Board Certification in Cosmetic Surgery: all ABCS board certified cosmetic surgeons have had specific training performing liposuction as part of their American Academy of Cosmetic Surgery certified cosmetic surgery fellowship. Also, by choosing a board certified cosmetic surgeon, you can take comfort in knowing your procedure will be performed in an accredited surgery center.

Drug treatment may be necessary to address other aspects of metabolic syndrome. Hypertension should be treated. Statins may be prescribed to treat unhealthy lipid levels. Some healthcare practitioners also recommend aspirin to decrease the risk of inappropriate blood clots. Some may prescribe medications to increase insulin sensitivity (although there is not widespread agreement on this).
Cyclical ketogenic diet (CKD): If you find it difficult to stick to a very low-carb diet every day, especially for months on end, you might want to consider a carb-cycling diet instead. Carb cycling increases carbohydrate intake (and sometimes calories in general) only at the right time and in the right amounts, usually about 1–2 times per week (such as on weekends).
Stock up: Jet.com's new City Grocery service (available in select markets) makes it easy to ensure you always have keto-friendly veggies in the fridge. We love their delivery scheduling tool; simply fill your cart, then decide which day and timeframe you'd like your groceries delivered. One of our faves: Urban Roots Green Squash Veggie Noodles are great for whipping up low-carb "pasta" dishes.
I have great respect for Harvard Medical School. I notice that they support their readers posting comments and I am most appreciative of the article and all the many thoughtful comments by the readers. The readers seem to have the most expertise here and I hope that the doctor who wrote the article will think long and hard about the comments by readers. After 35 years of clinical practice in mental health, I notice that all issues of emotion involve medical issues, nutrition, and the gut bacteria. I would say that these issues and all of the executive brain functions seem to improve with ketogenic principles. For those that apply it in a flexible and smart manner, it appears to improve every area of their lives. I strongly encourage the author of the article to take one class via The Institute for Functional Medicine. If he is open to more learning he can take more classes and get certified. I’m sure a fine doctor, he will be an even better doctor and personally healthier, if he gets more training. Are we all open to new learning(especially us healthcare providers)?
Note: Are you a vegetarian or vegan and want to go on a ketogenic diet? It’s still possible! Just keep in mind that the dietary restrictions can sometimes be a little bit intense. Make sure to plan ahead and prepare to aid your success. To help out, we’ve published articles (with 7 day meal plans included) for both the vegetarian ketogenic diet and the vegan ketogenic diet.

The keto diet also appears to help induce autophagy, which helps clear damaged cells from the body, including senescent cells that serve no functional purpose but still linger inside tissues and organs. In animal studies when rats are put on the ketogenic diet, autophagic pathways are created that reduce brain injury during and after seizures. (21)
Many people struggle with weight loss issues. Losing belly fat in particular is about more than just aesthetics: visceral fat, the kind of fat that tends to settle around the midsection, can cause an increase in your body's production of stress hormones that can affect your body's insulin production. As a result, excess belly fat can lead to serious complications like type 2 diabetes and heart disease.[1] There is no way to target belly fat, but diet and exercise will eventually burn off belly fat. Knowing how to take the first step can help you feel better and get you on the road to a healthier, more active lifestyle.

