#91 - Can you recoil skin after weight loss with guest co-host @drtessmauricio

Hi, my name is Jorge Cruise and I'm the number one New York Times bestselling author and leading fitness, nutrition, and peak performance trainer to the world's busiest celebrities. You may have seen my work with Oprah Winfrey, Khloe Kardashian, Tyra Banks, Kelly Clarkson, or even Dr. Oz.

My career started because in my early 20s I was out of control and addicted to sweets, carbs and salty snacks, and experts told me to simply count calories to get control.

They were wrong. My passion to get control of my hunger led me to find simple ways backed by science that would turn off physical hunger as well as my emotional eating instantly, and I know I can help you too. Welcome to the Jorge Cruise Show.

Well, happy Tuesday.

It is November the 10th. This is Jorge Cruise Cruise, and welcome to the show. Um, this is the podcast that really has become the number one podcast to help people get control or regain control, um, radically over their hunger, specifically over sugar, carbs, salty snack foods, and emotional eating. Because I can tell you, all those items, all those things that a lot of people don't want to talk about, are the very things that cause weight gain. Uh, never have I met anyone who has a problem with overeating protein or fats. It's always carbohydrates, it's always sugar, it's always salty snack foods like potato chips. And it's the potato that's the problem, not the salt. Or corn chips, one of my favorites, right? And it's not the salt, it's the the corn, and those are all carbs. And carbs and sugar and all that does help us feel better. So it's connected to emotional eating because rarely— I've really never met anyone who, when they're having a rough day or a stressful night or they're feeling lonely or anxious, do they feel like they want to have a hard-boiled egg, you know? It just doesn't happen. Or, or have some bacon or have a steak. They want a bag of chips, you know, or they want to have sugar, if you know what I mean, or some carbohydrate. And it's not a carrot, and it's not an apple. Maybe an apple, I would doubt it. If not, it's something quite more processed and traditional like chocolate. Chocolate something, right? And even alcohol. So if that's something that you can relate to, I'm your guy because I'll tell you, my life's work has really been to help some of the busiest celebrities overcome their concerns with sugar, carbs, salty snack foods, and all that, and do it in an easy, simple way. Now for today's show, we're gonna sit down and chat with Dr. Tess Mauricio. Dr. Tess is probably the world's leading dermatologist. She's known as the world's most favorite dermatologist. She's Stanford trained. We met, I met her over 10 years ago on set at The Talk at CBS Studios in Los Angeles, and we've become friends ever since. She's a sponsor of the show, I do have to say that. But more importantly, she's been on the show before, episode 37, when we talked about vitamin D And on today's show, we changed the topic though dramatically because I really wanted to kind of take the flip side of the positive intention that we all have to control our hunger so we can hopefully get healthy. And after that health process occurs, what happens if we lose, say, 50 pounds? What happens if we lose over 100 pounds? And a lot of my clients over my career have lost so much more than that. And the biggest question is, hey, I have extra skin now, what do I do with it? And so I have had certain clients recoil their skin after weight loss and certain clients that haven't. And so what I want to share with you on today's show and what Dr. Tess is going to educate us on is really how to do that without surgery, although that is an option, but it's the last option. And really some of the biggest strategies out there to help fortify the skin when it's going through that healing. And you'll be happy to hear that one of her strategies is using collagen, which is really bone marrow, because a lot of, a lot of people don't realize that collagen is bone marrow, because I would say less than 5 years ago was something I wasn't even consuming, uh, and it's been out there for many years. I mean, sages have used this for years to, to give them health and benefits, uh, so it's nothing new. But what you had to do to do this a couple years ago, maybe 5 years ago, it wasn't as popular. You'd have to buy actual bones and boil them and get the marrow out from within the bone, and that collagen is what's inside of there. And so in today's world, there's so many ways to get this that are so much more convenient from protein shakes to soups to tablets, things like that. And so we're going to talk about how to do that, how to get it, and how it can help restore skin elasticity so you can recoil that skin after weight loss, even if you've lost more than 50 or say over 50 pounds. So I'm super excited to have Dr. Tess on the show. And you know, like I said, she's a sponsor of the show, but I really do believe in her work. And because she's such a popular guest on so many talk shows, she's been busy, but I was able to get her on the show today. So I'm thrilled to have her on, and it's a great episode. It's short, it's sweet, and it's powerful. Now, before we get started, I want to give a shout out to our sponsors. First, the Primal Kitchen for their free chipotle lemon mayo that they're giving all of us if we simply go to their website primalkitchen.com and then forward slash Jorge Cruise. Now, maybe you're thinking, Jorge, what is this mayo again? Well, mayonnaise is a condiment that I use on my steak. It's something you can put on vegetables. But the problem with most mayo or even salad dressings is they're made with soybean or canola oil, which is super inflammatory. And our goal is to have healthy fats to turn off hunger so we can fast and get control of our hunger while we're doing that. And this is a product I use every single day, uh, in my meal strategy to really turn off hunger further. It's like dialing it down even further down where there is no hunger. And so check them out at primalkitchen.com/jorgecruise for your free chipotle lemon mayo with— made from avocado oil. And you're going to absolutely love it because it's such a simple biohack. We're also brought to you by Joovv. You've heard about Joovv, and I love them because they're giving us a free gift with the promo code Jorge Cruise. But what Joovv is, it's red light therapy that really helps, especially now that it's getting darker and colder and winter's around the corner, helps us really feel good. It helps solve my seasonal mood disorder because it creates this beautiful bright red light that makes the room feel like you're seeing a gorgeous sunset in Hawaii. And I think it's so important to have a way to always feel good and also have a light that gives you that energy without taking away the, the positive. And a lot of times they use this at night as well because it's a red light and doesn't have any blue light, so it won't interrupt your sleep at night whether you do it in the morning or night. So it's really, really great. Now I'll give you their website, and they're giving us a free gift with the promo code Jorge. It's joovv.com/jorge. Check them out. And finally, we're brought to you by Dr. Tess. And so thank you to Dr. Tess for being on the show today. And she, if you guys don't realize this, she's been doing this for the last week, has given us a coupon code for 50% off all her products, including her Healthy Skin, which she's going to talk about on the show today, which is a collagen tablet that is absolutely incredible and is one of the strategies. And it's 50% off, and I think you're going to love it. But don't take my word for it, listen to the show and then give it a shot. And it's money-back guarantee, 50%. You just go to her website, shopdrtesse.com, enter the promo code, checkout code DRTESS, D-R-T-E-S-S, and you get 50% off of all her products, including her Lively Healthy Skin, which is what we're going to talk about, because it has the collagen. So with that said, guys, I'm excited because really, this is a question that so many of us have had. And I had this question when I lost the weight 2 years ago. And I can tell you, every one of my clients who loses more than, say, 40 or 50 pounds is scared about their skin not recoiling. And so today, I think you're going to have not just the confidence to know what to do, but you're gonna know that there is a solution out there that's not just surgery-based, that you can actually restore skin and really make it strong again. There's a great metaphor she uses about how our skin as it ages and as it gets stretched from being overweight becomes more like a linen, right? And our goal is to restore it to more of a denim where it doesn't wrinkle and it doesn't break down as quick. And so she's gonna talk about all the strategies, collagen being one of them, on how to do that. And I think more importantly, she's gonna share with us the science behind how skin becomes old and how we can keep it young, because that is so important. It is the largest organ in the body, and I think with that said, you're going to understand how to take care of your skin at the highest level so you stay your most youthful, healthiest self while you lose weight. I think that's the key to it all. So without holding back anymore, guys, if you're ready, I'm ready.

