You can’t get something for nothing — especially when it comes to weight loss.
A new study by Brazilian researchers shows that when patients lose fat through liposuction — a popular cosmetic surgery that sucks away fat cells from under the skin — it tends to come back. Worse, it gets redistributed deep within patients’ abdomen, where it can cause more damage to health than did the subcutaneous fat it replaced.
The good news is that there’s a way to maintain lipo’s slimming effect: good old-fashioned exercise.
In the study, published in the Journal of Clinical Endocrinology and Metabolism, researchers at the University of São Paulo recruited 36 healthy but inactive women aged 20 to 35. The women were not obese, but all volunteered to have 2.5 to 3 lbs. of abdominal fat removed through liposuction.
By six months after surgery, half of the women had regained fat — largely as visceral fat, the type that accumulates around organs deep within the abdomen and is known to cause metabolic changes that increase risks for heart disease and diabetes. These women gained 10% more visceral fat than they’d had before surgery.
The other half of the participants didn’t gain back the fat. Why? Because they had been randomly assigned to start exercising after surgery. Compared with their counterparts who remained sedentary after liposuction, these women started a four-month workout regimen, involving both cardio and weight-lifting three times a week. Not only didn’t they gain back the fat, but they ended up with less fat in their bodies overall. They also got physically fitter and showed improved insulin sensitivity.
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Why liposuction may trigger visceral fat gain isn’t fully understood. The authors speculate that people may expend less energy after the surgery, which leads to fat gain. Because the body is finely tuned to defend its fat stores, it will try to compensate for the abrupt loss of fat. But exercise may mitigate that drive and recalibrate how much the body thinks it should weigh.
“The good news is that exercise training was effective in counteracting this compensatory growth,” said lead study author Dr. Fabiana Braga Benatti of the University of São Paulo in a statement.
The authors say patients who are considering liposuction should be informed of the possible compensatory visceral fat gain and any potentially associated health risks, noting that their study is the first to determine that fat can be gained back as quickly as six months after liposuction. Previous studies in animals and humans have also shown that fat rebounds after lipo, but typically over longer time frames.
The authors conclude that liposuction patients should be urged to exercise. “If someone chooses to undergo liposuction, it is very important, if not essential, that this person exercises after the surgery,” said Benatti.
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Unfortunately, few patients who undergo liposuction exercise after their treatment, according to the New York Times. “[F]rom what I hear from plastic surgeons, people do not commonly exercise after liposuction,” Benatti told the Times, and that situation “could lead to deleterious effects in the long term.”