The body doesn't react to all fats in the same way. Research correlates high intake of saturated fat (the kind in meat and dairy) to increased visceral fat, says Patton. On the other hand, monounsaturated fats (the kind in olive oil and avocados) and specific types of polyunsaturated fats (mainly omega-3s, found in walnuts, sunflower seeds, and fatty fish like salmon) have anti-inflammatory effects in the body, and if eaten in proper portions may do your body good. But Patton warns that eating too much fat of any kind increases your calorie intake and could lead to weight gain, so enjoy healthy fats in moderation. 
In relation to overall caloric intake, carbohydrates comprise around 55% of the typical American diet, ranging from 200 to 350 g/day. The vast potential of refined carbohydrates to cause harmful effects were relatively neglected until recently. A greater intake of sugar-laden food is associated with a 44% increased prevalence of metabolic syndrome and obesity and a 26% increase in the risk of developing diabetes mellitus. In a 2012 study of all cardiometabolic deaths (heart disease, stroke, and type 2 diabetes) in the United States, an estimated 45.4% were associated with suboptimal intakes of 10 dietary factors. The largest estimated mortality was associated with high sodium intake (9.5%), followed by low intake of nuts and seeds (8.5%), high intake of processed meats (8.2%), low intake of omega-3 fats (7.8%), low intake of vegetables 7.6%), low intake of fruits (7.5%), and high intake of artificially sweetened beverages (7.4%). The lowest estimated mortality was associated with low polyunsaturated fats (2.3%) and unprocessed red meats (0.4%). In addition to this direct harm, excess consumption of low-quality carbohydrates may displace and leave no room in the diet for healthier foods like nuts, unprocessed grains,  fruits, and vegetables.
People suffering from diabetes and taking insulin or oral hypoglycemic agents suffer severe hypoglycemia if the medications are not appropriately adjusted before initiating this diet. The ketogenic diet is contraindicated in patients with pancreatitis, liver failure, disorders of fat metabolism, primary carnitine deficiency, carnitine palmitoyltransferase deficiency, carnitine translocase deficiency, porphyrias, or pyruvate kinase deficiency. People on a ketogenic diet rarely can have a false positive breath alcohol test. Due to ketonemia, acetone in the body can sometimes be reduced to isopropanol by hepatic alcohol dehydrogenase which can give a false positive alcohol breath test result. 
High-volume, low-calorie greens will fill you up, without filling you out. Test panelist Kyle Cambridge says regular salads turbocharged his success: “My wife Stacie and I decided to add salad to each meal, and the pounds started melting off.” Kyle lost 25 pounds and four inches in just six weeks on the program. “I even had to buy a new belt!” he said. “But the best was when Stacie came up to me in the kitchen, and gave me a hug. She laughed and smiled and said ‘I can wrap my hands around you again.'”
Metabolic syndrome promotes coronary heart disease through several mechanisms. It increases the thrombogenicity of circulating blood, in part by raising plasminogen activator type 1 and adipokine levels, and it causes endothelial dysfunction. [14] Metabolic syndrome may also increase cardiovascular risks by increasing arterial stiffness. [15] Additional mechanisms include oxidative stress, [16] which has been associated with numerous components of metabolic syndrome. [17]

It is to be appreciated and emphasised that the dreaded complications of pulmonary embolism, deep venous thrombosis, penetration injuries, bleeding, pulmonary oedema, hypovolemic shock, fat emboli, drug toxicity and mortality are absent in every large series of large volume liposuction. In all these cases, credit goes to a strict adherence to the 5 pillars of safety (safe surgeon, safe anaesthesiologist, safe facility, safe co-workers and a properly selected patient).


