Liposuction against Disease? No Dice

No Substitute

For years, researchers thought that fat is fat, and taking it off of your hips, abdomen, and thighs by way of liposuction might increase your health in the same way that diet and exercise can benefit your well-being. However, a 2004 study found that there's just no substitute for dieting in the fight against heart disease, high blood pressure, and diabetes. That's the lowdown according to researchers from the Washington University School of Medicine in St. Louis.

No Metabolic Benefits

In the June 17, 2004 issue of the New England Journal of Medicine, the Washington University research team reported that reducing abdominal fat through liposuction did not furnish the same benefits to the metabolism that are associated with weight loss brought about by dieting. It has long been known that too much fat in the abdominal area is linked with the inability of insulin to regulate sugar and fat in the metabolism, which often leads to diseases like type 2 diabetes, high blood pressure, heart disease, and abnormal blood lipids.

Even when liposuction removed large amounts of subcutaneous fat, up to 20% of the total body fat mass of the participants, it was found that no medical benefits accrued, stated the report, authored by Samuel Klein, M.D., the Danforth Professor of Medicine and Nutritional Science. Klein commented that if the same subjects had lost that amount of weight through diet, there would have been a concurrent turnabout in terms of insulin sensitivity as well as in other risk factors for disease, for instance, heart disease.

Klein's team looked at 15 overweight women, whose fat was concentrated in the abdomen. Of these women, eight had normal glucose tolerance, and seven suffered from type 2 diabetes. The women were tested both before and after abdominal liposuction, with the post surgery workup at 10-12 weeks after surgery.

Measures relating to the insulin sensitivity of the fatty tissues, muscle, and liver were performed with the help of an insulin clamp. This technique helps scientists measure the performance of the metabolism; it can assess how insulin keeps the liver from making glucose and breaking down fat and how insulin triggers the muscle tissue to take in glucose. The scientists also checked triglyceride and cholesterol levels, blood pressure, and other risk factors associated with heart disease.

"It was remarkable how similar the results were before and after the procedure," said Klein. "There were no changes in insulin sensitivity, blood lipids, blood pressure, or inflammatory markers associated with coronary heart disease in any of our study subjects."

There was an upside to the study, since it was demonstrated that large amounts of fat can safely be removed through liposuction.

"We confirmed that it is possible to do large-volume liposuction safely," says coauthor V. Leroy Young, M.D., former professor of plastic and reconstructive surgery at Washington University and a physician in private practice. "In the past, we usually removed no more than about 5 liters of fat, but in this study we showed you can safely remove four times that amount."


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