Weight‑loss injections cut pounds but often leave loose skin; NHS removal surgery access remains limited

People who lose substantial weight with prescription injections report a new challenge: loose skin that can linger after rapid weight loss, even as their health improves. The issue has gained attention as weight‑loss drugs such as Wegovy and Mounjaro expand in NHS services and private clinics.

Two years after Wegovy began to be prescribed on the NHS for patients attending weight‑management clinics in England, Wales and Scotland, users say the gains come with a caveat. Wegovy has been available on the NHS for two years and privately since spring 2023. Mounjaro became available privately in February 2024 and via the NHS in June. Emilly Murray, 35, of Liverpool, has lost nearly six stone since December thanks to weight‑loss injections, but now wears clothes to hide loose skin and says it "really does get me down." "I can't wear what I want to wear," she says, "I cannot get my legs out because the skin hangs over my knee so much." While she doesn't regret losing weight for the benefit of her health, Emilly says the loose skin on her thighs "really does get me down" as it makes her feel self‑conscious, and the way she looks naked makes her feel like a "catfish". "It looks okay when it's all pulled in, but then I feel like, when I take my clothes off, I look like a 90‑year‑old woman. It is horrendous."

Experts say loose skin is a common consequence of rapid weight loss. Nora Nugent, president of the British Association of Aesthetic Plastic Surgeons, says, "The more rapid [the weight loss], the more loose skin." While it can irritate and lead to infection in some cases, for many people it is an unwanted nuisance rather than a medical problem. In online communities dedicated to weight‑loss drugs, people discuss strategies to reduce sagging, including building muscle, collagen supplements and lotions, though Nugent notes that after "significant" weight loss, surgery is often the only effective option.

Access to body‑contouring procedures is limited in the United Kingdom. There are several kinds of procedures to remove loose skin, collectively known as body contouring, but they are rarely available on the NHS and only if patients meet specific criteria. They would need to show that their loose skin significantly interferes with everyday tasks such as washing and dressing themselves, said Mark Soldin, a plastic surgeon who works in private practice and for the NHS. He notes that some patients in London and nearby Surrey could face private costs of up to £40,000 depending on the amount of skin and the procedures chosen. "There are more important things for the NHS to deal with - people that have had trauma like broken legs, heart attacks and so on," he adds. Emilly aims to have enough money for surgery by next spring and says she is saving, and may have to use loans or credit cards.

Grace Parkin, who lives in Sheffield, has saved for tummy tuck, liposuction and a breast uplift but plans to go abroad to have them done because it is cheaper. "I've put the effort in, lost nine stone (57kg), and spent years and years hating the way that I look," she says. "I want to look how I want to look." Next year, Parkin is heading overseas for three skin procedures in a bid to save money.

Laura Hughes, a 47‑year‑old from Aberdeen, has also undergone major weight loss and says she now embraces the changes in her life. She lost about 12 stone (76kg) and has begun new activities, such as DJ lessons and posting selfies. "You have in your head that it's this fairy tale - you're going to get to the end and you'll have this perfect body and you're going to look in the mirror and feel fantastic," she says, "but sadly, that isn't the case, because there is the [loose] skin that goes with it." Not everyone shares that view, however. Some people, like Charmaine Hines, view loose skin as a reminder of the journey rather than a problem.

Baaps cautions that surgery abroad carries risks. Nugent says tummy tucks are among the procedures that most often accompany complications when done overseas, and the association is compiling data on patients who return with problems. The NHS advises patients considering surgery abroad to discuss it with their GP beforehand.

Beyond the individual experiences, health officials note that tackling obesity remains a priority for the NHS, given that obesity‑related illnesses such as cancer and heart disease drive substantial costs. The treatment of obesity‑related conditions is estimated to cost the NHS about £11 billion a year. Yet body contouring is largely treated as cosmetic surgery and a low priority in NHS budgeting, which means many patients must navigate private care or travel abroad if they want this form of support.

For some patients, the prospect of surgery abroad is a difficult decision, balancing cost savings against potential complications and the practicalities of travel. The NHS stresses the importance of discussing all options with a GP and weighing medical needs against financial realities. As patients continue to pursue weight loss through medication, the medical community is watching how to best address the accompanying challenges of loose skin, including the role of accessible and affordable body‑contouring options.

Not all patients express regret about loose skin. Some, like Laura Hughes, have found new confidence and activities after major weight loss, illustrating the wide range of experiences in the wake of medical weight management. The ongoing discussion highlights the need for clearer pathways and support as people navigate both the health benefits and the practical realities of significant body changes.