Research

Energy balance

Large-volume surgical removal of subcutaneous abdominal fat (liposuction) does not improve insulin sensitivity or cardiovascular risk factors in obese individuals, whereas caloric restriction (negative energy balance) rapidly improves metabolic health independent of significant fat loss.

Surgical removal of fat (liposuction) does not fix metabolic health or insulin resistance. To improve metabolic health, you must create a negative energy balance (eat less than you burn), which reduces fat in the liver and muscles, rather than just trying to reduce total body fat mass through surgery.

GoodRefutesHIGH confidence
Despite this surgically induced decrease in adiposity, the insulin sensitivity of the study participants did not change... In addition, the plasma glucose, insulin, and lipoprotein levels did not change after large-volume liposuction.
David E. Kelley · New England Journal of Medicine · 2004

Why this rating

Based on a specific clinical study (Klein et al.) cited in a perspective piece, showing robust data on insulin action.

Source

Thermodynamics, Liposuction, and Metabolism

David E. Kelley · New England Journal of Medicine · 2004

DOI 10.1056/nejmp048115

narrative_reviewCited 29×
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DOI resolved against Crossref · corpus check 2026-06-10

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