I have heard of an operation that would remove excess fat and result in immediate weight reduction. What is it called ?

The operation you have heard of is a surgical procedure called Liposuction. Liposuction is a method by which the surgeon, loosens and removes fat from any area of the body using metal tubes connected to a suction machine. It was done by a fifty-five-year-old Parisian doctor, Dr. Genard Illouz in 1977.

Is Liposuction a treatment of obesity ?

Dr. Narendra Pandya the eminent plastic surgeon and physician to the President of India and attached to Jaslok, Breach Candy, Bhatia General and Nair Hospital in Bombay, clearly states, " Liposuction or lipolysis ( lips = fat, lysis = break down) is not an answer to obesity. Most people would like to use this method as a short cut to becoming thin. Removal of too much fat at a time can be fatal. At the most, one can suck upto two to two and half kilos. Some people feel if they weigh 100 kilos, after the operation they should weigh just 75 kilos. This kind of magic is not possible and many times people are disappointed with the results. "

"The fat cells, though reduced in number can definitely increase in size. In fact no plastic surgeon can guarantee a permanent cure for obesity or a harmonious distribution of fat if one puts on weight later, even if one undergoes liposuction," says Dr. Pandya.

Dr. S.P. Armungam also a plastic surgeon, is of the same opinion "liposuction is not a cure for obesity." Liposuction does not treat the underlying cause of obesity. If ever you decide upon such an operation, you must consult your own family doctor or a specialists who will evaluate your suitability for undergoing liposuction, and explain to you in detail the possiblities of various complications you may meet with during and after undergoing surgery.

Who are the persons suitable for Liposuction?

1. Liposuction is indicated in obese persons who are twice their ideal weight, who have failed to lose weight despite atleast five years of medical (i.e. non-surgical) treatment.
2. Liposuction is also recommended for persons with a reasonably normal weight, the non-obese, and a healthy , young elastic skin, but with extra localized fat in certain areas such as hips, thighs, arms etc. These persons get the best result from liposuction.

What are the complications of liposuction?

1. An immediate complication of liposuction could be a haematoma. Haematoma is the medical term for a tumour or swelling containing blood. Liposuction can lead to a collection of blood in the area operated upon.
2. Liquid fat can break and collect inside the body.
3. Serum ( a blood component) can collect in the body and form an abscess ( collection of pus) which can be removed only through re- operation.
4. A vacuum can be caused in the body while the fat is being pumped out and this can lead to uneasiness, pain and skin irregularities.
5. Fat embolism can take place. That means a fat globule can enter the blood stream and can be carried to the heart or any other part of the body causing uneasiness.
6. Sometimes, if the doctor is not experienced enough he might suck out fat irregularly, as a result of which the skin may become grooved and the distribution of fat may be uneven. Further during the operation muscles may also get damaged.

What is lipectomy?

Lipectomy is cutting away excess fat. Generally, as in liposuction, it is done in the abdominal, thigh, knee, ankle, arm and chin areas and wherever there are unsightly bulges. In lipectomy excess fat and over hanging skin are cut away.

Post-operatively the patient is hospitalized for about three to five days as the scar is big, with a number of stitches. After the operation the patient is required to wear an elastic bandage for about six weeks.

As with the procedure of Liposuction, Lipectomy is also not a treatment of obesity, as it does not take into account the underlying cause of obesity.

Do you approve of "short circuiting operations that result in considerable weight loss ?"

There is plenty of medical controversy over the use or abuse of this kind of surgical treatment for weight reduction.

Some of the short circuiting operations are :

1. The stapling of stomach : In this case the stomach is folded to reduce its capacity for food. This makes a person feel full even with less quantity of food. The intake of food is thus automatically reduced.
2. The Gastro-jejunal bypass : In this case the surgeon, completely severs your gastro ( stomach) jejunal (first part of small intestines) tract and reconnects it so that you are actually "short circuiting" and you don’t absorb much of the food that you would otherwise absorb. Hopefully, after you reach your ideal weight a second operation reconnects you.

These are both major surgical procedures : they should not be considered unless every other bonafide method of weight reduction has failed.

These operations have fairly unpleasant effects and abdominal fullness all the time and the procedures by themselves create complications.

Are there any newer non-surgical methods in treatment of obesity ?

Among the newer methods are :

1. Balloon Technique : Here a non-toxic, non-soluble material is introduced into the stomach and then inflated into a balloon. The principle is the same as that for stapling of stomach. The capacity of the stomach is reduced for food. Due to constant abdominal fullness and unpleasantness felt by the patients, this technique has not gained popularity.
2. Sucrose Polyester : Sucrose polyester is a recently synthesised material that feels and tastes like fat and can be used like fat in cooking but does not get absorbed by the body. The body is thus protected from the harmful effects of excessive oil in the diet, its excessive storage in fat cells leading to obesity. The use of sucrose polyester is still in experimental stage and its use in the treatment of obesity is doubtful.