Beyond the Scalpel: Navigating Weight Management and Liposuction Realities

Featured HL Home Page, Wellness January 16, 2024 By Grace Sarkisian

Photo Credit: Courtesy of Shutterstock

Iulianna C Taritsa, BA; Kirsten A. Schuster, MD, JD; Samuel J Lin, MD, MBA, FACS 

Liposuction stands as a prevalent choice in body contouring procedures. It’s important to note that while highly effective in sculpting, it is not intended as a method for weight loss or a substitute for traditional weight loss approaches. The ideal candidate for liposuction is someone who would like to reduce or remove bulges of fat resistant to diet and exercise.1 Removing these localized pockets of fat can improve overall appearance if the patient finds these areas when thinking about liposuction. The ideal liposuction candidate is someone within 30% of a healthy body mass index (BMI).2 Liposuction is likely not the best option for individuals seeking to lose a large amount of weight and has not succeeded in doing so with diet and exercise alone.

Exploring the Weight Equation

An individual’s weight is controlled by a balance between the number of calories consumed, the proportion of calories stored, and how many calories an individual burns from exercise and their metabolism. These factors can be influenced by a combination of genetics and environmental elements. Genetics can play a role in metabolism (how many calories are stored over time and how quickly those calories are burned off through certain activities) and there may be some component of genetics in the foods we choose to eat. Individuals who seem to keep weight off easily may have genetically higher metabolisms or might be controlling their weight through diet and exercise habits. Studies have shown that obesity may have a large heritable component, with estimates of genetic heritability between 40% and 70%.3,4

Sustaining Success Through Exercise, Diet, and Beyond

While losing weight is difficult, the harder challenge is often keeping the pounds off. As weight gain is based on the balance between energy use and energy intake, weight loss maintenance – like the initial weight loss – is often dependent on diet and exercise.5 Concerning exercise, studies show benefits of 200 to 300 minutes (about 5 hours) of moderate-intensity physical activity per week.6 Recommendations regarding diet are less universal. Despite an ever-rotating media promotion of different diet strategies including macronutrient-based options (e.g. Atkin’s, ketogenic variations) and intermittent fasting, however, no specific diets have been shown to produce superior benefits in weight maintenance after one year. Instead, consistent, low-calorie meals – especially breakfast – with a variety of foods may be key to minimizing the body’s physiological adaptations that resist weight loss.5,7

Tips and Tricks for Effective Weight Management

While there is no single best strategy for weight management, here are a few tips and tricks that may help curb weight gain:

  • Plan your meals – Although often time intensive, meal planning helps draw attention to exactly what and how much you are eating. As a result, it is often helpful in preventing overindulgence and combatting the influence of cravings.7
  • Skip the late-night snacks – Late-night eating causes disruptions in your circadian rhythms, and changes in body temperature cycles. It also increases free cortisol production which raises your risk of obesity and metabolic syndromes.5
  • Grab a friend – Social support, whether through groups or individual partners, helps to increase accountability and adherence to your plan.6
  • Download an app – It is often difficult to accurately gauge how much you are eating and how many calories you are burning. Internet-based apps help you with these calculations and can provide individualized counseling to help you stay on track and reach your goals.8
  • Weigh yourself weekly – The scale can be frustrating. Routine weigh-ins, however, help to catch the slip-ups before they turn into larger gains.7
  • Talk to your doctor – While diet and exercise are almost universally important factors, weight management needs can be very individualized. Baseline weight and pre-existing conditions can impact your ability to keep the weight off and more intensive interventions including medications or surgery may be indicated.

References

  1. Shiffman, M. A., & Di Giuseppe, Alberto. (Eds.). (2010). Body Contouring : Art, Science, and Clinical Practice (1st ed. 2010.). Springer Berlin Heidelberg. https://doi.org/10.1007/978-3-642-02639-3
  2. Chia CT, Neinstein RM, Theodorou SJ. Evidence-Based Medicine: Liposuction. Plast Reconstr Surg. 2017 Jan;139(1):267e-274e.
  3. Maes, H. H., Neale, M. C. & Eaves, L. J. Genetic and environmental factors in relative body weight and human obesity. Behav. Genet. 27, 325–351 (1997)
  4. Elks, C. E. et al. Variability in the heritability of body mass index: a systematic review and meta-regression. Front. Endocrinol. 3, 29 (2012).
  5. Kim JY. Optimal diet strategies for weight loss and weight loss maintenance. J Obesity & Metabolic Syndrome 2021;30:20-31.
  6. Swift DL, McGee JE, Earnest CP, Carlisle E, Nygard M, Johannsen NM. The effects of exercise and physical activity on weight loss and maintenance. Progress in Cardiovascular Diseases. 2018;61(2):206-213.
  7. Wing RR & Phelan S. Long-term weight loss maintenance. Am J Clin Nutr 2005;82(suppl):222S-5S.
  8. Gudzune KA, Huftless S, Maruthur N, Wilson R, Segal J. Strategies to prevent weight gain in workplace and college settings: A systematic review. Prev Med 2013;57:268-277

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