May 8, 2014 at 7:10 PM ET
For all the pitches urging us to lose weight for a bikini-perfect body, rarely do we hear about the sagging skin that can remain after we slim down. That is, until Brooke Birmingham, the Illinois blogger who lost 170 pounds, posted a bikini photo of herself that she said Shape magazine wouldn't show. Birmingham's post ignited online support, with many calling Birmingham an inspiration.
This woman is the perfect example of what women look like after major weight loss. I applaud her for being brave!! We need to get away from airbrushed, photoshopped, surgically enhanced images. -- Dawn Hiatt Hanson
She looks amazing. And congrats to her on her amazing weight loss!! She is truly inspiring. So what if she has some extra skin, it doesn't make her any less beautiful than a woman with a perfectly toned body. I give her credit for being brave enough to put herself out there for all of you to judge and criticize. -- Andrea Fisher Valley
Thank you so much for posting your picture. I have lost 110 pounds and don't like to look at my naked body. I too have loose skin. I look at all the before and after articles and they never seem to look the way I do. I think they are all squeezed in to control garments and photo shopped to get rid of the rolls. You just can't lose that much weight and be firm all over. You are to be commended for being so courageous to post your after picture. Congrats on your weight loss! -- Angie Blanchard Bradshaw
I can identify with her. I lost and gained over the years. Heaviest 343. Now 155 and maintaining for 2+ years. The body is saggy and arms like a flying squirrel BUT I'm healthy and a lot better off. Just don't catch me without my Spanx!! -- Victoria McIntire
Many women feel better about their bodies when they take steps to improve their health, including reaching a healthy weight, says Helen L. Coons, Ph.D., clinical psychologist and president and clinical director of Women’s Mental Health Associates in Philadelphia.
“They feel empowered and have an improved body image that they took care of themselves this way and their body responded,” she says.
But while some women, like Birmingham, feel proud of their weight loss success, others are self-conscious of the extra skin that may be left over on their bellies, arms or thighs.
Coons says it’s important to focus on the progress they’ve made and on their health, which is more important than the sagging skin. But if they are bothered by the loose skin, there are options they can pursue, such as physical training and wearing clothes they feel comfortable in.
More extreme weight-loss patients have chosen to remove the loose skin through cosmetic surgery. This extra skin (which is usually caused by losing 100 pounds or more in a short amount of time) can happen to those who lose weight through diet and exercise but more often to weight-loss surgery patients.
“These patients are getting rashes and infections where the skin is rubbing against skin,” says Dr. Scot Glasberg, a cosmetic surgeon in New York and president-elect of the American Society of Plastic Surgeons. And the excess skin can lead to other physical problems, such as bad posture and back pain.
The body contouring procedures to remove excess skin can bring physical and psychological benefits, he says. And a 2013 study in the journal Plastic and Reconstructive Surgery showed that people who had weight loss surgery followed by a body contouring procedure were less likely to gain the weight back.
If you've lost weight, share your "after" weight-loss photos on TODAY Health Facebook. Bikinis not required!