Let's get started right Now, during quarantine, I've been helping a group of women drop weight. I have one gal, Sandy, who's lost 91 pounds. I just interviewed live on IG. Sandy, Sandy, 91 pounds. And then I interviewed Cindy who lost 44 pounds. And their number one question, you can imagine anyone who's lost a lot of weight and they do it in a fairly efficient manner, it doesn't take like 20 years to lose it, you know, they have this elasticity issue with their skin where their skin seems to lose its ability to recoil. So today we're going to talk about that, to tease it, right? And I think that's such an important thing about strategies to, I mean, to give us hope and to hopefully restore the skin, right, Tess?

Absolutely. I think, you know, you're doing such an incredible job. Obviously, you know, science proved it so many times and more and more we understand that the metabolic syndrome and obesity is really kind of the, you know, what's underlying many of the things that we see as far as we as doctors, you know, with diabetes, with heart disease, kidney disease, and, you know, decreasing the immune function as well. And so, but, you know, from the cosmetic standpoint, I think it can be distressing for people who are doing the right thing. They are, you know, creating a healthier lifestyle. They are reaching their goals. They're dropping their, you know, their hypertension medicine. They're not, no longer taking diabetic medicines. They feel great. They have more energy. But now many of them after weight loss feel like they look older. Keeps them actually from enjoying the weight loss where they're actually—

Yes.

