WHEN ACTOR ETHAN Suplee went from 550 (250 kg) to 300 pounds (137 kg) on his 6’1” frame, he imagined he’d finally look at his body and feel no shame. He thought he’d feel confident and look in the mirror at a body he was proud of after a lifetime of insecurity over his weight.
Suplee was clinically obese by age 10. After struggling with overeating and fad diets throughout his youth, he took his first major effort to lose weight at age 26 in 2002 with a liquid diet, then a blood type diet. By 2005, between a keto diet and consistent trainer-led workouts, he had dropped 250 pounds (113 kg).
But he hadn’t considered what might remain once he lost the weight: skin. Lots of it. “I’m smaller, but nothing is tighter at all,” Suplee recalls thinking. Wrinkles fell over his knees. Excess skin covered his thighs. He was insecure about it and he mostly wore baggy clothes to hide it. “The apron around my abdomen was the worst of it,” Suplee says. “It looked like a gut under my clothing.”
Suplee was faced with a problem he couldn’t solve through hard work in the gym and a disciplined diet. For those who undergo high volume weight loss, that is a common feeling, and it’s a silent challenge of weight loss for both the unhealthily overweight and the bodybuilding crowd alike. A few months ago, bodybuilder and YouTube star Dr. Mike Israetel also had a surgery to cut away his loosen skin. “Skin is a really tricky thing, because you work so hard to try to get to a point where you feel, quote, unquote, normal,” Suplee says. Over the next few years, he tried fad trends like mineral supplements, red light treatments, and lotions to remove excess skin. “But there’s not something that can magically remove the skin,” Suplee says. “That’s like saying, ‘I want to diet one of my fingers off.’ There’s no autophagy that’s going to take that away. It’s an organ.”
Patients who lose large amounts of weight like Suplee are sometimes horrified by their excess skin, says University of Virginia Associate Professor and plastic surgeon Chris Campbell. Campbell spoke with a physician in Pittsburgh who said he had patients with body dysmorphic disorder because of their loose skin. “They’ve been fat for 30 years; suddenly, they’re lean, but it’s not what a magazine looks like,” Campbell says. “And they have a hard time dealing with that.”
Suplee in the midst of his weight loss journey.
Increasingly, loose skin removal surgery is a common next step for people who have undergone extreme weight loss, like Suplee—and it’s become much more popular in the last six years, according to Campbell. In 2022, the American Society of Plastic Surgery reported that tummy tucks, upper arm lifts (to get rid of flapping/excess skin), lower body, and buttocks lifts all increased in occurrence by about 23 percent from years prior. This rise is due primarily to the increase in bariatric surgeries covered by insurance, as well as a rise in GLP-1 medications for weight loss such as Ozempic and Wegovy.
Campbell says that most patients start with the removal of excess belly skin. He will put three to four feet of incisions on their body to lift and cut off pounds of skin. An abdomen surgery can take 90 minutes; a person who has lost several hundred pounds can be in surgery for three hours. And complications can arise, including infection due to open wounds.
Suplee underwent his first excess skin removal surgery in 2008, a circumferential body lift. The procedure removed excess skin from his abdomen, hips, lower back and buttocks. Recovery, however, turned into a months-long nightmare. In hindsight, Suplee says, he had the procedure done too soon. He had gained some weight back since his initial consultation and he wasn’t physically and mentally fit at the time of surgery.
He lost a tremendous amount of blood during the initial procedure and had to be given six blood transfusions. Then he tried to start moving around too soon post-operation, fell over, and split open his side. His surgeon couldn’t sew him back together due to risk of infection, so Suplee was put on a wound vac and heavy antibiotics for almost five months. “It was an incredibly awful experience,” he says.
Campbell, who performs anywhere from one to four loose skin removal surgeries per week, says that recovery times can vary from six weeks to several months. Often patients return for several surgeries to address loose and excess skin, which was also the case for Suplee.
In 2010, just two years after the first procedure, Suplee’s weight was back up to 400 pounds (181 kg). He began cycling and extreme dieting to lose weight. He dropped down to 220 pounds (100 kg) and still had giant sections of skin on his breasts and sides. “I still looked bulky and flabby in the upper part of my body,” Suplee says. “And I wasn’t happy with that.”
So he underwent a second skin removal procedure in 2012, which went much more smoothly; he recovered within six weeks. But again, he gained back the weight. By 2016, he had returned to 400 pounds (181 kg).
In 2018, Suplee decided to be even more thoughtful and intentional in his weight loss approach. After 16 years of cyclical weight loss-gain-loss-gain and following fad diets and short-term solutions, Suplee learned dietary strategies and workout plans that worked for him. He weighed his food, he realised he could eat some carbs, and he established a long-term plan. “That’s where I really figured out how to live the rest of my life,” Suplee says.
Today, while the 49-year-old has maintained a healthy weight, consistent workout routine, and nutritious diet, he still has loose skin all across his body. “I don’t love it, but I like it more than if I was to fill it out with fat,” Suplee says of his loose skin. He has also acknowledged that he will always struggle with body image and weight, and that there isn’t a perfect or easy solution. “This idea of having a body that looks the way I want it to look—I think it doesn’t exist,” he says.
Campbell notes that the majority of patients are happy with their weight loss, which then carries over to patience and understanding about excess skin and how to manage it. “By and large, the psychological aspect is favorable after body contouring,” Campbell says.
Suplee says that because he had never seen anyone talk about this aspect of a body transformation, he didn’t realize his skin wouldn’t shrink as he lost weight. That’s a major reason he prioritizes speaking about his own experience. “I talk about it every chance I get, because it’s gonna happen,” Suplee says. “If you have a massive amount of weight to lose, then you’re gonna have loose skin.”
Still, Suplee has hit major milestones that he never expected as a young man battling insecurities about his body. The first time he could see abdominal definition was in 2019, when he whittled his way down to nine percent body fat. He has ridden a full marathon on a rowing machine, bench pressed 405 pounds (183 kg), and he can run around with his grandkids in a park all day and still have energy. “I am so utterly impressed with what I’ve been able to do physically,” Suplee says. “That doesn’t mean I’m never self-conscious or don’t want to binge eat sometimes. I’ve had to do deep introspection.”
And he has learned that the scale and the mirror could only provide so much satisfaction. He has shifted his mindset to maintenance and being content with his overall health, not struggling to make a number go down. He talks about body image, fitness and more on his American Glutton podcast and Substack each week.
He also has an important rule for himself in regards to self-image. He often stands in front of a mirror and doesn’t walk away until he has found something to admire. It may take half an hour. But he will stand there until he sees something positive about his appearance.
“I think about how the people I care about care about me,” Suplee says. “And if I’m in my head thinking bad thoughts about myself, I’m basically shitting on someone they care about. And that’s not the person I want to be.”
This article originally appeared on Men’s Health US.
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