Cutting Out The Fat Does Nothing For ObesityTuesday, April 2, 2013
Regular readers will be well aware of the role that the accumulation of fat depots inside your abdomen (visceral fat) play in the development of metabolic complications of obesity like diabetes, hypertension, hypertriglyceridemia and fatty liver disease.
One of the ideas on why this fat depot should be so important is the notion that blood from this visceral fat drains directly to the liver, carrying not only large amounts of fatty acids but also various pro-inflammatory adipokines.
So, based on this (perhaps simplistic notion), one could wonder whether simply surgically removing this internal fat depot would make a difference (we already know that simply vacuuming off the fat under your skin makes no difference and if at all, makes things even worse).
Now, El Sdralis and colleagues from the University of Patras, Greece, in a paper published in Obesity Surgery, present their finding from a prospective randomized study in 31 patients with morbid obesity submitted to sleeve gastrectomy with or without surgically removing the omentum – an internal fat apron that contains a large amount of visceral fat.
During the 1-year follow-up, body mass index (BMI) decreased markedly with all of the hormones and adipokines (e.g. insulin, IL-6, hs-CRP, adiponectin,HDL-choldesterol, etc.) significantly moving in the right direction in both groups.
While this study does not answer the question of whether or not simply removing omental fat alone would have any beneficial effects, it certainly shows that doing so provides no additional benefit in someone already undergoing a sleeve gastrectomy.
This may well be because the weight loss associated with the sleeve gastrectomy (as with any other bariatric surgery) is more than enough to improve the metabolic complications of excess abdominal fat – removing the fat itself therefore has no additional benefit.
This is good news as the opposite finding may have prompted more surgeons to embark on the adventure of dissecting the omentum – a rather messy procedure that would add both time and possible complications to the surgery.
Sdralis E, Argentou M, Mead N, Kehagias I, Alexandridis T, & Kalfarentzos F (2013). A Prospective Randomized Study Comparing Patients with Morbid Obesity Submitted to Sleeve Gastrectomy With or Without Omentectomy. Obesity surgery PMID: 23526069