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Can Liposuction Cause Weight Gain?

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Updated May 28, 2009

Question: Can Liposuction Cause Weight Gain?
Liposuction causing weight gain? Seems like a contradiction, doesn't it? After all, the point of liposuction is to appear more slim and trim. Why would anyone go for it if it actually does the opposite? Even a procedure that seems fairly simple and straightforward can be more complex than it appears. Liposuction is no exception.
Answer:

Unfortunately, there is no easy answer to this question. For the most part, liposuction has a very high patient satisfaction rate. However, there have been reports of some patients finding it more difficult to maintain their weight following liposuction. These reports have been largely anecdotal, so it is hard to say for certain whether this difficulty can be accounted for by other factors having nothing to do with their surgeries (lifestyle, stress, advancing age, hormonal influences, etc.) Furthermore, although many of the patients complaining of post-op weight gain claim not to have changed their eating habits, that is not necessarily the case. Ask anyone who has ever kept a food journal, and they’ll tell you how easy it can be to underestimate what you are really taking in.

The truth is that some studies do suggest that liposuction can play a role in increasing certain patients’ propensity for weight gain. Here’s the theory:

Liposuction removes only subcutaneous fat, deposits located just below the skin, and leaves untouched the most dangerous kind of fat, visceral fat (fat deposits located inside the abdominal cavity). While no studies to date have clearly shown a causative relationship between liposuction and weight gain, some studies have shown that surgical removal of subcutaneous fat may contribute to increased visceral fat, which then poses an increased risk of developing insulin resistance (a precursor to diabetes which does tend to encourage weight gain) and elevated triglycerides. This effect appears to be magnified when large amounts of fat are removed, when the patient is obese, and/or when the fat is removed specifically from fat deposits in the lower body (butt, hips, and thighs).

There are other theories about this phenomenon which point to the body’s natural drive to restore balance. Most of us have heard how the body has a certain weight “set-point” to which it will always try to return if weight is lost. This is especially true if we go on a “crash” diet and lose weight quickly. The body does not have enough time to adjust to its new state, and so it goes to work trying to return to the status quo. The body responds by slowing metabolism and increasing production of the hormones that make us feel hungry. Some experts then begin asking the question, “Couldn’t this same phenomenon happen as a result of fat loss through liposuction?”

It appears that the few available studies on this subject are by no means offering proof of a correlation, or even a definitive answer to this burning question. In fact, it seems that an argument can also be made that weight gain following liposuction could be related to a shift in the patient’s attitude toward weight gain, diet, and exercise. (After all, she can just have the fat “sucked out” again if need be, right?)

If you are considering liposuction, but are concerned about this question, the best approach is not an unfamiliar refrain. If you decide that you really want to have liposuction to rid yourself of localized fat deposits which seem resistant to diet and exercise, you should be sure to lose as much of your excess weight as possible (via sensible diet and exercise) before going under the knife. The less fat that is taken out surgically, the less risk you have of any adverse metabolic effects post-operatively.

Did you gain weight after having liposuction? Are you afraid to have liposuction because you're worried about future weight gain? Or do you think it's all a matter of lifestyle, diet, and exercise. Share your thoughts and your stories here.

Sources:

Effect of Liposuction on Insulin Resistance and Vascular Inflammatory Markers in Obese Women; Giugliano G, Nicoletti G, Grella E, Giugliano F, Esposito K, Scuderi N, D'Andrea F. Br J Plast Surg. 2004;57:190–194. December, 2003

The Key to Long-Term Success in Liposuction: A Guide for Plastic Surgeons and Patients. Rohrich, Rod J. M.D.; Broughton, George II M.D., Ph.D. *; Horton, Bauer B.S., J.D., C.P.A.; Lipschitz, Avron M.D.; Kenkel, Jeffrey M. M.D.; Brown, Spencer A. Ph.D.; Journal of Plastic & Reconstructive Surgery, Volume 114, Issue 7, pgs 1945-1952, December 2004

Role of a Critical Visceral Adipose Tissue Threshold (CVATT) in Metabolic Syndrome: Implications for Controlling Dietary Carbohydrates: A Review; Eric S Freedland, Boston University School of Medicine, Marblehead, MA; Nutrition and Metabolism, 2004; 1: 12

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