.

I believe I've read that about 95% of us regain the weight we lose. As far as I know, that is independent of what method we use to lose it.

Actually, I was never sure if they were counting people, or weight loss attempts. I like to think (hope?) that it means that 95% of weight loss attempts fail in that way, but that eventually, a much higher percentage of us can ultimately lose the weight (perhaps after multiple failures) and keep it off.

(Why did I have to go and read that?)

Because to be forewarned is to be forearmed.

Whenever I see someone post that they will NEVER be overweight again, I always say a silent prayer of sorts that they are right, but I always think, you don't know that for sure. Regaining weight is WAY, WAY, WAY too easy.

Vicki, I'm with you, I hope it's the attempts that fail, but that there is actually a higher percentage of people that achieve good results and maintain that result.

I don't think we can ever really know if we can maintain forever, but for me, this particular weight loss experience feels different.

In the past, I've gotten almost to goal, only to have this very defined moment when I knew that losing weight wasn't *the answer* I thought it was to whatever problems motivated me to try to lose the weight. It didn't make me popular in high school or make my first husband love me later on. I'm hoping that this time, because I was only looking for weight loss to make me healthier and mebbe a bit better looking (not holding out for gorgeous), I can avoid that.

I dated a guy who had lost over 150 pounds... and he had loads of skin that just hung down. When I met him he had been doing BFL for over two years. His skin was not "snapping" back into shape. He had told me, and after seeing his skin, that surgery was his only choice. The excess skin on his stomach alone was probably an additional 15 lbs that just hung there. I myself am very lucky. My skin is resiliant and shows little from the 50 lbs I gained/lost. Not everyone is so lucky.

There are people that do become addicted to plastic surgery. But there are others that make the choice for sugery, be it WLS or plastic surgery, because they believe it will make a difference in their life.

Any surgery, IMHO, should require the Dr to talk about the psycholocial effects it will have on them and their family.

Hmm my ticker is broken! Forgive my above typos, its way late here!

One last thing regarding skin: ~ 420 lbs my skin brokedown years ago and the plastic surgery will be a necessity for me no matter what. I could live with the extra 15-20 lbs the skin will weigh and will totally do so after I have two children. After that, its tummy tuck central. Regardless of how anyone else may feel I feel that I will deserve it, and cherish it as the final leg of my weight loss transformation.