| Liposuction doesn't change metabolic
problems
By Anthony J. Brown, MD
NEW YORK (Reuters Health) - Obesity is associated with various
metabolic problems that raise the risk of heart disease. Now, new
research indicates that although liposuction can produce dramatic
weight loss, the operation does nothing to address the metabolic
issues.
"From previous studies there was a suggestion that liposuction
might improve some of the metabolic abnormalities associated with
obesity--mainly the risk factors for heart disease," lead author
Dr. Samuel Klein, from Washington University in St. Louis, told
Reuters Health. "But there were some flaws and limitations
with those studies."
With the newer liposuction techniques developed in the last decade,
"you can now remove much larger volumes of fat than previously,"
Klein explained. "So, we thought it would it would be worthwhile
to reevaluate liposuction as a potential treatment for obesity-related
metabolic abnormalities."
Even with a relatively large amount of fat removal, there was no
evidence that liposuction altered the patients' metabolic abnormalities,
Klein said.
The study, which is reported in The New England Journal of Medicine,
involved 15 obese women who were assessed before and 12 weeks after
undergoing liposuction. Seven of the women had type 2 diabetes.
As expected, liposuction was associated with substantial reductions
in body fat and body weight. Despite these effects, there was no
change in the patients' metabolic abnormalities, such as poor sensitivity
to insulin and elevated blood levels of certain inflammation proteins.
In addition, the operation did not reduce high cholesterol levels
or high blood pressure.
"This study does help us reevaluate the whole paradigm of
what weight loss does for obese people," Klein said. "With
liposuction, you're removing whole fat cells -- you're not changing
the remaining fat cells and you're not removing fat that is present
in (other) tissues, like liver and muscle. In contrast, with dieting,
there is a general shrinking of all fat cells that seems to have
beneficial metabolic effects."
Klein noted that because it is a forced type of dieting, stomach-stapling
surgery, unlike liposuction, does have a beneficial effect on metabolic
parameters.
SOURCE: The New England Journal of Medicine, June 17, 2004.
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