Loose hanging skin tone, on a extremely fit older female athlete

Patient: I am in my fifties, small framed, 110 lb, and very fit and very athletic. I work out 6 days wk. I exercise doing Yoga and Palates, aerobics and pop physique. I run Marathons and long distance (8-10 miles) per day. Always watch my diet.The problem is that in spite of all this exercise, my skin just hangs loosely off my frame and body, everywhere – arms, legs, neck, chest. Just drooping everywhere. As if there’s a shrinking person inside my own body. I’m understandably very upset by this, can you help me?

Doctor: