Can body contouring influence long-term weight loss post-bariatric surgery?

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A recent study published in Plastic and Reconstructive Surgery challenges the previously held belief that body contouring surgeries aid in long-term weight loss or weight maintenance after bariatric surgery.

The study, led by ASPS Member Surgeon Teresa Benacquista, MD, of Montefiore Medical Center, suggests that the primary benefits of body contouring are related to the improvement in the quality of life and not necessarily linked to weight loss.

The study included 2,531 patients who had undergone bariatric surgery from 2009 to 2012. A subgroup of 350 patients later underwent body contouring, primarily aimed at removing excess skin after massive weight loss.

At a one-year follow-up, these patients had, on average, a lower body mass index (BMI) by about 3 kg/m^2 compared to those who only had bariatric surgery. By the seven-year mark, this difference increased to 5 kg/m^2.

However, the study also found that patients who consulted about but did not undergo body contouring also exhibited sustained weight loss, questioning the causative role of body contouring in long-term weight loss.

Interpretation and Implications

The study underlines that while patients who undergo body contouring may experience sustained weight loss, the effect is not solely attributable to the contouring procedures.

People who consulted about the procedure but did not go through with it also showed a comparable pattern of weight loss.

Dr. Benacquista suggests that “the apparent benefits of body contouring in massive weight loss patients are likely psychosocial, related to improvements in physical functioning.”

Ethnicity and Type of Bariatric Surgery

The type of bariatric surgery also seemed to play a role in sustained weight loss. Patients who underwent sleeve gastrectomy generally had lower sustained weight loss compared to those who had a gastric bypass.

Moreover, the study highlighted racial and ethnic disparities in weight loss outcomes, with Black patients showing lower sustained weight loss compared to other racial or ethnic groups.

Conclusion

While body contouring may offer psychosocial benefits and improvements in physical functioning, its impact on long-term weight loss post-bariatric surgery is minimal according to this study.

This new insight poses questions about the perceived benefits of body contouring and could potentially influence future clinical practices and patient expectations.

The research team notes that more investigation is required to fully understand the impact of body contouring on long-term weight loss, especially as the study brings in new perspectives that diverge from previously held views.

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The study was published in Plastic & Reconstructive Surgery.

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