title: Liposuction induces a compensatory increase of visceral fat which is effectively counteracted by physical activity: a randomized trial.
abstract: BACKGROUND
  Liposuction is suggested to result in long-term body fat regain that could lead to increased cardiometabolic risk. We hypothesized that physical activity could prevent this effect.
  
  
  OBJECTIVE
  Our objective was 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.
  
  
  METHODS
  Thirty-six healthy normal-weight women participated in this 6-month randomized controlled trial at the University of Sao Paulo, Sao Paulo, Brazil.
  
  
  METHODS
  Patients underwent a small-volume abdominal liposuction. Two months after surgery, the subjects were randomly allocated into two groups: trained (TR, n = 18, 4-month exercise program) and nontrained (NT, n = 18).
  
  
  METHODS
  Body fat distribution (assessed by computed tomography) was assessed before the intervention (PRE) and 2 months (POST2), and 6 months (POST6) after surgery. Secondary outcome measures included body composition, metabolic parameters and dietary intake, assessed at PRE, POST2, and POST6, and total energy expenditure, physical capacity, and sc adipocyte size and lipid metabolism-related gene expression, assessed at PRE and POST6.
  
  
  RESULTS
  Liposuction was effective in reducing sc abdominal fat (PRE vs. POST2, P = 0.0001). Despite the sustained sc abdominal fat decrement at POST6 (P = 0.0001), the 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: School of Physical Education and Sport, University of Sao Paulo, 05025-010 Sao Paulo, Brazil. fabenatti@usp.br
authors.forename: Fabiana
authors.initials: F
authors.lastname: Benatti
authors.forename: Marina
authors.initials: M
authors.lastname: Solis
authors.forename: Guilherme
authors.initials: G
authors.lastname: Artioli
authors.forename: Eduardo
authors.initials: E
authors.lastname: Montag
authors.forename: Vitor
authors.initials: V
authors.lastname: Painelli
authors.forename: Fábio
authors.initials: F
authors.lastname: Saito
authors.forename: Luciana
authors.initials: L
authors.lastname: Baptista
authors.forename: Luiz Augusto
authors.initials: LA
authors.lastname: Costa
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Neves
authors.forename: Marília
authors.initials: M
authors.lastname: Seelaender
authors.forename: Eduardo
authors.initials: E
authors.lastname: Ferriolli
authors.forename: Karina
authors.initials: K
authors.lastname: Pfrimer
authors.forename: Fernanda
authors.initials: F
authors.lastname: Lima
authors.forename: Hamilton
authors.initials: H
authors.lastname: Roschel
authors.forename: Bruno
authors.initials: B
authors.lastname: Gualano
authors.forename: Antonio
authors.initials: A
authors.lastname: Lancha
mesh_terms: D000328:Adult; D001823:Body Composition / Q000502:physiology; D003131:Combined Modality Therapy; D004435:Eating / Q000502:physiology; D004734:Energy Metabolism / Q000502:physiology; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000378:metabolism / Q000473:pathology*; D015187:Lipectomy / Q000009:adverse effects* / Q000534:rehabilitation; D009043:Motor Activity / Q000502:physiology*; D009765:Obesity / Q000453:epidemiology / Q000378:metabolism / Q000473:pathology / Q000628:therapy; D010349:Patient Compliance / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000209:etiology* / Q000628:therapy*; D011184:Postoperative Period; D016896:Treatment Outcome; D015854:Up-Regulation; D015430:Weight Gain / Q000502:physiology; D055815:Young Adult