Why liposuction is not a treatment for obesity

Posted on the 20 May 2011 at 09:51

Researchers from the University of Colorado have carried out controlled trials on 32 women over a 12 month period.  The team led by Dr Teri L. Hernandez and Dr Robert H. Eckel selected 14 of the women to undergo contouring Liposuction to the thighs and lower abdomen, whilst the remaining 18 followed strict dietary plans.   

The non-obese women were selected as they all had disproportionately large amounts of adipose tissue concentrated in their lower abdomen, hips or thighs.  After 6 weeks those who had undergone the surgery had lost an average 2.1% of fat compared to 0.28% of the control group.  This disparity was reduced at the 6 month mark and had virtually disappeared when measured after the full 12 months.  After 1 year the thigh region of the liposuction participants remained reduced, but fat accumulated in their abdominal region, compared to controls. This was found both viscerally and subcutaneously, regardless of whether the abdominal area was the target of the procedure.  The researchers concluded that after liposuction, body fat "was restored and redistributed from the thigh to the abdomen".

The women admitted prior to the study that they wanted to rid their lower abdomen and thighs of the excessive fat and were happy with the results of the surgery.  After the trial the women in the control group were offered the surgery and despite the findings, more than half elected to undergo the same procedure. 

Cosmetic experts are keen to stress that liposuction is not a replacement for a healthy diet and is performed primarily to remove stubborn adipose tissue that doesn’t respond to regular dieting and exercise.  Dr Bea Brookes of Viridian Medical (www.viridianmedical.co.uk) comments:

“It’s not unusual to see a woman who is slimmer in the waist but who has significant deposits in the hip and thigh area, which would only respond to a restricted low fat and low carbohydrate diet with intense interval exercise.  Even then spot fat reduction is impossible for some and is a hard habit to acquire and maintain.”

Dr Bea Brookes cautions that this is a relatively small study in scientific terms and therefore we should interpret the data with caution.  She goes on to praise the study for highlighting the importance of adequately selecting patients and fully preparing information such as a sensible eating plan before and after the procedure.  Dr Brookes recommends a low GI diet to help prevent visceral fat (fat around the abdominal organs) from accumulating – as visceral fat behaves differently to fat in other parts of the body.

As a clinician herself, Dr Brookes says a patient asking “will the fat go elsewhere?” is common during consultations and is difficult to answer.  She goes on to say that “my own impression is that those who heed advice on diet tend to keep it off long term – I like to call it protecting the investment!”     

To learn more about the findings consult "Fat Redistribution Following Suction Lipectomy: Defense of Body Fat and Patterns of Restoration." Published through the Obesity Online journal April 2011

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