1. Is liposuction a reasonable treatment for obesity?
Liposuction is not a good treatment of obesity. Liposuction is not effective, even as a last resort, for people who are unable to lose weight by dieting and exercise. Obese patients almost always regain the weight that is removed by liposuction unless there is a dramatic reduction in calorie intake (by dieting) or a significant increase in calorie expenditure (by exercising). Whenever large volume liposuction has been used in an attempt to treat obesity by surgery, there has been a significant increase in the incidence of serious surgical complications. It is not safe to remove huge amounts of fat by liposuction. It is dangerous to remove more than 8 to 10 pounds of fat by liposuction in a single day. Thus, liposuction will not be of any significant benefit for an obese patient who believes that liposuction will aid in the effort to lose weight.
On the other hand, an overweight person whose weight has been stable for many years and has certain problem-areas of fat may be a good candidate for liposuction. Liposuction in an obese patient is reasonable when the goal is to improve a troublesome body contour area. It is not reasonable to use liposuction as a surgical technique for weight loss.
2. Are some localized areas of fat resistant to diet and exercise?
Yes. Fat located in any area of the body, and especially the abdomen, hips, and under the chin is often resistant to diet or exercise. Similarly, after pregnancy, the fat on the abdomen and hips may persist despite concerted efforts at dieting and exercising.
3. Are some localized areas of fat inherited?
Yes. Localized accumulations of fat are often inherited and frequently impossible to eliminate by exercise or dieting. After the age of 30, an individual often gains fat according to a genetically predetermined pattern. For these people, liposuction is literally a dream come true. Liposuction is the only realist means of significantly changing the body’s silhouette. In effect, liposuction is equivalent to being able to focus the effects of dieting to specific areas of the body.
4. Does the total number of fat cells in the body increase as a person gains weight?
The total number of fat cells in the human body does increase when a person gains a large amount of weight. The normal small daily or weekly fluctuations in a person’s weight are usually associated with an incremental increase or decrease in the average size of the individual’s fat cells. However, there is a maximum size to which fat cells can grow. With significant weight gain new fat cells are created from fibroblasts. On the other hand, when a patient loses a substantial amount of weight by dieting, the fat cells simply shrink in size but do not necessarily diminish in number. Thus, if liposuction is done on a patient who had previously been obese but who had lost a considerable amount of weight by the time of liposuction , then the surgeon will typically need to remove the same number of fat cells as if the person had remained obese.