—hiding from people because people will say, "Wow, you look older now." So it's one of those conundrums, but you know, as we know, fat really provides structural support for our skin and it's really important. And even with the natural aging process, there is volume loss. And you know, one of the most common procedures that we perform in our clinic is restoring volume with hyaluronic acid fillers, with fat transfer, because we do understand that it's not just really, you know, the weight loss.

So let's do this before we dive into the solutions to what do we do with this saggy skin, you know, and is it surgery? Because, you know, everyone thinks, oh, I have to get a surgery and it's a fortune and it's painful. Tell us a little bit of the Dr.

Tess story. Yeah. You know, I really grew up with very bad skin, severe eczema. You know, I actually grew up always hiding my skin. I never wore shorts. Even through med school, I just didn't show because I had scarring from my skin issues. So it's one of those things where I really lived through the psychological impact of not having great skin. So when I entered medical school at Stanford, I thought I, you know, what I wanted to really help people with is boost their psychological well-being. And so I did a lot of my research in psychiatry and I thought I was going to be a psychiatrist specifically a geriatric psychiatrist. Because as we do get older, so many things happen in our life with the aging process that we end up not feeling so good. And so then I did a rotation in dermatology, and what I found was, you know, when you treat people's skin, whether it's acne, whether it's psoriasis, whether it's eczema, when you do that, you really boost the patient's well-being. Their self-confidence. Their psyche, right? Self-esteem, totally. And so I thought this was the best way where I can help my patients with their psychological well-being. And dermatologists have an armamentarium of incredible tools, now more than ever, to truly achieve this for our patients. And I really wasn't born with great skin. And so when I look at myself in the mirror, I cannot believe that were what we're able to achieve.

What would you say for women that think it's too late? Because I know today we're going to start right now and for men too, because hey, come on guys, guys and women. And I feel like I know I've lost on average, I've kept off 40 to 50 pounds off at my heaviest when it was at UCSD where I was an emotional eater and I didn't know about intermittent fasting, but start with this. If you would test about the one option that I think most people think is the only option when you lose, say, 50 pounds or even 91 pounds, like my gal Sandy, right?, and they think, oh my gosh, I've got these stretch marks. So tell us what a stretch mark is and why the skin changes when we get heavy. And then what happens when we lose the weight? It comes back in, but it's not quite the same. And then once we understand what this is, this loose skin, right? Let's talk about some solutions.

Is that okay? Yeah? Absolutely. Well, you know, the skin, there's, there's two main proteins. There's, there are cells called fibroblasts and these are cells that actually producing the two main proteins that are in the skin. One is collagen. I think everyone's heard of collagen. So collagen basically provides the strength, tensile strength, right? But it doesn't really provide a lot of elasticity. So elastin is a special type of protein that actually allows, like you were talking about, recoil. Had that experience where you stretch a rubber band and then you feel it and you let go boom, it comes back to its original state. As we get older, just with natural, you know, aging, intrinsic aging, and if you love going out in the sun, obviously, you know, UV exposure break down both collagen and elastin. And so older skin, and we can see this under the microscope, if you took a biopsy of a young skin versus, you know, aged sun damaged skin, you can see, you can stain elastin fibers And the way they look, they're no longer long, they're not beautiful, they're cut up, like they're chopped up. They're no longer as effective to allow that recoil. And actually, you know, surgeons and doctors, this is kind of how they test whether or not, you know, you have enough elastin, you have enough elasticity to warrant having a major surgical procedure, is you can test An easy thing is on your face, areas that are thinner have obviously less collagen and less elastin to begin with.

You can pull the skin. So listen up everyone, if this is on the podcast, listen and maybe go to YouTube to watch the video. But so Dr. Tess, tell them what you're doing. Describe it.

I am pulling my under eye skin and you can pull parts of your skin. And it, you know, if it takes time, a few seconds for it to go back or it doesn't actually go back, to baseline, then you know that you've lost elasticity. You know that you have lost elastin in that area. And so when you gain weight, you know, so what happens is that your skin, those fibers, the collagen, the elastin gets stretched. And when you lose weight, sometimes they're stretched to a point where they get damaged. And when you reach that point, When you lose the weight, it doesn't come back anymore, and then you don't have the recoil, you'll have saggy skin. The stretch marks is essentially the same damage. Collagen and elastin allows the skin to be thinner so that you actually, you know, if you look, sometimes the skin looks almost translucent. They also lose the pigment as well. And so So that's one of the reasons why I really encourage people to keep, maintain a healthy weight. Because point of no return, when you've stretched your collagen and elastin fibers and it doesn't come back anymore. And then you think about the options that, you know, that are available for you to get rid of that excess skin. Yep.

