The general mantra is that liposuction is not a treatment for obesity. In my experience of thousands of liposuction cases, I have found some obese patients to be excellent candidates with patient satisfaction afterwards.If the concern is the abdomen, hips and waist, then, first and foremost, the diagnosis has to be subcutaneous fat and not intra-abdominal fat.It is only the fat between the muscle and skin layers that can be removed with liposuction. I have had obese patients where high-volume liposuction has been done, giving patients a more normal body proportion.For some people, it's virtually impossible to fit into normal clothes because one area of the body is so much bigger than others.For people who are proportionately overweight, weight loss is usually a much better option if possible.Liposuction is a procedure that works well to change fat distribution and change people's proportions. In some ways, this is irrelevant to someone's overall weight or BMI.For patients who carry significant amounts of intra-abdominal fat, or gut fat, liposuction tends to give poor patient satisfaction. It's not a yes-or-no, all-or-none answer. You need to be personally assessed to see if you're a candidate based on what your expectations are and what can be delivered.I disagree with other surgeons that make blanket statements about not performing liposuction on obese patients.It simply is not that simple. Some patients cannot or will not lose weight. Is it unfair for these people to not have access to something that can change the shape of their body for the better?I have seen many patients who have gotten kickstarts from liposuction and lost significant amounts of weight after.However, I would not rely on the procedure to be the motivating factor for losing weight.I would like to share a few thoughts about weight loss with you. These come from personal experience.Several years ago, I also weighed 250 pounds, though I am 6'2".While liposuction is generally not prescribed as a treatment for obesity, most patients who get liposuction are somewhat overweight. From having met thousands of people interested in liposuction, I have had ample opportunity to talk to many, many people about their struggle with weight. A few repeating patterns seem to emerge. Perhaps the most common one is people not eating frequently enough. Losing weight by not eating is a fallacy. In reality, we tend to overeat after having gone hungry. Another common misunderstanding is the relationship between weight and exercise. Most patients are not successful at losing weight by exercising without changes in diet. Losing weight is 90% about diet. Exercise has to do with fitness. Think of diet and exercise as two separate entities with two separate purposes. That said, I encourage everyone to exercise on a regular basis. The majority of people get hungry from working out and tend to overeat afterwards, sometimes feeling justified to do so after a strenuous workout. The number of calories burned during a typical workout session is far less than people believe. Any successful weight reduction program has to be based on permanent change. Any temporary diet plan will ultimately fail if not followed by permanent changes in behavior. It is important to understand the role that insulin plays in obesity and what causes surges in insulin. If you read the late Dr. Atkins' book, you will learn that his obsession was with controlling insulin much more so than with eliminating carbohydrates. It is also important to learn about the glycemic index and glycemic loads. Avoid eating meals that give a high glycemic load. This is somewhat similar to saying avoid eating large carbohydrate-based meals, though understanding what foods constitute as bad carbohydrate meals is critical. This will be learned after mastering the concepts of the glycemic index and glycemic load. Here are my rules to keep weight under control: Never go hungry.Never eat a large meal.Never, never, never eat a large meal when you are hungry.Avoid large carbohydrate-based meals.Don't expect exercise to get your weight down and don't blame the lack of exercise for not being able to maintain your weight.Step on the scale every day after you get out of the shower in the morning.Accept weight fluctuations. None of us stay at the same weight or continue to go down in weight. Don't beat yourself up if you gain a few pounds. It's the long-term, rest-of-your-life progress that matters. I hope that is of some help. Best of luck, Mats Hagstrom, M.D.