Fat Returns After Liposuction … NOT

A study appeared in a journal titled “Obesity” which was reported by a group from the University of Colorado. In a nutshell the study used sophisticated techniques to prove a doubtful if not unsubstantiated conclusion. More than 100 years ago Mark Twain wrote (quotations are used despite my paraphrasing) “There are three kinds of lies in the world. There are lies. There are worse lies. And then there are statistics.” I read the article and noted a number of background and design errors in the study and I would have forgotten about it except that a reporter called me for an interview regarding the study. The reporter told me that the article had been picked up and circulated by the press and was being taken seriously in the lay literature (magazines and newspapers). Now it is one thing for educated investigators to report their findings and argue their conclusions; it is quite another to publish these findings in the lay press where inadequacies and inconsistencies are taken for truths by unsophisticated readers.

So… here goes: my analysis of the data. First, the study was done on patients with “small volume liposuction”; a group which has previously been shown to have little metabolic changes after liposuction. Second, studies in which metabolic changes have been demonstrated are numerous in the diabetes literature and demonstrate at the least changes in insulin resistance and blood sugar. Much more important is the authors’ conclusion that there is a homeostasis in the human body which compels the body to hold a fixed amount of fat so if you take some away it naturally comes back. How many of us have lost weight on a diet. How many of us have gained it back? How many of us complained that we went off our diet and the fat came back. Do any of us think this happened by serendipity? How many overweight patients do you know that gained weight after losing it and were not eating more.

Lastly, fat is deposited according to hormone receptors that are present on adipocytes (fat cells).. Females in pubertal years deposit fat on hips, thighs, and buttocks; in reproductive years on hips and abdomen; in pre-menopausal years on arms , shoulders, breasts. You don’t have to believe me. Ask anyone who has been there. So when these investigators found increased fat in the abdomen a year after liposuction, I am not sure what they were thinking.

Twenty years ago cosmetic surgeons felt that women increased breast size after liposuction and you would not believe how many men came to my office in support of their wives having a liposuction procedure. Five years later we found it was not true and in my practice only 15% of female patients developed larger breasts. Yet the myth goes on. Now women who gain weight after liposuction will blame the liposuction and the self sustaining prophesy will continue.

Fat returns after low volume liposuction ? … NOT!