Aug. 25, 2000 -- You already know that liposuction, the fat-removal surgery, can help sculpt a more shapely physique. But what if it also could provide some of the same health benefits as diet and exercise, such as reducing the risk of type 2 diabetes? A government-funded study now under way aims to find out just that.
Type 2 diabetes, which is closely linked to obesity, begins with something called insulin resistance. This means that the pancreas makes plenty of insulin -- the hormone that regulates blood sugar levels -- but the body does not recognize and use it properly. Blood sugar rises dangerously, but can usually be controlled with pills -- although insulin is sometimes required. Type 2 diabetes is by far the more common type, and the number of cases in the U.S. is increasing rapidly.
The good news is that the downward spiral from insulin resistance to type 2 diabetes can almost always be stopped through weight loss and exercise. And now, researchers say, liposuction could offer a quicker fix.
This is despite the fact that liposuction has long been considered a good option only for those who aren't seriously overweight. According to an official policy statement from the American Society of Plastic Surgeons (ASPS), "the ideal candidate for liposuction is a healthy adult with localized areas of fat." The procedure, they say "cannot compensate for deficiencies in diet and exercise [and is] generally not suitable for weight loss." Ironically, the ASPS is one of three sponsors of the study, along with the Lipoplasty Society of North America and the National Institutes of Health.
"Liposuction wasdeveloped for [removing] localized fatty deposits from thin people," agrees study leader Sharon Y. Giese, MD, a clinical assistant professor at SUNY Downstate College of Medicine in Brooklyn, N.Y. But years of experience have convinced her that the procedure can be performed safely on people who are 20-50 pounds above their ideal weight.
What surprised Giese, prompting the pilot study on which this latest research is based, was the fact that "75% of patients maintained their weight loss [from liposuction] without changing any of their eating or exercise habits." To a trained biochemist, she tells WebMD, "it didn't make sense. People should have to eat less and exercise more [to maintain the loss]."
In that initial study, Giese removed "an average of 12 pounds of subcutaneous fat from 14 healthy, overweight premenopausal women, half of whom had some level of insulin resistance" as shown by high insulin levels in the blood. Six weeks later, each "was down one to 2 clothing sizes -- a loss of about 12 pounds and 12 inches" -- and had less insulin resistance.
At the annual ASPS meeting in October, Giese will present data showing that in 75% of the women, "all the four-month findings -- weight, blood pressure decreases, and improved insulin resistance -- were maintained at one year."