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Risks From Obesity Same After Liposuction

June 16, 2004 -- Liposuction may help you shrink your girth, but not the health-related risks of obesity such as heart disease, high blood pressure, and diabetes. To improve your health you need to drop pounds the old-fashioned way -- reducing calories with diet and exercise, new research shows.

After removing excess belly fat with liposuction in 15 obese women, researchers found that the sudden weight loss offered no improvements in health-related risk factors associated with obesity, such as insulin sensitivity, high cholesterol and other blood fats, and high blood pressure.

"We were a little surprised because we removed a lot of fat -- an average of 22 pounds in each patient," study researcher Samuel Klein, MD, tells WebMD. "That translated to about 20% of the person's total body fat content."

Still, the fat removed produced no improvement in any of the risk factors associated with obesity -- those which boost risk of heart disease and diabetes, says Klein, the Danforth Professor of Medicine and Nutritional Science at Washington University School of Medicine in St. Louis.

Old-Fashioned Weight Loss Best

"Had these patients lost this much fat by dieting, we would have expected to see marked improvements," he says. "Even losing a little fat by dieting -- far less than what we removed with liposuction -- causes significant metabolic benefits."

A possible explanation: "When you lose weight with dieting or exercise, you shrink the size of fat cells, which improves this metabolic profile," Klein tells WebMD. "With liposuction, you remove the number of fat cells, but you don't shrink the size of remaining fat cells."

The researchers say that dieting which results in fewer total calories on a daily basis shrinks fat cells. You need to achieve a negative energy balance -- burning more calories than you consume -- to achieve the health benefits of weight loss, he says.

The type of fat removed with liposuction may also explain Klein's findings, published in this week's New England Journal of Medicine.

In liposuction, fat is removed from beneath the skin of the abdomen or other areas. But previous studies indicate that excess fat that surrounds internal organs is most likely to increase the risk of obesity-related health problems.

Lessons Learned From Animals

Past research on animals shows that surgically removing this visceral fat yielded "marked and nearly immediate improvements in insulin resistance," notes David E. Kelley, of the University of Pittsburgh Obesity and Nutrition Research Center, who wrote an accompanying editorial to Klein's study. But surgically removing subcutaneous fat -- as done in Klein's research -- has had little effect in those animal studies.

"Unfortunately, the take-home message of our study repeats that sad message: Diet and exercise is the way to reduce health risks associated with obesity," says Klein.

But there is one silver lining to his research, at least for those considering liposuction for quick weight loss: It demonstrates that it's safe to surgically vacuum large amounts of fat. None of his study participants suffered complications as a result of the amount of fat removed. And in this particular study, the amount of fat suctioned was much higher than what is typically removed.

"This shouldn't be seen as an indictment for liposuction because it does provide good cosmetic benefits," Klein tells WebMD. "And it may stimulate people to become more active, which can help them lose more weight or keep it off. If it achieves that, as it often does with people who get liposuction, that is a good thing."

SOURCES: Klein, S. New England Journal of Medicine, June 17, 2004; vol 350: pp 2549-2557. Samuel Klein, MD, Danforth Professor of Medicine and Nutritional Science, Washington University School of Medicine, St. Louis. David E. Kelley, MD, professor of medicine, University of Pittsburgh School of Medicine, Obesity and Nutrition Research Center, Pittsburgh.

http://my.webmd.com/content/Article...0000_1000_1n_03

I just had lipo on my abs and thighs 1 month ago today. I do not believe it's a quick fix so I don't have to diet..like ALOT of people seem to think after lipo. Dieting and lipo go hand in hand, because if you do not watch what you eat you GAIN in OTHER areas..then what? So now I am doing Atkins for Life:) After ALL the pain I've been through the past month, I wouldn't want to screw up my results:) That's a very interesting posting and makes a great point.

Quote:

"Had these patients lost this much fat by dieting, we would have expected to see marked improvements," he says. "Even losing a little fat by dieting -- far less than what we removed with liposuction -- causes significant metabolic benefits."

Here's another explanation : The benefits of weight loss have little to do the actual weight loss. The improvements are brought about by changing the way you eat. If you achieve weight loss, even with low-fat (ick) , it means you have started eating better than you were before.

After removing excess belly fat with liposuction in 15 obese women, researchers found that the sudden weight loss offered no improvements in health-related risk factors associated with obesity, such as insulin sensitivity, high cholesterol and other blood fats, and high blood pressure.

