Liposuction induces a compensatory increase of visceral fat which is 1 effectively counteracted by physical activity: a randomized trial

• Grant number: 12/23484-0
• Support Opportunities: Regular Research Grants - Publications - Scientific article
• Start date: March 01, 2013
• End date: August 31, 2013
• Field of knowledge: Health Sciences - Physical Education
• Principal Investigator: Antonio Herbert Lancha Junior
• Grantee: Antonio Herbert Lancha Junior
• Host Institution: Escola de Educação Física e Esporte (EEFE). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

Context: Liposuction is suggested to result in long-term body fat regain which could lead to increased cardiometabolic risk. We hypothesized that physical activity could prevent this effect. Objective: To investigate the effects of liposuction on body fat distribution and cardiometabolic risk factors in women who were either exercise-trained or not after surgery. Design: A six-month randomized controlled trial. Setting: University of Sao Paulo, Sao Paulo, Brazil. Participants: Thirty-six healthy normal-weight women. Interventions: Patients underwent a small-volume abdominal liposuction. Two months after surgery the subjects were randomly allocated into two groups: trained (TR, n=18, four-month exercise program) and non-trained (NT, n=18). Main outcome measures: Body fat distribution (assessed by computed tomography) was assessed prior to the intervention (PRE), two (POST2), and six months after surgery (POST6). Secondary outcome measures included body composition, metabolic parameters and dietary intake, assessed at PRE, POST 2, and POST 6, and total energy expenditure, physical capacity, and subcutaneous adipocyte size and lipid metabolism-related gene expression, assessed at PRE and POST6. Results: Liposuction was effective in reducing subcutaneous abdominal fat (SAT) (PRE vs. POST2, p=0.0001). Despite the sustained SAT decrement at POST6 (p=0.0001), NT group showed a significant 10% increase in visceral fat from PRE to POST6 (p=0.04; effect size=-0.72) and decreased energy expenditure (p=0.01; effect size=0.95) when compared with TR. Dietary intake, adipocyte size, and gene expression were unchanged over time. Conclusion: Abdominal liposuction does not induce regrowth of fat, but it does trigger a compensatory increase of visceral fat, which is effectively counteracted by physical activity. (AU)