Central obesity is a key feature of the syndrome, being both a sign and a cause, in that the increasing adiposity often reflected in high waist circumference may both result from and contribute to insulin resistance. However, despite the importance of obesity, patients who are of normal weight may also be insulin-resistant and have the syndrome.[27]
Merck & Co., Inc., Kenilworth, NJ, USA is a global healthcare leader working to help the world be well. From developing new therapies that treat and prevent disease to helping people in need, we are committed to improving health and well-being around the world.  The Merck Manual was first published in 1899 as a service to the community.  The legacy of this great resource continues as the Merck Manual in the US and Canada and the MSD Manual outside of North America.  Learn more about our commitment to Global Medical Knowledge.
Vegan ketogenic diet or vegetarian diet: Yes, both are possible. Instead of animal products, plenty of low-carb, nutrient-dense vegan and/or vegetarian foods are included. Nuts, seeds, low-carb fruits and veggies, leafy greens, healthy fats and fermented foods are all excellent choices on a plant-based keto diet. There’s also a similar plan called ketotarian, which combines keto with vegetarian, vegan and/or pescatarian diets for supposedly greater health benefits.

Under most circumstances, when liposuction is an outpatient procedure, recovery is usually quick. Most people can return to work within a few days and to normal activities within about two weeks. You should expect bruising, swelling and soreness for a least a few weeks. However, every person's outcome will vary based on factors such as volume of fat cells removed and area of removal. Your doctor will discuss what results you can expect to achieve and how to best maintain your new body shape.
Conklin's fasting therapy was adopted by neurologists in mainstream practice. In 1916, a Dr McMurray wrote to the New York Medical Journal claiming to have successfully treated epilepsy patients with a fast, followed by a starch- and sugar-free diet, since 1912. In 1921, prominent endocrinologist Henry Rawle Geyelin reported his experiences to the American Medical Association convention. He had seen Conklin's success first-hand and had attempted to reproduce the results in 36 of his own patients. He achieved similar results despite only having studied the patients for a short time. Further studies in the 1920s indicated that seizures generally returned after the fast. Charles P. Howland, the parent of one of Conklin's successful patients and a wealthy New York corporate lawyer, gave his brother John Elias Howland a gift of $5,000 to study "the ketosis of starvation". As professor of paediatrics at Johns Hopkins Hospital, John E. Howland used the money to fund research undertaken by neurologist Stanley Cobb and his assistant William G. Lennox.[10]
Watching that extra junk around your trunk turn your body into a full-blown Buddha belly puts you at an increased risk for heart disease, diabetes, and early death. Luckily, losing the weight doesn’t have to take forever; with these 22 belly fat-fighting tips, you can shave two inches off your waistline in as little as two weeks. Think your age will stand in the way of your weight loss? The 20 Ways to Lose Your Belly When You’re Older will help folks of any age get on track to their best body ever.
During this procedure, Dr. Schlessinger will first mark the areas to be suctioned. At that time, you will then be taken to the state-certified ambulatory surgical center and a trained nurse will numb the areas to be treated. This will take about an hour or two, but during this time you will be able to watch TV or listen to music at your leisure. After this time, you will have a short time to relax and let the numbing take effect.
This website is provided for information and education purposes only and is not intended to offer specific medical or surgical advice to anyone. No doctor/patient relationship has been established by the use of this site, and no diagnosis or treatment is being provided. The information contained here should be used in consultation with a doctor of your choice. No claim or opinion on these pages is intended to be medical advice or to replace a one-on-one relationship with a qualified health care professional. No guarantees or warranties are made regarding any of the information contained herein.
Belly fat is slightly different than other fat deposits on the body and is often called visceral fat. Visceral fat is considered the most dangerous form of fat in the body because it is in such close proximity to our vital organs. It is actually located beneath the abdominal muscles and the subcutaneous layer of fat, making it difficult to see and even harder to get rid of! These larger fat cells release hormones and chemicals that can be dangerous in many ways, leading to an increased risk of various diseases and metabolic imbalances.

