Q: As I’ve grown older, my body shape has changed and I have more fat around my abdomen and thighs. I eat well, exercise regularly and go on long walks every day, so I feel like liposuction might be the answer. But I’m wondering if the fat that is removed will come back due to my genetics?
A: It’s not unusual to accumulate extra pudge over time. Although genetics certainly plays a role in your body shape, experts agree that your lifestyle is the biggest influence. Even regular exercisers aren’t immune. Nearly 13,000 male and female runners were surveyed in the International Journal of Obesity. Age-related weight gain occurred even among those men and women who were consistently running. Of course, the more they ran, the less likely they were to gain or to be overweight.
Staying active and eating nutritious foods is a sure way to stay healthy, but it might not always prevent the extra weight from aging-related loss of muscle and increased body fat. That’s because how much you eat and exercise, what you eat, and what type of exercise you do all play a role.
Are you really living the same active, healthy lifestyle that you used to? It’s easy to have an inflated perception: Research shows that people tend to view and report their lifestyle behaviors more positively than they prove to be when they are actually measured. Have you ever tracked what you eat and how much you exercise? (See my recommendations for keeping and assessing a Diet Diary in “The Weight Is Over”) You may discover that there are easy ways to cut out extra calories from eating and to maximize how many you burn from activity.
There is no doubt that there is a tendency to take it easier as we age. While you may have been an avid aerobicizer and runner in your 20s and 30s, perhaps in your 40s and 50s you dialed it down to walking and stretching-based workouts like Pilates. Unless you significantly increase the time you spend walking, you may be burning fewer calories than you did in your running days. And substituting vigorous exercise routines with low-key workouts like Pilates may improve balance and body control, but won’t do much for your weight because you don’t burn many calories doing slow, stretching-based movements.
Plus, daily energy expenditure is reduced with every technological advance. A study in the journal Medicine and Science in Sports and Exercise found that the type of vacuum cleaner used affected how many calories a person can burn while cleaning. In theory, vacuuming (as well as other household cleaning) involves upper and lower body movement and can contribute to meeting your daily activity quota. But vacuuming is certainly less vigorous—and so burns fewer calories—than scrubbing and sweeping. And researchers at the University of Nebraska Medical Center in Omaha found that using a turbo-charged vacuum resulted in less effort—and therefore fewer calories expended—for the same amount of rug cleaned with a less powerful vacuum.
So, before you run off to get lipo, seriously evaluate whether you can improve how you eat and maximize your daily calorie burn. In fact, you might as well start with that; even plastic surgeons say liposuction will not absolve you from having to spend the rest of your life eating better and exercising more.
The reason that some people believe that liposuction is a permanent fat fix is because it used to be thought that you’re born with a set number of fat cells. So, if you get some sucked out, you forever reduce your tendency to store fat. But research shows that this is simply not true. Fat cells that remain will still fill up with more fat if you eat more calories than your body needs. And adults can develop brand new fat cells when more fat needs to be stored than the body has room for. So even if surgery removes a few adipocytes from your thighs, you may later find that your arms or calves—or anywhere else you have fat cells—gets fatter.
A study published in the journal Plastic and Reconstructive Surgery surveyed 209 liposuction patients—most of whom had undergone the procedure more than two years earlier—and found that 81 percent had not lost any weight, and 43 percent actually gained more! (Most gained five to 10 pounds.) The researchers concluded that for liposuction to be a success, the patient must begin practicing a healthy lifestyle immediately after surgery and should eat a well-balanced diet and exercise regularly.
The irony, of course, is that if you commit to eating well and doing the right type and amount of exercise, you’re likely to prevent weight gain, and should be able to lose weight and keep it off long-term. And that’s without bearing the risks of liposuction: A review in the journal Dermatologic Surgery concluded that while rates of death and complications from plastic surgery vary according to different studies, death rates from lipo may be as frequent as one in 1000, and one study of 24,000 liposuction procedures found that one out of every 346 resulted in significant complications.
