It "will be a more rigorous version of the pilot study," she says, involving five black and five white insulin-resistant women, all between 20 and 50 pounds overweight. The surgery, "a big operation that takes between four and five hours" and requires an overnight hospital stay, will be offered at a discount, says Giese, who is still searching for eligible participants.
Giese tells WebMD that large-volume liposuction will be especially helpful for those who, like her patients in the earlier study, "have gained 20 or 30 pounds at a particular, identifiable time -- during pregnancy, from stress, or after an injury -- and then have trouble losing it."
But according to Zimmerman, surgery "is not a reasonable approach" for preventing a disease that can almost always be avoided through basic lifestyle changes. "It's true that lifestyle modification is not easy for many people, but even if the study is markedly positive, we wouldn't extend that [to recommending] liposuction for all those who fit the characteristics of people in this study."
Even Giese advises liposuction as "a combined approach with diet and exercise." But if the new study is a success, "it might change the current standard for who should get liposuction. This is a new approach and it's nontraditional, but I think it can be incorporated into a weight-loss management program."
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.