But luckily not everyone needs to do surgery. Because some of the solutions, I mean, is surgery, let's start with that, I guess, maybe make that one first. Is surgery the option or how would you, if someone's watching, listening, they're like, oh God, yeah, no, I need surgery. Where do we decide to try some other strategies? Because I think we have two other ones we're gonna talk about outside of surgery that can give us a rebirth, kind of like come back as a phoenix, you know, come back reborn.

Most people, when they start seeing saggy skin, they automatically think about surgery. Surgery. There's a huge field now that's really expanded over the last 10 years, and this is really the non-surgical, non-invasive way to, like you're talking about, rebuild collagen and elastin under the skin and restore some of that lost elasticity. And it really, you know, depends on how much weight was lost, how fast that weight was lost, and also the age of the patient. Like you're saying, you know, someone who lost weight in their, you know, they're in their 20s, the skin, you know, skin's natural elasticity will be better than someone who's lost weight, same amount of weight, in their 50s or older. And so, and also the amount of sun damage also impacts how much elasticity is there. So I would say that if you've lost 10 to maybe even 40 pounds, then you really have a good chance of, you know, not needing surgery.

And we can use other options to kind of bring the skin back. Correct. And maybe surgery is something to consider after how many pounds would you say? Over 40, 50?

Yes. So, so definitely, you know, if you've lost 90 pounds or more, and many patients, I see patients who after bariatric, surgery, they lose 100 pounds, then they may have too much excess skin for the non-surgical approaches. But it is a personal choice, Jorge Cruise. These surgical approaches require you to go under general anesthesia. They're lengthy surgeries. They have big scars. And so, you know, many patients, even if they've lost over 40 pounds, They want to see what they can do without surgery and they'll be happy with some improvement, understanding that it won't be so tight and so perfect, but they just don't want the major surgery.

Yeah. I always share with my clients about autophagy. It's something that people talk about and obviously it helps kind of clean the house, if you will, the housekeeping, right? And including the regeneration of the skin. How can fasting help us? What have you read? What is some of the science on this?

Yeah. So, autophagy, autophagy, or autophagy, depends on how you say it. Essentially, it's self-feeding, right? And so it's a Greek word, autophagus, and essentially this is a system, a process that our cells go through, and it's a natural process where we're basically just cleaning up, cleaning up cells and parts of cells that are not doing what they're supposed to. They're sort of lazy. Some, some term, you know, some call it zombie cells where it's just there and it's messing up with the homeostasis of our body. And so there's a lot of, you know, talk and discussions about autophagy or autophagy when it comes to dealing with excess skin. Yes. And we can, we know that we can activate this process, which is very important in, like I said, in all of our cells, with intermittent fasting, with exercise, with application of heat or cold. And so in these situations, we can biohack. I love biohacking. I'm a believer in intermittent fasting, and I got to that because, you know, I work with with doctors who basically were in the middle of major research for longevity, and then, you know, we started talking about, hey, you know, the skin is our largest organ. We know that when we do intermittent fasting, we really activate our cells' natural repair and regenerative process, and our skin cells, you know, our skin overturns itself within you know, 28 days. So it really impacts your psychological well-being, right? So yes, we're not taking care of your heart or your kidneys. It's hidden. No one knows unless you get a test and your doctor scolds you. But you're not taking care of your skin. Everybody sees it. It affects you emotionally. And so that's why it's really important to take care of it. But the good news is there's a lot of biohacks. Hey everyone, it's Jorge Cruise.

Hey, I wanted to interrupt the show just for for one single minute to invite you to join the number one newsletter that really is about controlling appetite. I called Zero Hunger Live, and you can go to zerohungerlive.com. The bottom of the page, we have a sign up for this newsletter. Comes out every Friday from yours truly, and it really is the number one source on my best biohacks that we don't even cover on the show to help control appetite, including emotional Hunger. So if you are struggling with that, please join our newsletter. Check it out at zero, the number zero, but spelled out Z-E-R-O, hungerlive.com, and you'll sign up and get it for free every Friday, and it's exclusive to listeners.

All right, just go to zerohungerlive.com.

Let's get back to the show.

Yes. We now know, and intermittent fasting, I believe, definitely for me it works. I talk to my patients about it as well, and it makes sense. Now, as far as excess skin goes, I really feel like if you do have a lot of excess skin from weight loss, try not to rush into going and having surgery. Injury. Think of, you know, I mean, when that happens, there's an injury that happens to your skin. And we know that the skin and our cells can repair, but we know also that there are things we can do to optimize the healing process.

How can collagen help our skin come back, you know?

