As our body fat increases and beyond certain limits, associated alterations such as insulin resistance, systemic inflammation, oxidative stress, etc., may begin to appear, which also exert a positive feedback role between them, aggravating the problem and making it perpetual over time. Therefore, overweight and obesity are directly related to metabolic alterations.

But it is not only about the amount of body fat, but where it accumulates. The abdominal obesity phenotype implies a greater accumulation of visceral fat and therefore a greater risk of suffering from metabolic syndrome and associated pathologies such as type 2 diabetes, atherogenic dyslipidemia, osteoarthritis, cardiovascular disease or cancer.

Usually, these metabolic problems have always been associated with excess visceral fat, rather than with subcutaneous adipose tissue due to its lower metabolic activity, lower emission of inflammatory cytokines and higher leptin production. But even this more or less adequate depot for harboring nutritional excesses could be problematic, especially when it undergoes alterations such as hypertrophy of its adipocytes, hypoxia and necro-apoptosis.

And this is the reason why, after liposuction surgery where a large part of the subcutaneous adipose tissue is removed, if lifestyle habits are not modified (exercise, diet, chronic stress, etc.) and the patient continues in conditions of positive energy balance, there is the possibility of an increase in the accumulation of fat in the visceral adipose tissue, since when suddenly removing adipocytes from the subcutaneous adipose tissue the excess fat will tend to accumulate in the adipocytes of the visceral adipose tissue. Therefore, in spite of losing fat by liposuction, there will be no improvement of these metabolic alterations and they may even worsen.

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