Liposuction no cure-all, study says

Having 20 pounds of fat removed by liposuction makes people look better but provides none of the protection from heart disease and diabetes that would result from losing the same amount of weight through diet and exercise, researchers are reporting.

A report being published today in The New England Journal of Medicine challenges several earlier studies, suggesting that liposuction could improve health by lowering blood fats and other risk factors linked to diabetes.

Those studies had led many plastic surgeons to begin promoting liposuction, particularly procedures removing many pounds of fat, as a medical treatment for obesity rather than merely a cosmetic operation, said Dr. Samuel Klein, the first author of the new study and director of the Center for Human Nutrition at the Washington University School of Medicine in St. Louis.

"But what this study tells you is that losing fat itself by sucking it out does not give metabolic benefits," Klein said.

One reason for the finding may be that liposuction removes fat only from under the skin, whereas dieting and exercise reduce deeper deposits in the organs and inside the abdomen; such deposits are believed to be more dangerous. In addition, while liposuction removes some fat cells, it does not shrink the billions left behind. Dieting does shrink fat cells, making them less prone to release harmful substances.

Liposuction, in which surgeons break up fat deposits and vacuum them out, is the most common type of cosmetic surgery in the United States, with almost 400,000 procedures a year. Most patients are women ages 19 to 50.

In the study, 10 to 12 weeks after the surgery, Klein's team measured the women's blood pressure and their blood levels of cholesterol, triglycerides, glucose, insulin and other substances used to gauge the risk of heart disease and diabetes. They found no improvements.

Many previous studies had shown that the same weight loss, if achieved through dieting and exercise, typically produced significant improvements in most or all of the risk factors.

In the earlier experiments that found possible health benefits from liposuction, Klein said, improvements may have occurred because participants began dieting and exercising after they had liposuction, and not because of the surgery itself.

By contrast, the women in Klein's study, sedentary to begin with, agreed not to begin diets or exercise programs after the liposuction.