17 June 2004

PLANNING LIPOSUCTION? THINK AGAIN
No Real Benefits


From the New England Journal of Medicine (NEJM)
Notice the decrease in size of the surrounding white structure,
which is the removed subcutaneous fat in liposuction.
Yellow arrows mine.


=Increased waist circumference
=Increased abdominal subcutaneous fat
=Increased visceral fat
The factors listed above are all manifestations of abdominal obesity. Abdominal obesity is a busy term used by cardiologists, endocrinologists, and internists. At one point in your periodic clinical visit, your doctor might have also mentioned this term to you. Abdominal obesity along with insulin resistance are known to be risk factors of coronary heart disease. Recently, in several journal reports (this one and this one), it has been suggested that liposuction can be curative for the metabolic complications of obesity.

I have no personal knowledge of the local numbers of liposuction cases in the Philippines, but in the US, there are more than 370,000 liposuction procedures done annually [ASAPS Data, 2002]. All of these are done mainly for aesthetic reasons. Nobody really thinks it is healthy, or that health should take precedence over beauty. From a doctor's point of view, I have long known that liposuction or any cosmetic procedure done on the body have little or no effect on the overall metabolic state of the individual. As such, insulin resistance and the risk for coronary disease does not go down when you undertake such procedures. The June 17 issue of the NEJM validates this in a report which showed that "abdominal liposuction does not significantly improve obesity-associated metabolic abnormalities and decreasing adipose tissue mass alone will not achieve the metabolic benefits of weight loss.".

Bottomline: Exercise, physical activity, and diet modifications are still best for improving your metabolic state and fighting off diabetes and coronary heart disease. Liposuction is the quickie method of getting rid of fat. It is expensive, might be dangerous (read this), and on a lighter note, it might be your easiest ticket to a legal battle (read this).

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