Obesity is related to most of the risk factors for diabetes and coronary heart disease. And losing weight can improve the results of tests for these risk factors (blood sugar, blood pressure, and etc). So one might anticipate that removing body fat by liposuction would also help in this respect. This possibility has been examined by a study reported in the New England Journal of Medicine. The objective of the research was to quantify the consequences of liposuction on the metabolic risk factors for coronary heart disease in overweight females. Here’s a summation of the results.
Fifteen women with abdominal obesity (waist size more than 39 ins, or 100 cm) were enrolled in the research. Their typical body mass index (BMI) was 37.7. Ten of them had normal sugar threshold (i.e. they were not diabetic) and 7 of them had type II diabetes, treated with oral medication.
Before their surgery, each subject had a test to demonstrate the effectiveness of insulin on the blood glucose levels in their liver, muscle, and fatty cells after intravenous glucose administration followed by an infusion of insulin; it was a measure of insulin sensitivity, which can be reduced in diabetes.
Other assessments measured markers of chronic inflammation in the blood (C-reactive protein or CRP, interleukin-6, and tumor necrosis factor), blood fats, and blood pressure.
Each week thereafter, the women had ‘large-volume’ liposuction (removal of over 4 liters of fluid, which is 60% fat); in fact, on average, 16-17 liters were removed. Five to 12 months after the tests the operations were repeated.
The non-diabetics had their body fat decreased by 18%, and the diabetic by 19%, 10 weeks after liposuction. Average BMI levels was reduced by 2.3 points in non-diabetics and by 3.9 points in diabetics.
What was notable was that liposuction had no substantial effect on insulin sensitivity of the liver, muscle, or fat tissue; it didn’t modify the inflammatory blood markers predictive of coronary artery disease; and other cardiac risk factors — blood pressure, blood sugar, blood lipids — were also unaffected.
Clearly, abdominal liposuction had no significant beneficial effects on the problems often categorized as the metabolic symptoms, and which are associated with an increased risk of coronary and diabetes heart disease. Why was this so? An associated editorial in exactly the same medical journal tries to offer a reason.
Dr Kelley points out that losing weight by dieting and exercise does enhance metabolic and cardiovascular risk factors. So what is the distinction when losing weight by liposuction? It appears that these outcomes are produced by the ‘negative energy balance’ activated by eating fewer calories and burning more calories in exercise. A negative balance isn’t generated by liposuction in this sense.
The article points out that before writing off liposuction as a sort of therapy for obesity, we should remember that it can help considerably with people’s appearance, and reducing weight quickly in this manner can reduce the chance of heart failure and improve knee arthritis. Nonetheless, liposuction is not the panacea that some had hoped, for health improvement. The article instead recommends following a suitable calorie-controlled diet combined with lots of exercise.