Considerations in Weight Loss Medication: Losing weight without losing your healthy skin

Weight loss medications | Skin changes due to weight loss medications | Skin changes due to weight loss procedures | Skin Changes Associated with Rapid Weight Reduction | Misuse of medications for weight loss | Management strategies | Future Directions and Research | Conclusion

Key Takeaways

 

1. Rising Obesity Treatments: More people are using weight loss methods as obesity increases globally.
2. Skin Effects: Weight loss treatments can affect the skin. Knowing these effects helps in providing better care.
3. Choosing Treatments Carefully: Picking the right weight loss methods can reduce skin problems. Some treatments may improve skin health.
4. Teamwork in Care: Treating obesity well requires experts from different fields, like dermatology and endocrinology, working together.

Obesity is a major problem in current society, and many of us are eager to shed weight and get back in shape as rapidly as possible. The advanced medical field today offers a range of medical and surgical options to achieve this goal, in addition to the lifestyle modifications we can adapt to. Unfortunately, in this relentless struggle for weight loss, we often focus solely on the numbers on the weighing scale, forgetting to consider the impact on our skin.

In this article, we will explore the overlooked connection between weight loss strategies and their effects on dermatological health. Keep reading to uncover the lesser-known practical side of rapid weight reduction and its implications for your skin.

 

Weight loss medications

Typically, you will be motivated to adapt lifestyle changes as the first step to losing weight. However, since the longer duration needed and the poor compliance and continuation of the routine, most seek an easier way to achieve the goal. Medications are available in both oral and injectable forms. Common weight loss medications include Orlistat, Phentermine/Topiramate, Liraglutide, Naltrexone/Bupropion, Wegovy, Ozempic, and Lorcaserin. They work through appetite suppression by stimulating the GLP-1 receptors, fat absorption inhibition, or both. Furthermore, there are invasive surgeries that promote weight loss rapidly for people who are highly obese.^[1]

Side effects and suitability of these methods vary, necessitating consultation with a healthcare provider before use.

 

Skin changes due to weight loss medications

While some oral medications are likely to help you cure or subside skin conditions like psoriasis, others may give you various types of skin rashes.^[2] Listed below are some common oral weight loss medication pills and their specific side effects on your skin.

1. glucagon-like peptide 1 (GLP-1) analogues (e.g. Liraglutide, Wegovy and Ozempic)

Vesiculopustular dermatosis is a known side effect of this drug.^[3]

2. Dietary fat absorption inhibitors (e.g. Orilstat)

These drugs work by inhibiting pancreatic and gastric lipase enzymes that are essential for breakdown and absorption of fat you eat. Therefore, it also reduces absorption of fat soluble vitamins such as vit A, D, E, and K, leading to poor skin health and rashes including Lichenoid drug reactions, and bullous leukocytoclastic vasculitis.^[4],[5],[6]

3. Anorexigenic drug (e.g. Metformin)

May cause itchy skin rashes and patchy hair loss, namely psoriasiform drug eruption, acute alopecia and lichen planus.^[7],[8]

There are some injectable drugs for weight loss with adverse effects on your skin health. Main concerns are injection site abscesses where infection and pus-filled pockets form at the site where the injection is given.  Furthermore, there is evidence to show drugs acting via adipocytolysis: destruction of fat cells (e.g. Deoxycholic acid) might cause skin ulceration and skin necrosis locally at the injection site.^[9]

 

Skin changes due to weight loss procedures

1. Bariatric surgery

Recommended for people with a body mass index ≥40 kg/m2 or people with a lot of other comorbidities.^[1] The scientific basis behind the surgery is to reduce the gastric food absorption capacity by removing/ bypassing a part of the stomach. Bariatric surgery aids weight loss and can improve conditions like hidradenitis suppurativa and psoriasis. Yet, it may also lead to issues such as nutritional deficiencies, bowel-related skin conditions, PASH syndrome (linked with skin conditions like pyoderma gangrenosum, acne, and hidradenitis suppurativa), vasculitis, and excess skin.^[10]

2. Liposuction

Liposuction, a method aimed at reshaping body contours, involves suctioning out subcutaneous fat following saline injection.^[1] However, it is not regarded as a weight reduction technique despite being used as one by some people. Skin alterations linked with liposuction encompass skin redundancy or laxity, infection, and skin necrosis, documented in approximately 10%, <1%, and 1% of instances, respectively.^[11]

 

Skin Changes Associated with Rapid Weight Reduction

Rapid weight reduction itself can lead to some skin issues. It may cause significant changes in the skin’s appearance, including the development of excess skin and stretch marks. The severity of these changes can be influenced by various factors such as the rate of weight loss, age, genetics, and skin elasticity. To address these concerns, preventative measures and treatment options are available.

 

Misuse of medications for weight loss

Misuse of drugs intended for other purposes to achieve weight loss is also seen in the community. Such drugs include laxatives and stimulants. Laxatives induce weight loss through dehydration and nutrient absorption reduction but can lead to skin diseases like photosensitivity, urticaria, fixed drug eruptions, and finger clubbing.^[12] Stimulants like amphetamines and dinitrophenol promote weight loss but may also cause skin issues such as xerosis, pruritus, malodor, hyperhidrosis, xerostomia, premature aging, skin necrosis, acne excoriee, or lichenoid drug eruptions.^[13] It is best not to use these drugs for weight loss as it may lead to a lot of bad consequences, not limited to your skin.

 

Management strategies

Non-surgical approaches may include maintaining a steady rate of weight loss, staying hydrated, and adopting a balanced diet rich in nutrients that support skin health. Additionally, moisturizing the skin regularly and practicing good skincare habits can help improve elasticity and reduce the appearance of stretch marks. In more severe cases, surgical interventions such as body contouring procedures may be considered to remove excess skin and restore a more toned appearance. Consulting a healthcare professional can help individuals navigate the best course of action based on their individual needs and goals.

Effective communication between patients and their healthcare team is essential. Patients should openly discuss their concerns and symptoms, allowing healthcare providers to tailor treatment plans accordingly.

 

Future Directions and Research

As the field of dermatological considerations in weight loss medication and rapid weight reduction continues to evolve, future directions and research hold promise for advancing patient care. Ongoing research efforts are focused on improving skin outcomes for patients undergoing rapid weight reduction, with a particular emphasis on minimizing excess skin and addressing skin-related side effects.

Additionally, research into minimally invasive procedures like non-surgical body contouring techniques is underway, aiming to address excess skin resulting from rapid weight reduction without invasive surgery. Studies are exploring the use of cavitation and ultrasound technologies to tighten loose skin and enhance overall skin texture following weight loss.^[14]

In terms of patient education and support, healthcare providers are implementing comprehensive programs that include counseling sessions on skincare routines, nutritional guidance to support skin health, and psychological support to address body image concerns. Online resources and support groups also play a vital role in connecting patients undergoing weight loss treatment, fostering a sense of community and providing valuable advice and encouragement throughout their journey.

Conclusion

As obesity rates escalate globally, there’s a corresponding increase in the utilization of therapies and procedures aimed at promoting weight loss. While these interventions generally benefit patients, they can also bring about skin-related effects that necessitate thorough medical understanding. By carefully selecting appropriate treatments, adverse effects can be minimized, and in certain instances, skin symptoms may even improve. Additionally, addressing obesity necessitates a multidisciplinary approach, highlighting collaboration among dermatologists, endocrinologists, and primary care providers to ensure holistic patient care. As novel medications and therapies emerge for obesity, ongoing reporting and research on their cutaneous effects by medical practitioners are crucial for enhancing future management of obesity.