• Your body is still growing — In one study, epileptic children experienced a reduction in symptoms and improved cognitive performance when a ketogenic diet was introduced.49 However, this may have a negative effect on the growth of their bodies in the long run, according to a study published in the journal Developmental Medicine & Child Neurology.50


People who have metabolic syndrome or are at risk for it may need to take medicine as treatment. This is especially true if diet and other lifestyle changes have not made a difference. Your doctor may prescribe medicine to help lower blood pressure, improve insulin metabolism, lower LDL cholesterol and raise HDL cholesterol, increase weight loss, or some combination of these.
Pre-tunnelling (Mladick)[25] increases instrument control as, without suction, it creates desired superficial as well as deep planes of fat removal. It prevents an inadvertent removal in the sub-dermal fat layer that can result in contour irregularities. Similarly, cross tunnelling with at least two port sites at right angles are used to treat an area of adiposity. The use of multiple port sites provides for better contouring and feathering of edges.
Cirrhosis of the liver refers to a disease in which normal liver cells are replaced by scar tissue caused by alcohol and viral hepatitis B and C. This disease leads to abnormalities in the liver's ability to handle toxins and blood flow, causing internal bleeding, kidney failure, mental confusion, coma, body fluid accumulation, and frequent infections.
A: The amount of weight you lose is entirely dependent on you. Obviously adding exercise to your regimen will speed up your weight loss. Cutting out things that are common “stall” causes is also a good thing. Artificial sweeteners, dairy, wheat products and by-products (wheat gluten, wheat flours, and anything with an identifiable wheat product in it).
The ketogenic diet is indicated as an adjunctive (additional) treatment in children and young people with drug-resistant epilepsy.[26][27] It is approved by national clinical guidelines in Scotland,[27] England, and Wales[26] and reimbursed by nearly all US insurance companies.[28] Children with a focal lesion (a single point of brain abnormality causing the epilepsy) who would make suitable candidates for surgery are more likely to become seizure-free with surgery than with the ketogenic diet.[9][29] About a third of epilepsy centres that offer the ketogenic diet also offer a dietary therapy to adults. Some clinicians consider the two less restrictive dietary variants—the low glycaemic index treatment and the modified Atkins diet—to be more appropriate for adolescents and adults.[9] A liquid form of the ketogenic diet is particularly easy to prepare for, and well tolerated by, infants on formula and children who are tube-fed.[5][30]

