What causes one to develop a large pannus? and what can be done about it?

First I am quite short (5'0" tall) and quite big (278 pounds), down from my heaviest of 305 this past spring.  I had put on 60+ pounds over the past 15 years after having 2 children before my recent weight loss.  My belly has grown huge over the years and currently extends to my mid thigh.  My pcp has told me that I have a stage 4 pannus.  What exactly causes one to develop a large pannus?  What can be done to treat it?  Will it continue to get bigger if I do nothing?  and what consequences would I face by not doing anything?  Are there many others out there who have dealt with this?

The development of the pannus is just an individual experience based on where your body carries its weight.  If you have a stage 4 pannus before weight loss, it's probably not going to change much, except that the fat will go away.  That's the bad news.  The good news is that, at that level, most insurance covers a panniculectomy, which is just what it sounds like, removal of the pannus.  I don't know of anything that you can do to make it better.  Your skin will probably spring back a little, but not enough.  So plan on plastic surgery to complete your weight loss journey.

On the breast reduction, you may be able to coordinate both surgeries if your surgeons are willing.  But I'd recommend waiting until you've lost the weight and then go for a lift and reduction for the best result.  You're going to lose weight everywhere, including your breasts, so you might as well wait and see what you're left with before you decide on what you want done with them!

Make sure to document everything that happens with your pannus through your weight loss process.  It's very easy for rashes and fungal infections to develop underneath.  If you see a rash, take a picture and date it.  Make sure to see your PCP or dermatologist and have them document as well.  The more documentation regarding issues with your pannus, the more ammunition you have for having insurance pay for removal.  Removal through plastic surgery is the only way I know of to get rid of it once all of the fat is gone.  :D

Jen

The pannus is just the part of your belly than hangs down over the genital area and the top of your thighs. What causes you to develop it is simply gaining too much weight in your belly.  Gravity pulls on the fat and pulls it, and the skin it is attached to, down.  If you continue to gain weight, the pannus will continue to get bigger.  If you lose weight, it will get smaller (although the excess skin will stick around). If you do nothing, it will just...well... hang around and continue to affect your mobility and place stress on your spine. 

The only way to "treat" it is to lose weight and then have the excess skin removed surgically.

Yes, it is quite common on people who have been morbidly obese or super morbidly obese.  With the size of your pannus already, your medical insurance will probably (although there is no guarantee) cover the surgery to remove it.  A panniculectomy is not the same as a full tummy tuck, though.  It is just removal of the excess skin below the belly button.

Lora

I have a stage 5 pannus.  At my highest weight I did have a large belly but maybe a grade 2 pannus.  Currently down 200 pounds and everything has fell.  I am currently fighting my insurance company, trying to change their decision not to remove the hanging skin and fat.  My plastic surgeon believes I have about 40# to remove.  I have my family doctor and plastic surgeon fighting for me.  As far as treating it, the only way to get rid of it is to have  it removed.  Mine hinders my movement, I can't get on my exercise bike or walk long distances because things are now in the way.  The fight goes on.  Good luck to you! Through  it all, its the best thing I have done for myself and my family.