Liposuction and Fat Regain

If body fat really is actively regulated by the body, rather than just being a passive result of voluntary food intake and exercise behaviors, then liposuction shouldn't be very effective at reducing total fat mass in the long run.  People should return to their body fat "setpoint" rather than remaining at a lower fat mass. 

Teri L. Hernandez and colleagues recently performed the first ever randomized liposuction study to answer this question (1).  Participants were randomly selected to either receive liposuction, or not.  They were all instructed not to make any lifestyle changes for the duration of the study, and body fatness was measured at 6 weeks, 6 months and one year by DXA. 

At 6 weeks, the liposuction group was significantly leaner than the control group.  At 6 months, the difference between the two groups had decreased.  At one year, it had decreased further and the difference between the groups was no longer statistically significant.  Furthermore, the liposuction group regained fat disproportionately in the abdominal area (belly), which is more dangerous than where it was before. The investigators stated:

We conclude that [body fat] is not only restored to baseline levels in nonobese women after small-volume liposuction, but is redistributed abdominally.

This is consistent with animal studies showing that when you surgically remove fat, total fat mass "catches up" to animals that had no fat removed (2).  Fat mass is too important to be left up to chance.  That's why the body regulates it, and that's why any satisfying resolution of obesity must address that regulatory mechanism.

Laura's five conference highlights

Prof Laura McAllister

 Last week, we held our annual Stakeholder Conference – designed to unite key stakeholders from across sectors over a day and a half to discuss, debate and identify practical ways to deliver our shared agenda. Here, our Chair - Prof Laura McAllister - blogs about her conference highlights:

1.      New advocates for sport

Talking to people that either are new to the sports sector or new to our conference was a definite highlight. If we are to deliver the Vision for Sport in Wales, we need to reach out to new sectors - like education and health - that can use the leverage of sport. I believe that we cannot afford not to spend on sport – it helps community cohesion, improves health, skills & confidence. We need more people championing sport – whether it’s across local authority departments, in business or different government organisations.

2.      Keynote from Peter Keen, UK Sport’s Director of Performance

Peter reiterated a key theme of the conference: calculated risk-taking. He said, “The fear of failure needs to be your constant companion in the pursuit of excellence.” I think that this is relevant whatever sector you work in. The sports sector needs to be more edgy. It needs to be more comfortable with trying new ways of working and taking those calculated risks.

Only by trying new ways of working and applying the lessons can we begin to reach our aspirations. It was also useful that he was able to gain an increased understanding of what we’re doing in Wales and where we want to be (the no.1 nation on the basis of medals per capita at the Commonwealth Games!)

3.      Address from Huw Lewis, Minister responsible for Sport

We’re entering a hugely exciting time for Welsh sport. Not only do have two home Games on home soil - London 2012 and Glasgow 2014 – but we also have a Welsh Government whose programme links with our shared Vision. . This provides us with an unrivalled opportunity to drive sport forward. The Minister was clear that the focus is very much on outcomes and delivery and this will be their challenge to us. I was particularly pleased that the Minister stated that physical development is as important as reading and writing, which is going to be something that we will need to push with our colleagues in education.

4.      Natalie Davies, Young Ambassador & Panel Member

All of our speakers and panelists were first-class, but I must reserve special mention for Natalie Davies. In my opinion, she was the best panelist of the day. At 17, she is one of many Young Ambassadors across Wales that are encouraging their peers to take part in sport. And they’re doing a brilliant job! I have been so impressed by our Young Ambassadors and Natalie showed us how important it is to actively listen to young people. Her enthusiasm was boundless and she spoke from the heart. See for yourself in this film clip!

5.      Synergies

We were delighted to welcome Chief Medical Officer Dr Tony Jewell and Children’s Commissioner for Wales Keith Towler onto our panel. There are so many synergies in our work. We have a shared agenda and we need to make the most of that. I want the sports sector to focus on creating new alliances with different sectors because I honestly believe we all want the same thing.

And as Keith Towler said, “If Wales can’t collaborate – who can?”

A strong theme of the conference was that sport needs to be more entrepreneurial. It needs to try different things. Chris Brindley talked about the importance of customer service if we’re to get every child in Wales hooked on sport for life. We need to think about we can reach new potential customers, what’s getting in the way of them consuming the product (sport!). How do we communicate? Are we maximising social media to reach our audiences? Do we have the data and information we need to judge our performance?

On a final note, I would like to thank everyone who attended and to those who contributed via our Twitter debate. If you’re not already on board the Twitter juggernaut, get involved! It’s a great way to raise the profile of the sector and to debate the important issues. You can follow @sport_wales to keep up to date and you’ll find me @LauraMcAllister.