Besides, he adds, abdominal obesity is controlled by a whole other set of signals, so that even after liposuction, the underlying causes for obesity remain. "Those causes are not addressed by taking out fat cells." He points out that, contrary to recent theories, "One can keep making new fat cells throughout life, so little can be gained by liposuction."

Liposuction for obese patients is "a prescription for disaster," according to Gerald Imber, M.D., a plastic surgeon in New York City and clinical assistant professor of plastic surgery at Cornell-Weill Medical College. The greater the volume of fat and tissue fluids, including plasma, that are sucked out, the greater the chance of severe dehydration and electrolyte imbalances.

"When you remove six, eight, or ten liters of mixed fat and water, you are courting disaster," he says. "Liposuction is not meant to change a size 16 to a size 8."

According to a consensus of the experts, the ideal liposuction candidate is a mature adult between the ages of 30 and 50 years old, male or female, in good health, who has dieted and exercised to lose unwanted pounds, with good skin tone, with a set of realistic expectations, and who wants a limited procedure for body contouring.

With Liposuction, Buyer Beware
Anyone considering liposuction should consider all the options, and consumers need to be very careful when selecting a doctor. The saying "caveat emptor" (buyer beware) has never been truer, says Morello. Liposuction sounds so deceptively simple, but in the hands of unskilled doctors, it poses a real threat to people's health, he adds. To complicate matters, anyone with a medical degree can perform liposuction, even with only the briefest weekend training period.

Fighting fat may be the number one battle for many Americans, but liposuction may not be the best weapon to win that slimmer, trimmer body.