Leafy greens like collard greens, watercress, kale, and arugula may not be on your everyday list, but they all contain a compound called sulforaphane. This nutrient has been shown to act directly on the genes that determine “adipocyte differentiation”—basically, turning a stem cell into a fat cell. A healthier intake of the compound means a healthier body weight for you. And just a scant teaspoon of vinaigrette will help your body absorb the fat-soluble nutrients.
Doing crunches until the cows come home? Stop it! When you're down to your final inches of belly fat, the dreaded crunch won't be the exercise that finally reveals your six-pack. "You can't spot reduce," Jill says. Instead, she suggests doing functional exercises that use the muscles in your core—abdominals, back, pelvic, obliques—as well as other body parts. "These exercises use more muscles, so there is a higher rate of calorie burn while you are doing them," she says. Planks are her favorite functional exercise—they activate not just your core muscles but also your arm, leg, and butt muscles.
There are numerous benefits that come with being on keto: from weight loss and increased energy levels to therapeutic medical applications. Most anyone can safely benefit from eating a low-carb, high-fat diet. Below, you’ll find a short list of the benefits you can receive from a ketogenic diet. For a more comprehensive list, you can also read our in-depth article here >
In fact, a loss of just 3 percent to 5 percent of your current body weight can lower your triglycerides, blood glucose and the risk of developing type 2 diabetes. Greater amounts of weight loss can also improve blood pressure readings, lower LDL (“bad”) cholesterol and increase HDL cholesterol. (1) Thankfully, there’s a proven metabolic syndrome diet and natural treatment plan to get your metabolic function back in proper working order.
Advent of the tumescent technique in 1987 has allowed for safe contouring in ambulatory single session liposuction under regional or general anaesthesia. Safety and aesthetic issues define MegaLiposuction to be in Volume in litres of more than 10% of Body weight in Kgs. 870 cases of liposuction were performed between September 2000 and August 2008. In (65%) cases, the total volume of aspirate was greater then 5 liters. (Range: 5 to 25 liters). In 24% cases, the large volume liposuction was combined with a limited or a total block lipectomy. Regional anaesthesia with conscious sedation was preferred except where liposuction was for above the subcostal region (the Upper Trunk, Lateral Chest, Back, Gynaecomastia, Breast, Arms and Face) or when the patient so desired. Tumescent infiltration with Lactated ringer, adrenalin, triamcinalone and hyalase was made in all cases. This approach has clinically shown less tissue edema in the post operative period than when the conventional physiological saline was being used in place of Ringer Lactate. The amount injected varied from 1,000 ml to 12,500 ml depending on the size, site and area. Local anesthetic was included only to the terminal portion of the tumescent mixture while infiltrating the sub-costal regions, or when above costal region was combined with below costal region being anaesthetized with Spinal Anaesthesia. The aspirate was restricted to the unstained white / yellow fat and the amount of fat aspirated did not have any bearing to the amount of solution infiltrated. There was no major complication. Blood transfusion was given only on one occasion when the patient had been on aspirin and had also received Low Molecular weight Heparin intra-operative. The hospital stay ranged from 8 to 24 hours for liposuction as well as for liposuction with a lipectomy. Serous discharge from access sites, sero-sanguinous fluid accumulation requiring drainage were necessitated in less than 10% cases. Minor re-contouring touch ups were requested in 5% cases. Early ambulation was encouraged for mobilization of third space fluid shifts to expedite recovery and to prevent deep vein thrombosis. More than 10% patients were operated on for Liposuction of other areas, after a gap of 7 days to 6 months. Meticulous perioperative monitoring of systemic functions ensures safety in tumescent megaliposuction for the obese and rewarding results can be achieved in a single sitting.
Belly fat is excess abdominal fat surrounding the organs in your stomach. There are three types of fat: triglycerides (the fat that circulates in your blood), subcutaneous fat (the layer directly below the skin’s surface) and visceral fat (dangerous belly fat). Visceral fat is located beneath the muscles in your stomach and poses many dangers to your health when there is too much of it.
Include physical activity in your daily routine. For most healthy adults, the Department of Health and Human Services recommends moderate aerobic activity, such as brisk walking, for at least 150 minutes a week or vigorous aerobic activity, such as jogging, for at least 75 minutes a week. If you use a step counter, remember that it takes an average of 10,000 steps per day to prevent weight gain. Some studies indicate it might take 15,000 steps per day to prevent the regain of weight after significant weight loss.
Polycystic ovarian syndrome. Thought to be related to insulin resistance, this disorder involves the release of extra male hormones by the ovaries, which can lead to abnormal menstrual bleeding, excessive hair growth, acne, and fertility problems. It is also associated with an increased risk for obesity, hypertension, and — in the long-term — diabetes, heart disease, and cancer.
The tumescent technique. This involves even more fluid than is used in the super-wet technique. The surgeon will infuse three to six times as much fluid as the volume of the aspirate (fat, fluid and blood content) to be removed. Proponents say the tumescent technique swells the tissues, which aids in fat removal; but detractors say it interferes with the surgeon's ability to sculpt. Opponents also claim the technique is unsafe because of potential fluid overload and an overdose of anesthetic.
• High-protein ketogenic diet — This method is a variant of the SKD. In a high-protein diet, you increase the ratio of protein consumption to 10 percent and reduce your healthy fat consumption by 10 percent. In a study involving obese men that tried this method, researchers noted that it helped reduce their hunger and lowered their food intake significantly, resulting in weight loss.11
Keto diets are high in healthy fats and protein also tend to be very filling, which can help reduce overeating of empty calories, sweets and junk foods. (4) For most people eating a healthy low-carb diet, it’s easy to consume an appropriate amount of calories, but not too many, since things like sugary drinks, cookies, bread, cereals, ice cream or other desserts and snack bars are off-limits.

