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Judith J. Wurtman, PhD Headshot

Liposuction: The Fat Cells That Never Let Go

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Since there is no magic pill that will make us thin, the next best thing seems to be sucking fat out of our bodies. No machine exists, yet, that passes a wand over our fat thighs, bellies and spare tire and vaporizes the offensive fat. Liposuction is about the best cosmetic surgery can offer, and its popularity attests to the effectiveness of the procedure in contouring bodies to our specifications, rather than the geography of our fat deposits.

But alas, liposuction has now been shown to be as impermanent as a quick weight-loss diet in keeping us thin. The New York Times recently described the results of a study published in the journal Obesity. Conducted last fall, the study revealed that that a year after liposuction removed fat, it came back. And horrors of horrors, it reappeared mostly in the upper abdomen, shoulders and triceps (the back of the arms).

The image is appalling and sounds like something out of a bad science fiction movie. The researchers explained that the fat did not appear again in the area from which it was removed because the fat cells there were destroyed. But, like water during a rainstorm seeking a dry creek to fill, the new fat being made by the body sought out fat cells in other parts of the body, often some distance away from the fat cells that had been sucked out. Presumably--and this is painful to contemplate--if one had liposuction in all the traditional areas where fat is usually deposited (and we all are familiar with those places), then the new fat might seek out fat cells in places where it normally doesn't go, including the face and head. "Fat head" might not just be a term of derision but also a description of new fat deposits.

Still, the study was misleading. The subtitle to the piece stated: "A study on liposuction confirms the patient's worst fears: that weight loss is temporary."

Weight loss? From liposuction? How much weight could one lose from liposuction? Three pounds, maybe five pounds? I doubt that any patient truly believes that suctioning out fat deposits from her thighs or belly is going to do anything more than sculpt her body into a shape she is pleased with. Does any woman regard liposuction as the answer to dropping from a size 14 to a size 4 in an afternoon?

Many people who opt for liposuction have already lost weight, dropped to an acceptable clothing size, watch what they eat and exercise regularly. They may trek to a liposuction specialist because, despite their best efforts, they don't like the way they look in a bikini.

However, the study does pose an important warning to people who may fail to maintain their weight loss after liposuction -- they erroneously believe they won't have to worry because their fat is gone forever.

According to the Dr. Rudolph Leibel, a medical researcher quoted in the article, fat cells are continuously made because the life span of a fat cell is about seven years. The new ones are just as eager to fill up with fat as the ones they have replaced. Some obesity researchers believe this may be why it is so hard to deviate from a set weight, no matter how many times we attempt to get thinner. Unless the ex-dieter is exceptionally vigilant about calorie consumption and maintaining a vigorous exercise schedule, weight will be regained and the fat cells filled once more.

Certainly numerous studies have discouraged us with the statistics on weight gain after the end of the diet. Reading them can lead to the decision to keep pre-diet clothes because they probably will, unfortunately, fit again.

So should people opting for liposuction be asked to sign a consent form agreeing not to be upset if, a year or so after the operation, fat appears in awkward places? Or should the operation be off-limits to anyone who has not been able to maintain an appropriate weight for, say, five years after the end of a diet? At the very least, the interested patient must be told that liposuction does not equal substantial weight loss, and that weight gain equals new fat deposits.

There is something else the article did not mention. People who resist the weight-loss process might feel that a fat-removing procedure gives them a head start on looking thinner. Knowing that the mirror will show sleeker thighs or a flatter tummy (after the swelling goes down) might motivate some to take on a long diet and commitment to exercise. Liposuction might be the push that gets them started, but they must be told that suctioning out fat does not remove the reasons they gained their weight or eliminate the reasons they may gain it again. Otherwise, they will be doomed to disappointment--and more fat.