A study by author Dr. Sharon Giese, an associate professor of plastic surgery at State University of New York, has found that overweight women who had large amounts of fat suctioned out experienced sustained weight loss as well as reduced blood pressure and improved insulin levels two years later.
The thinner ? and healthier ? women are the happiest patients she?s seen, Giese says. But some doctors are concerned about the potential risks of the procedure, known as large-volume lipoplasty. Plus, since the study was so small ? only 14 people ? and the patients weren?t compared to a control group, definite conclusions cannot be drawn from it, says Dr. Mark Jewell, a plastic surgeon in Eugene, Oregon. ?There may be some health benefits to this, but it hasn?t been specifically compared to just having someone lose 20 pounds of weight,? he says.
Liposuction is the most popular cosmetic surgery in the United States, with 385,390 procedures performed in 2001. The operation is traditionally used to slim isolated trouble spots on people of normal weight, but Giese said it?s time to start thinking of liposuction as a way for overweight people to shed significant pounds. ?Sixty-one percent of the population is overweight or obese, and you aren?t going to adequately help these people with spot reduction,? she says.
The average cost for having fat sucked from a single site is about $2,500, but the removal of large amounts of fat or fat from multiple areas can push the cost upwards of $10,000.Fourteen overweight ? but not obese ? women who had unsuccessfully attempted to lose weight through diet and exercise for years had an average of 13 pounds suctioned from their thighs, abdomens, upper backs and flanks, Giese says. Two years later, she found that 70 percent had maintained their surgical weight loss or had lost additional weight; another 15 percent had maintained a significant portion of their weight loss. Two patients regained the weight. Most of these women are two dress sizes smaller, with four inches off their waists.
Before liposuction, eight of the 14 women had elevated insulin levels, suggesting they were at high risk for diabetes. But after the surgery, their insulin had decreased to normal, healthy levels ? and remained there for two years. Plus, systolic blood pressure decreased for all the patients ? from an average of 132 to 126. Normal systolic blood pressure is lower than 130. ?When someone?s overweight, there?s an increased risk of a bunch of diseases ? it?s not just unattractive, it?s unhealthy,? Giese says. ?This is better weight maintenance than with any diet plan out there.?
In the mid-1990s there was a jump in liposuction complications and the death rate rose to about one in 5,000 procedures as doctors began removing vast amounts of fat in an office setting, doing multiple operations at once and operating on high-risk patients. A report released last year showed safety has improved tenfold, with the death rate dropping to one in 47,415.
Jewell fears that if many doctors start using liposuction as a weight loss method, some of the safety advances will be reversed. Giese counters that there is no evidence that large volume lipoplasty performed in a hospital setting ? where she always performs the procedure ? is any more dangerous than removing smaller amounts. She said she uses very strict patient criteria, such as excluding patients who are obese or who have other pre-existing health conditions that would put them at risk for surgical complications.
She says that this method is not for a patient in her 20s who hasn?t tried to lose weight the hard way. ?This is for chronic dieters who?ve always failed to lose weight, especially if they have a history of type 2 diabetes in their family,? she says. ?If you?re overweight, you?re at increased medical risk so you have to weigh those risks with that of liposuction.?
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Each day, thousands of sit-ups and crunches are done in gyms across the country in the hopes of attaining a flat stomach. Fitness instructors have created hundreds of different ways to exercise this one area of the body.
Strong abdominal muscles protect our internal organs, aid the lungs in breathing, and maintaining good posture, which can help reduce low back pain. But the idea that exercising the stomach muscles will result in an attractive, toned midsection is false. "You can have very strong abdominal muscles, but never see them because of a layer of fat covering them," explains Jeffrey Potteiger, director of the health and human performance laboratory at Virginia Commonwealth University in Richmond, Va. Without diet modification and cardiovascular exercise, you simply won't lose the fat that will show off your midriff.
There is no such thing as spot reduction, says Potteiger. "When you lose body fat, you lose it from everywhere, and there is no way to target one particular area. Most of those people [in advertisements] have never even used those machines," he says. ?They've either been blessed with great genetics or they've been engaging in a strict diet and exercise regimen that allows them to maintain a low level of body fat."
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