Insulin is a hormone that lets your body use or store sugar as fuel. Ketogenic diets make you burn through this fuel quickly, so you don’t need to store it. This means your body needs -- and makes -- less insulin. Those lower levels may help protect you against some kinds of cancer or even slow the growth of cancer cells. More research is needed on this, though.
Certain studies suggest that keto diets may “starve” cancer cells. A highly processed, pro-inflammatory, low-nutrient foods can feed cancer cells causing them to proliferate. What’s the connection between high-sugar consumption and cancer? The regular cells found in our bodies are able to use fat for energy, but it’s believed that cancer cells cannot metabolically shift to use fat rather than glucose. (11)
Dr. Campos, it is so discouraging to see that you disparage the ketogenic diet based on your assumption that it is very heavy in poor quality processed meats. No diet that relies on processed foods can be viewed as “healthy”. Become better informed by getting up to speed with what Jeff Volek, RD, PhD, calls a “well-formulated ketogenic diet.” Also, learn more about the potential of the diet to slow cancer progression (my specialty). You owe it to your patients who are depending on you for advice. Present them with facts, not opinions.
Fat layers are treated from deep to superficial in sequence and in parallel tracks. As the procedure is progresses more superficially, canula size can be decreased along with reduction in suction intensity to help decrease risk of irregularity to the surface layers. Most traditional liposuction treatment involves removal of the deeper layers of fat. Superficial liposuction is done in individuals with flaccid skin or Localised Fat Deposits (LFDs) as an aid to better skin retraction. It is accomplished with narrow cannulae that make multiple closely spaced passes in the sub-dermal fat to effect an undermining of the affected tissue.

In the mid-1990s, Hollywood producer Jim Abrahams, whose son's severe epilepsy was effectively controlled by the diet, created the Charlie Foundation to promote it. Publicity included an appearance on NBC's Dateline programme and ...First Do No Harm (1997), a made-for-television film starring Meryl Streep. The foundation sponsored a multicentre research study, the results of which—announced in 1996—marked the beginning of renewed scientific interest in the diet.[1]

Recovery from SmartLipo depends on type of anesthetic used. While many physicians try to tell patients it is all about the SmartLipo, here is the secret: It's about the anesthetic that is used prior to doing the procedure. Tumescent liposuction, invented by a dermatologist, is the reason that dermatologists typically have patients up and about the day of the procedure and the reason that many of Dr. Schlessinger's patients go to work the next day or two after surgery.
"The keto diet is primarily used to help reduce the frequency of epileptic seizures in children. While it also has been tried for weight loss, only short-term results have been studied, and the results have been mixed. We don't know if it works in the long term, nor whether it's safe," warns registered dietitian Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women's Hospital.
Arteries (are-te-rease): The blood vessels that carry oxygen-rich blood away from your heart for delivery to every part of your body. Arteries look like thin tubes or hoses. The walls are made of a tough outer layer, a middle layer of muscle and a smooth inner wall that helps blood flow easily. The muscle layer expands and contracts to help blood move.
Eating slowly will also help cinch your waist, too. Inhaling croissants while run-walking to work will do little to satiate you – not that you’ll do much digesting anyway, with all that cortisol flooding your system. Instead, by making time to eat and focusing on your food (that also means not scrolling through Instagram), you’ll wind up eating less and you’ll feel fuller for longer.

A systematic review in 2018 looked at 16 studies on the ketogenic diet in adults. It concluded that the treatment was becoming more popular for that group of patients, that the efficacy in adults was similar to children, the side effects relatively mild. However, many patients gave up with the diet, for various reasons, and the quality of evidence was inferior to studies on children. Health issues include high levels of low-density lipoprotein, high total cholesterol, and weight loss.[24]


I actually clicked on the story just to see if they included anything about it’s use in managing chronic migraine. I have chronic migraine, basically intractable. Nothing has helped. I’ve tried medications, meditations, and everything in between including a bunch of dietary changes. Keto is my next consideration. I’m happy to hear it helped you! Thanks for sharing
Despite continuous advances in the medical world, obesity continues to remain a major worldwide health hazard with adult mortality as high as 2.8 million per year. The majority of chronic diseases like diabetes, hypertension, and heart disease are largely related to obesity which is usually a product of unhealthy lifestyle and poor dietary habits. Appropriately tailored diet regimens for weight reduction can help manage the obesity epidemic to some extent. One diet regimen that has proven to be very effective for rapid weight loss is a very-low-carbohydrate and high-fat ketogenic diet.[1][2][3]