So, so yeah, so, so collagen is again, one of the key proteins in our skin. And as we age with sun damage, if you smoke, you're breaking down your collagen. If you eat a lot of carbs, you know, you, you're breaking down your collagen. And so what you can build, you can rebuild elastin, and you can also rebuild collagen. And the end result is just better skin, better, tighter, less saggy skin. And so, um, you know, so if you can build collagen and you can take collagen through your diet.

Can I tell them what I use, Tess? You got me this and I know you weren't gonna talk about it, but I want people to know because it has collagen. I put it out. This is a product that I use because it's in caplets and what's it capsules or whatever you call them? Tabs, tablets. I love this. Look at this guys. Literally it's collagen in tabs.

Yeah, so if you're tiny like me, you can take one a day. If you're like a normal person, you can take two. If you're a big guy, you can take 3 like Jorge. Right. So this healthy skin, Jorge, was inspired by my appearance. Yes. On the Dr. Oz Show. We actually, Dr. Oz and I talked about collagen as one of the top anti-aging ingredient that we should really think about. And so many studies have really proven it, whatever source it is, really over time can help. And it's great because it's not just helping your skin, actually. Obviously we're talking about— it can help your hair, it can help your nails. It really gives you the bulk, the bulk, the thickness, you know, the dermis, the bulk of the skin. It's called the dermis. And as we age, that thins out. And so you can think of a fabric, right? I always compare your linen fabric, how easy it is to wrinkle. Versus denim, how hard it is, almost impossible to wrinkle. And so that's kind of what happens with our skin as it thins and it loses collagen. And as we rebuild collagen and elastin, we go from linen to denim. And so there's a lot of ways in the clinic that we also do the Time Machine procedure rebuilds collagen and elastin, these types of procedures. Supplementation, I'm a huge believer in Collagen and also, Jorge, antioxidants, glutathione is in there, polypodium leucotomos, vitamin C is in there, selenium, turmeric, the beta carotenoids are all in there. Well, tell us what happens.

So if we take something in like this, the collagen, how quickly can people hopefully see a result? Does it take up to 12 months or is it—

Yeah, so So regeneration, you know, say if we're doing something to the skin. Yeah. We usually tell patients when we're asking our bodies to repair and regenerate, it can take 3 to 6 months and it can even take up to a year for the final result for these like radio frequency treatments. And then we optimize it with supplementation, autophagy, exercise, intermittent fasting, just increasing our body's natural potential to heal and regenerate, it can take up to a year for the final result. Our skin is our largest organ. It really is an indicator of our overall health. Mm-hmm. And so if we protect our skin through antioxidants, vitamins, and, you know, give it the collagen, which is the building blocks of basically what we need to rebuild our skin, our hair, our nails, we really are in much better shape. And if you are on that, you know, path to weight loss, don't wait until it's all over. Really, through the process of weight loss, you should be doing all of these things. You are minimizing the trauma, you're minimizing damage, you're upping the potential for repair and regeneration as you're losing weight.

Hey, it's Jorge Cruise Cruise.

If you have one more minute, I wanted to address something that I think is super important, and that is if you need help with anything from the show, if you need help about losing belly fat, if you want help about intermittent fasting, if you want help about exercise, interval training, anything at all, I want you to join my Fit Family on text. It's a brand new service I've just launched, and if you really do need help, I want you to text me right now. It really is that simple. You'll be part of my texting family. I have a group of people that I work with via text, and it's all for free. So I'd love you to join. All you have to do is text my Malibu number. It's a 424 area code number, so I'm gonna give it to you right now. Jot this down, or while you're listening, text me right now. I mean it. 424-228-9540. 9548, and you'll join my Fit Family. Let me give it to you one more time. It's area code 424-228-9548. Now, it's gonna work only in the US, so I have to say that if you're listening to our show outside of the US, sorry, no international texting yet at least. And, uh, but 80% of you in the US should be able to text me. I know if you have T-Mobile, you have to put on premium service or something like that. But this is free, and I'm going to be giving away a lot of my time on this texting service. A lot of free things like our Belly Fat Cure course will be announced on here.

So if you've done my survey, this is how you'll get access to it.

Uh, I'll be doing special livestream events only for people in my texting community, and I'll be announcing my next 19-day challenge on there as well. So really utilize this and and you'll get first glances from our show as well. So it'll be a great chance for us to connect, and I may even call you and FaceTime you. So kind of a fun thing. Again, the number— text me, literally do it right now— area code 424-228-9548. And I look forward to having you join my Fit Family. Take good care and God bless. Peace and purpose.