Sunday, April 1, 2012

The Skinny on Liposuction: Is surgically vacuuming away unwanted fat cells the fast and final answer to finally losing unwanted body fat?

Catherine is a very attractive woman.  She arrived for her appointment with her shiny blonde hair in a chic chignon; she wore a black turtleneck top, figure flattering slacks, and black suede pumps.  Her “look” showed she paid attention to detail in her understated yet well chosen accessories and smart use of make-up.  Catherine was a woman whose appearance mattered very much to her, and it showed.

For a moment, my mind returned to the labwork that was spread out on the desk between us.  I remember seeing her elevated glucose, high total and LDL cholesterol, and I knew she took medication for blood pressure.  I didn’t expect to see a woman with a figure like this to match those labs.  Quite frankly, I expected my 68 year old female patient to be overweight, a little out of shape, and in need of a weight loss program, STAT. 

She sat down and looked in my eyes.  “I know you must be wondering why I’m here.”  (I own a private practice in medical nutrition therapy specializing in weight loss, metabolic syndrome, pre diabetes and type 2 diabetes). “ My friends can’t believe I’m seeking help from a dietitian…I mean look at me, right?”

I remember thinking….you do look great, but your labs absolutely need improvement…  I let her continue.  What Catherine did next shocked me.  She stood up, unzipped her slacks, let them drop to the floor.  She lifted her top and showed me that under her “Spanx” camisole….on her upper back…was a roll of fat.  She faced me and next pointed to a distinct roll of fat…way up under her breasts, and a much more pronounced roll at  the top of her thighs.  It was honestly very weird to look at….very unnatural deposits of fat in very unusual places.    It was hidden under her spandex…. but it WAS there….and quite noticeable.

Thankfully, I already knew that Catherine’s  lab work proved she had Metabolism B.  Millions of people have Met B and are over-producers of insulin (a fat gain hormone).  Those with Met B typically have progressive issues with fatigue, focus/concentration, midline fat stores, mild depression, irritability, carb craving as well as progressively increasing glucose, lipids, and blood pressure.  Catherine had the labs and many of the symptoms but did not “appear” to have the body to match those labs…until she showed me what was going on underneath. 

Her eyes  began to tear up as she spoke.  “I’ve had several procedures in recent years to banish this fat.  I resorted to surgery only after the fasts, cleanses, starvation diets, liquid diets, medically supervised diets, WW, Jenny Craig failed me.  I exercised daily, had a personal trainer…did all I could do….but nothing got rid of the belly fat, the muffin top.”   In desperation, I decided to have liposuction. The surgeon suggested I try to lose the belly fat before the surgery, but it was impossible.  I was thrilled when the surgery was over….he had removed pounds of fat from my tummy and muffin top…my major problem areas”

In the case of liposuction, fat cells are “sucked” out of the body….think of a small vacuum tube inserted through small laparoscopic incisions removing fat cells as the surgeon directs its placement.  Fat cells are removed from the area of the liposuction.  Interesting thing about fat cells….when they are removed, they don’t grow back and replace themselves.  Once they are removed, they are removed.  That almost sounds too good to be true, right?  Catherine couldn’t diet or exercise away the fat, but she could have it removed once and for all.  Sounds promising right?

Not so fast….While  it’s true that fat cells don’t increase in number or replace themselves if they are removed.  But…it’s also true that fat cells will increase in size when we gain weight and decrease in size when we lose weight.  Catherine mistakenly thought her liposuction effectively removed the bane of her existence…the roll of fat round her middle. Gone gone and gone.

Well, no no and no.  As time progressed, Catherine began to notice the area directly above and directly below the area that had undergone lipo suction was getting larger.  At first she thought it was a figment of her imagination, but over time…it was obvious.

Time passed, Catherine returned to the plastic surgeon who recommended a little “clean up.”  When Catherine returned home after her second liposuction, she assumed she had finally won the battle of the bulge.  Unfortunately, the story did not end there.  As time passed, the scenario repeated itself.   After one more lipo AND a tummy tuck……Catherine was now in my office.  A 68 year old woman with an odd roll of fat directly under her breasts, on her upper back, and on her upper thighs.

Here’s the important message about liposuction and fat regain.  Millions of people have Metabolism B.  Met B is a hormonal imbalance of the fat gain hormone, insulin.  Insulin attaches itself to receptors on fat cells so they can store blood sugar.  I know that Catherine has Met B from her medical history: high glucose, high LDL cholesterol, triglycerides, blood pressure as well as low HDL cholesterol, low Vitamin D.  She makes excess insulin that makes her fatter around the middle.  When fat cells are removed, the excess insulin moves on to other fat cells and opens them for storage.  So….as fast as her fat cells were removed, her insulin found another place to connect!

The issue wasn’t in removing fat cells, it was and always will be in controlling her insulin! 

I taught Catherine a diet program that works directly on balancing her insulinHer fat stores began to shrink in size and her glucose, lipids, blood pressure , and Vitamin D normalized.  When I next saw her (8 weeks later) she still looked F A B U L O U S …as always….but she was also on the road to losing her “problem” fat and regaining her health and well-being.

Sometimes the answer IS too good to be true… this case…..the answer is in a change in diet/lifestyle to match a particular type of metabolism.  Try this before you begin a series of ineffective liposuctions.
Read more on Metabolism B at :

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