There are so many tricks, shortcuts, and gimmicks out there on achieving optimal ketosis – I’d suggest you don’t bother with any of that. Optimal ketosis can be accomplished through dietary nutrition alone (aka just eating food). You shouldn’t need a magic pill to do it. Just stay strict, remain vigilant, and be focused on recording what you eat (to make sure your carb and protein intake are correct).
What should you eat after working out? Exercise is beneficial for overall health. To get the most effective exercise, it is necessary to have good nutrition. There is a range of things to eat right after a workout that will help in specific fitness goals. It is also essential to eat to recover energy levels. Learn more about what to eat after a workout. Read now
“For some people, it’s knowing, ‘Typically I eat a whole sandwich,’” says Gagliardi. “‘Now, I’m going to make the decision to eat half a sandwich at lunch and save the other half for my dinner and essentially cut my calories in half. And they feel good about that. They’re not having to do math.” To get started, check out these 25 simple ways to cut 500 calories a day.
For weight loss, today's keto diets are the descendants of low-carb diets like the Atkins diet, which peaked in popularity in the early 2000s. Both types of diets reject carbs in favor of meatier meals. There is no single blueprint for the keto diet, but plans usually call for eating fewer than 50 grams of carbohydrates a day. (Wheat bread contains about 16 grams of carbohydrates per ounce, according to the USDA.) Celebrity adherents to the diet include Halle Berry and Kourtney Kardashian.
Tumescent liposuction (fluid injection) is the most common type of liposuction. It involves injecting a large amount of medicated solution into the areas before the fat is removed. Sometimes, the solution may be up to three times the amount of fat to be removed). The fluid is a mixture of local anesthetic (lidocaine), a drug that contracts the blood vessels (epinephrine), and an intravenous (IV) salt solution. Lidocaine helps numb the area during and after surgery. It may be the only anesthesia needed for the procedure. Epinephrine in the solution helps reduce loss of blood, bruising, and swelling. The IV solution helps remove the fat more easily. It is suctioned out along with the fat. This type of liposuction generally takes longer than other types.

First, I want to thank you for all of your dedication and work in providing this site. The difficulty of maintaining a healthy weight is a big problem for so many people. My personal question & issue in staying on Keto is my craving for fresh fruit. This a.m I had a large fresh peach along with my “Bullet Proof” coffee. Have I now sabotaged today’s Keto eating?


The amount of fat removed really depends on the size of the patient and their aesthetic goals. From a safety standpoint, the American Society of Plastic Surgeons recommends roughly 10 pounds of fat or less. Otherwise it is considered a high-volume liposuction, which does present an increased set of risks. It’s advised to get down to your ideal weight before undergoing a liposuction procedure.
Most of the bacteria that dwell in your gut are pretty useful. They produce hormones, regulate your immune system, digest food, extract nutrients, control your mood, manage your appetite, and much more besides. That obese people tend to have higher numbers of Firmicutes bacteria is no coincidence – according to research published in the online journal Nature, these bacteria increase the number of calories your body absorbs from food.
For many of Dr. Ayoub’s patients in Omaha, liposuction is the first surgical procedure they have ever undergone. So, it’s understandable that they would be nervous about having liposuction performed, despite their desire to lose their stubborn fatty deposits. When you work with us, though, you need not worry. Your safety and comfort are our top priorities, and we will do everything possible to make your liposuction procedure a pleasant experience.
What should you eat after working out? Exercise is beneficial for overall health. To get the most effective exercise, it is necessary to have good nutrition. There is a range of things to eat right after a workout that will help in specific fitness goals. It is also essential to eat to recover energy levels. Learn more about what to eat after a workout. Read now
A keto diet has shown to improve triglyceride levels and cholesterol levels most associated with arterial buildup. More specifically low-carb, high-fat diets show a dramatic increase in HDL and decrease in LDL particle concentration compared to low-fat diets.3A study in the long-term effects of a ketogenic diet shows a significant reduction in cholesterol levels, body weight, and blood glucose. Read more on keto and cholesterol >

There are several medical studies — such as two conducted by the Department of Radiation Oncology at the Holden Comprehensive Cancer Center for the University of Iowa, and the National Institutes of Health’s National Institute of Neurological Disorders and Stroke, for example — that show the ketogenic diet is an effective treatment for cancer and other serious health problems. (12)