"We were a little surprised because we removed a lot of fat -- an average of 22 pounds in each patient," study researcher Samuel Klein, MD, tells WebMD. "That translated to about 20% of the person's total body fat content."

Perhaps this doctor thinks that if he had cut off one of his patients' legs they would have been healthier. After all, that would be a significant amount of weight loss.

I know I'd find this!

I saw this when it aired on GMA.

Here's a link to ABC's website: http://abcnews.go.com/sections/GMA/...y_040513-1.html

Quote:

Straight to the Source
Doctors Remove Woman's Abdominal Fat to Help Control Diabetes

May 13, 2004 — Ginny Boddie has struggled with her weight since college, but she'd always considered herself active and healthy. Two years ago, all that changed.

"I was just extremely fatigued and I remember my brother saying some of the symptoms I was feeling were the same that he had when he became a diabetic at the same age," said Boddie, now 50. "And I was worried about it."

Blood sugar tests confirmed what Boddie, who lives in Weymouth, Mass., had feared.

"I stood over that machine praying that it was going to be within normal limits - and so I knew when I saw it I was in trouble," Boddie said. "I knew that it was not a good thing."

Like 15 million other Americans, Boddie had become an adult-onset diabetic, at risk for complications ranging from heart disease to blindness. But doctors tried something that Boddie says changed her life, and got her diabetes under control.

They surgically removed some of her abdominal fat.

Danger of Abdominal Fat

Doctors have long known that people who are overweight, like Boddie, are at increased risk for diabetes. But recently, they have learned that fat in the abdomen may be particularly dangerous.

"We know that when patients put on that type of fat, the abdominal fat, they tend to run into problems with blood sugar control and diabetes," said Justin Maykel, a chief resident at Beth Israel Deaconess Medical Center in Boston.

When a CAT scan was done on Boddie, doctors were able to actually measure the abdominal fat nestled next to her internal organs. Doctors think this "internal" fat releases chemicals that contribute to diseases including diabetes, even heart disease and stroke.

So doctors offered Boddie a unique opportunity. They asked her to be the first patient in the United States to have part of her abdominal fat removed surgically, in the hope of keeping her healthy longer.

A Life-Changing Removal

Though she understood the risks, she accepted.

"I was encouraged that there would be something that might help me that would eliminate some of the complications and I wouldn't have to live on all sorts of medications and be constantly worried about my diabetes," Boddie said. "Heck, anything you could do that was going to prevent later complications of diabetes later in your life was definitely worth the risks involved."

Using tiny instruments inserted through small incisions in the stomach, Boddie's doctors were able to enter the abdominal cavity and remove a 3-pound layer of fat that covered her internal organs.

Doctors are cautious, but Boddie says that removing some of her internal fat has changed her life.

She eats a normal diet and no longer considers herself a full-fledged diabetic. She has lost about 20 pounds.

"I know that I have to be concerned, but it isn't a major focus of my life anymore," Boddie said. "I know that it's still out there and I need to be careful, but I don't worry about my diabetes 24 hours a day."

Fat Isn't Lazy

Doctors say that growing evidence shows that fat doesn't just sit there in the body. It actually serves as an endocrine organ.

"It is now more clear that fat is not just a simple storage depot, but it is an active endocrine organ," said Edward Mun, a surgeon at Beth Israel Deaconess. "Fat cells release enormous numbers of mediators or hormones-and this is essentially the key organ now that controls our appetite and metabolism. It controls our sugar levels as well as cholesterol."

As abdominal fat builds up, it is perhaps more dangerous in terms of leading to high-risk diseases such as diabetes or hypertension, Mun said. Ultimately it can lead to something like coronary artery disease, or stroke.

Doctors say the advantage of the experimental surgery done on Boddie is clear.

"The surgical option is a definitive one — we know that patients diabetes improve with diet and exercise," Maykel said. "The problem is that people fall off their dietary restrictions, and they fall off their exercise regimens pretty quickly. In general, patients who have made a resolution to make these changes, about 80 percent of them have stopped a year out."

Now....on the show Dr Tim was clear that this was removal of INTERNAL fat, not liposuction. This is the fat that's found inside, around your organs.

He also stated that the woman had NORMAL blood sugars after the procedure and had been taken off all diabetic meds. He never mentioned her dieting.