Zimmerman says the "major question is whether the expense, risk, and effectiveness of surgery is better than lifestyle modification." Right now, he says, the evidence is that "in terms of overall health and not just body weight and insulin resistance, lifestyle modification would be better." However, he adds, "that may be why this study is important."
Giese holds that no other weight-loss method -- diet, exercise, or even diet pills -- comes close to matching her large-volume liposuction results in terms of lasting effectiveness. "Weight maintenance is rare; that's why Jenny Craig and Weight Watchers don't publish one-year results, because they fail," she says.
That's not so, says Karen Miller-Kovach, MS, RD, chief scientist at Weight Watchers Intl. in Woodbury, N.Y. She tells WebMD that, just this April at a scientific meeting, researchers presented the one-year results from an ongoing study comparing Weight Watchers and self-help weight-loss approaches in more than 400 overweight individuals.
After a year, those in the Weight Watchers group were significantly more likely than the self-helpers to have successfully maintained their weight loss.
"At one year, we have people keeping off about 12 pounds," says Miller-Kovach. "So the benefit is comparable [to large-volume liposuction]. But in the end, it comes down to risk and benefit. I may work for Weight Watchers, but liposuction certainly has more risks than attending our meetings."