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

Liposuction is one of the most commonly performed procedures in body contouring. The procedure is not considered a weight loss method or an alternative to weight loss, though patients may lose two to five pounds in total. The ideal candidate for liposuction is someone who would like to reduce or remove bulges of fat that are resistant to diet and exercise.¹ Liposuction is a contouring procedure and not a weight loss procedure. Removing these localized pockets of fat can improve overall appearance and comfort in clothes if the patient finds these areas to be uncomfortable. The ideal liposuction candidate is someone within 30% of a healthy body mass index (BMI).² For individuals seeking to lose a large amount of weight and have not succeeded in doing so with diet and exercise alone, liposuction is likely not the best option.

An individual’s weight is controlled by a balance between the number of calories consumed, the proportion of calories stored, and how many an individual burns from exercise and their metabolism. Each of these factors can be a function of both genetics and environment. 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

While losing weight is hard, the bigger 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 based dependent on diet and exercise.⁵ With regard to 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

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, and increases free cortisol production to increase 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 terrifying. 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