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Liposuction IS a Treatment for Obesity

Georgia, Alpharetta
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* Date : 01-03-2013 - 01:25 AM (4186 days ago),

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Liposuction IS a Treatment for Obesity

In the context of consultation for a body contouring procedure I am frequently asked: “How many pounds will I lose?” Conventional wisdom suggests that this is a bad prognostic sign. Traditional teaching and custom holds that liposuction is NOT a treatment for obesity. Patients focused on pounds and not appearance are not supposed to be good candidates for cosmetic surgery. In some plastic surgery practices the surgeon will not do a procedure on a patient with a BMI greater than 30. Lipo suction has traditionally been viewed as a treatment for the skinny ladies. Traditionally the “ideal patient has been within a few pounds of ideal body weight. She will have well localized small areas of fat, easily removed etc. However, improvements in technology, and methodology as well as greater comfort with management of co-existent medical problems, allows us to safely treat larger patients than in the past. Obesity per se is not a reason to deny a patient surgery if they have realistic expectations, and areas where an improvement in their appearance is technically feasible.
Obesity can be defined as a BMI greater than 30. BMI is a calculated number based on height and weight only. It does not take into account percent of body weight as fat or muscle. It is therefore limited in its value, but doctors use it anyway. Many factors are more important than BMI. First and foremost is the presence or absence of co-existing medical conditions (some commonly associated with obesity) must be determined. If present and managed properly pre-operatively; well controlled chronic conditions need not preclude cosmetic surgery. Even patients with a normal BMI can have issues which must be addressed prior to cosmetic surgery. We treat patients with hypertension, diabetes and other conditions via liposuction all the time. Because of the safety of the tumescent technique, and improvements in technology, many who were not previously considered candidates for liposuction or other body contouring procedures can be safely treated. Clearly there are advantages to having surgery performed by a doctor comfortable with managing concurrent medical problems. A BMI of even 40 or more- need not preclude body contouring procedures. Great results can be achieved even with these larger patients.
Few things motivate an obese patient to do the things they need to do to lose weight more than the observed improvement in their appearance after a body contouring procedure. An improved figure, better fitting clothing, more options in clothing choices etc. help motivate a patient to eat properly and increase their activity. We recently treated a gentleman with a BMI of 39. A modest improvement in his appearance after the surgery motivated him to comply with a 1200 calorie regimen and increase his activity appropriately. At the 6 week mark he was down to a BMI of 35 and had lost more than 20 pounds. Endurance and energy levels have soared. More than 80% of his weight loss had little to do directly with his liposuction procedure. Nonetheless, clearly the jump start was beneficial to him. We could share many similar anecdotes; whether fitting into a wedding gown or preparing for a reunion or seeing an ex-husband for the first time in a while etc. Liposuction can jump start a weight loss effort, and serve as a useful adjunctive motivational modality. Similarly, removal of fat per se helps with improvement in glucose tolerance (reducing insulin resistance)
and has positive effects on appetite. More on that later.
Understand that we are not advocating a quick fix approach to managing obesity. Rather we do see this therapeutic modality as a motivational tool to facilitate the lifestyle changes needed to conquer obesity.
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