To get the most benefit from the Keto diet, you should stay physically active. You might need to take it easier during the early ketosis period, especially if you feel fatigued or lightheaded. Walking, running, doing aerobics, weightlifting, training with kettlebells or whatever workout you prefer will boost your energy further. You can find books and online resources on how to adapt Keto meals or snacks for athletic training.
An easy way to determine if you have too much belly fat is to measure yourself at home. Take a measuring tape and wrap it around your bare stomach, directly above your hip bone. The tape should be snug but not too tight. For women, a measurement of 35 inches or more indicates an unhealthy amount of belly fat. For men, a measurement of 40 inches or more indicates an unhealthy measure.
The ketogenic diet is usually initiated in combination with the patient's existing anticonvulsant regimen, though patients may be weaned off anticonvulsants if the diet is successful. Some evidence of synergistic benefits is seen when the diet is combined with the vagus nerve stimulator or with the drug zonisamide, and that the diet may be less successful in children receiving phenobarbital.[18]
This website is provided for information and education purposes only and is not intended to offer specific medical or surgical advice to anyone. No doctor/patient relationship has been established by the use of this site, and no diagnosis or treatment is being provided. The information contained here should be used in consultation with a doctor of your choice. No claim or opinion on these pages is intended to be medical advice or to replace a one-on-one relationship with a qualified health care professional. No guarantees or warranties are made regarding any of the information contained herein.
Ultimately, you need to pick a healthy eating plan you can stick to, Stewart says. The benefit of a low-carb approach is that it simply involves learning better food choices—no calorie-counting is necessary. In general, a low-carb way of eating shifts your intake away from problem foods—those high in carbs and sugar and without much fiber, like bread, bagels and sodas—and toward high-fiber or high-protein choices, like vegetables, beans and healthy meats.
Keto diets are high in healthy fats and protein also tend to be very filling, which can help reduce overeating of empty calories, sweets and junk foods. (4) For most people eating a healthy low-carb diet, it’s easy to consume an appropriate amount of calories, but not too many, since things like sugary drinks, cookies, bread, cereals, ice cream or other desserts and snack bars are off-limits.

A: There's no specific answer for this question, as it is dependent on many factors. However, you may be able to spot improvements right away. In a study that tested the ketogenic diet on obese people, researchers noted that after 24 weeks, the test subjects lost around 14 kilograms (30.8 pounds) of excess weight, going from an average 101.03 kilograms to 86.67 kilograms (222.7 pounds to 191 pounds).67
Once the anesthesia has taken effect, the liposuction procedure is performed using a suction device attached to a small, stainless steel instrument called a cannula. Through small incisions, the cannula is inserted into fatty areas between skin and muscle where it removes excess fat either using a suction pump or a large syringe. This results in a smoother, improved body contour. The length of the procedure will vary with the amount of fat needing removed.
PAL technique is based on power assisted reciprocating movements of the cannulae. The advantage being, the surgeon is not fatigued with rapid to and fro movements of cannulae and can concentrate on refinement. It also allows the use of finer cannulae and the results are better. Some tough tissues like in Gynecomastia are relatively easily suctioned and Liposuction in female breast, (where UAL may have unproven potential for thermal damage to mammary gland) can also be managed.
"The battle of the bulge." That tiny, five-word phrase has been shoved in our faces for years, thanks to television, newspapers and magazines. Sometimes, no matter how hard you fight, the bulge has a tougher army. The fact is that certain people have fat cells that will not shrink, despite diet and exercise. You can thank heredity for that in some cases.
Fleury, N., Geldenhuys, S., & Gorman, S. (2016, October 11). Sun exposure and its effects on human health: Mechanisms through which sun exposure could reduce the risk of developing obesity and cardiometabolic dysfunction. International Journal of Environmental Research and Public Health, 13(10), 999. Retrieved from https://www.mdpi.com/1660-4601/13/10/999/htm

Metabolic syndrome between pregnancies increases the risk of recurrent preeclampsia, according to a retrospective cohort study of 197 women who had preeclampsia during their first pregnancy. Of the 197 women, 40 (20%) had metabolic syndrome between pregnancies. Of these 40 women, 18 (45%) had preeclampsia during their second pregnancy, compared with 27 (17%) of the 157 women without metabolic syndrome between pregnancies. The risk of recurrent preeclampsia increased with the number of components of the metabolic syndrome present. [68, 69]
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