Separating Fact From Fiction: Obesity and Plastic Surgery

Separating Fact From Fiction: Obesity and Plastic Surgery
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We might think that everyone knows the facts about obesity and weight loss, but a recent article in the New England Journal of Medicine exposes a number of myths and misunderstandings that many still believe. The results may surprise you, from the real link between eating more produce and weight loss to the amount of calories burned during sexual activity.

Defined as a body mass index (BMI) of 30 or higher, obesity is an epidemic -- more than one-third of American adults are obese and obesity-related medical costs in 2008 totaled nearly $150 billion dollars.

Adding more fruits and vegetables to your diet will result in weight loss, right? Wrong. Adding any elements to your diet without making other behavioral or environmental changes will not change your body. As I've said before, "healthy foods" can also be tricky -- you might be surprised to know that a can of grape soda contains fewer calories than a similarly-sized can of grape juice.

The conclusion the NEJM article draws is that there are so many unsupported beliefs about obesity in both scientific literature and the popular press that these misunderstandings are actually contributing to the epidemic.

Given the percentage of obesity in the population and the growth of the plastic surgery as an industry, plastic surgeons are seeing more and more overweight and obese patients. While we are discussing myths and presumptions, let's dispel the notion that body contouring is an effective treatment for obesity. Liposuction, for example, is best used to treat patients with isolated areas of fat; it is not a surgical technique for weight loss. Abdominoplasty and brachioplasty remove redundant skin from the abdomen and upper arms, respectively -- after the weight is lost.

A patient whose weight has been stable for years but is still having trouble with certain problem areas is a good candidate for liposuction -- not someone whose weight has been unstable and who is seeking full-body results. Obese patients should tread carefully when considering any surgical procedure and note that their physicians should make the following clear: Liposuction is not designed to remove tens of pounds from a body in a single day -- this is an extremely dangerous practice.

No matter the elective surgery, from facelifts to liposuction, the rule of thumb that many of my colleagues and I follow is to request that any potential patient get their body weight to below a BMI of 30. This lowers the risk of complications during surgery.

In addition to lowering their BMI in the short-term, healthy eating and exercise habits should be built into the patient's regular routine -- instead of simply trying to lose weight for a procedure, patients should have a thorough understanding about proven facts about calories and exercise. Without these habits good habits in place, any improvement provided by body contouring can be easily undone.

As always, an educated patient is a good patient. Do your reading and learn to separate fact from fiction. The NEJM article suggests asking the simple question: "How could someone actually know that?" when confronting a nutrition or exercise-related belief. Not a bad way to start sorting fact from fiction when it comes to your health and wellness.

And as for that last surprising fact? People expect that sex burns 100-300 calories, but on average it's closer to 21, or about the caloric value of a Hersheys Kiss.

P.S. If you're considering liposuction, review these four questions to better understand the procedure or consult the American Society for Aesthetic Plastic Surgery website for more information.

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