In general, fat is removed via a cannula (a hollow tube) and aspirator (a suction device). Liposuction techniques can be categorized by the amount of fluid injection and by the mechanism in which the cannula works. Note: If you want to use the liposuction fat as filler for the face or the lips, it is of great importance to know how and using which technique the fat will be removed.
Development of metabolic syndrome depends on distribution as well as amount of fat. Excess fat in the abdomen (called apple shape), particularly when it results in a high waist-to-hip ratio (reflecting a relatively low muscle-to-fat mass ratio), increases risk. The syndrome is less common among people who have excess subcutaneous fat around the hips (called pear shape) and a low waist-to-hip ratio (reflecting a higher muscle-to-fat mass ratio).
First reported in 2003, the idea of using a form of the Atkins diet to treat epilepsy came about after parents and patients discovered that the induction phase of the Atkins diet controlled seizures. The ketogenic diet team at Johns Hopkins Hospital modified the Atkins diet by removing the aim of achieving weight loss, extending the induction phase indefinitely, and specifically encouraging fat consumption. Compared with the ketogenic diet, the modified Atkins diet (MAD) places no limit on calories or protein, and the lower overall ketogenic ratio (about 1:1) does not need to be consistently maintained by all meals of the day. The MAD does not begin with a fast or with a stay in hospital and requires less dietitian support than the ketogenic diet. Carbohydrates are initially limited to 10 g per day in children or 20 g per day in adults, and are increased to 20–30 g per day after a month or so, depending on the effect on seizure control or tolerance of the restrictions. Like the ketogenic diet, the MAD requires vitamin and mineral supplements and children are carefully and periodically monitored at outpatient clinics.[48]
In Asia, the normal diet includes rice and noodles as the main energy source, making their elimination difficult. Therefore, the MCT-oil form of the diet, which allows more carbohydrate, has proved useful. In India, religious beliefs commonly affect the diet: some patients are vegetarians, will not eat root vegetables or avoid beef. The Indian ketogenic diet is started without a fast due to cultural opposition towards fasting in children. The low-fat, high-carbohydrate nature of the normal Indian and Asian diet means that their ketogenic diets typically have a lower ketogenic ratio (1:1) than in America and Europe. However, they appear to be just as effective.[54]
People suffering from diabetes and taking insulin or oral hypoglycemic agents suffer severe hypoglycemia if the medications are not appropriately adjusted before initiating this diet. The ketogenic diet is contraindicated in patients with pancreatitis, liver failure, disorders of fat metabolism, primary carnitine deficiency, carnitine palmitoyltransferase deficiency, carnitine translocase deficiency, porphyrias, or pyruvate kinase deficiency. People on a ketogenic diet rarely can have a false positive breath alcohol test. Due to ketonemia, acetone in the body can sometimes be reduced to isopropanol by hepatic alcohol dehydrogenase which can give a false positive alcohol breath test result. 
Patients with metabolic syndrome can have several disorders of coagulation that make it easier for blood clots to form within blood vessels. These blood clots are often a precipitating factor in developing heart attacks. Patients with metabolic syndrome should generally be placed on daily aspirin therapy to help prevent such clotting events. You should speak to a doctor, of course, before starting any new medication regimen.
Metabolic syndrome is a multiplex risk factor that arises from insulin resistance accompanying abnormal adipose deposition and function. [4] It is a risk factor for coronary heart disease, as well as diabetes, fatty liver, and several cancers. The clinical manifestations of this syndrome may include hypertension, hyperglycemia, hypertriglyceridemia, reduced high-density lipoprotein cholesterol (HDL-C), and abdominal obesity. (See Prognosis, Workup, Treatment, and Medication.)
^ Jump up to: a b c Vemuri VK, Janero DR, Makriyannis A (March 2008). "Pharmacotherapeutic targeting of the endocannabinoid signaling system: drugs for obesity and the metabolic syndrome". Physiology & Behavior. 93 (4–5): 671–86. doi:10.1016/j.physbeh.2007.11.012. PMC 3681125. PMID 18155257. The etiology of many appetitive disorders is characterized by a pathogenic component of reward-supported craving, be it for substances of abuse (including alcohol and nicotine) or food. Such maladies affect large numbers of people as prevalent socioeconomic and healthcare burdens. Yet in most instances drugs for their safe and effective pharmacotherapeutic management are lacking despite the attendant medical needs, collateral adverse physical and psychological effects, and enormous global market potential. The endocannabinoid signaling system plays a critical role in motivational homeostasis as a conduit for reward stimuli and a positive modulator of brain reward circuits. Endocannabinoid-system hyperactivity through CB1 receptor transmission is considered contributory to a range of appetitive disorders and, hence, is a major focus of contemporary pharmaceutical research.
The goal of metabolic syndrome treatment is to reduce the risk of heart disease and diabetes by controlling the associated problematic health conditions (high blood pressure, high cholesterol, diabetes, insulin resistance). “A study in which 53 percent of people had metabolic syndrome at the start found that over three years, intensive lifestyle changes—mainly diet and exercise—resulted in the lowest risk of developing diabetes and the lowest risk of developing metabolic syndrome in those who didn’t have it,” Ndumele says. Recommended changes include:
Eating mindfully. A child who learns to see food as fuel and not emotional compensation can start to make better choices at mealtime — for example, selecting complex carbs instead of simple carbs (whole-grain instead of white bread, brown rice instead of white); getting more fiber with beans, fruits, and vegetables; choosing "healthy" fats like olive oil and nuts; and avoiding too many empty calories from soda and sweets.
Hi Kelly, All packaged foods will have a nutrition label that list the macros per serving, including fat, protein and cabrohydrates. Net carbs, which is what most people look at for low carb and keto, are total carbs (the amount on the label) minus fiber and sugar alcohols, as explained in the article above. I have a low carb food list here that gives you a full list of all the foods you can eat, and the net carbs in each. You can also sign up above to be notified about the meal plans, which are a great way to get started.
A little garlic in your meals could mean a lot less weight around your middle. The results of a Korean study found that mice given a high-fat diet supplemented with garlic lost significantly more weight and abdominal fat than those who just ate fatty foods. Even better, they also improved their liver health, making it easier to stay healthy and burn off that excess fat in the long term. For more flavorful ways to make your food more enjoyable, turn to the metabolism-boosting spicy recipes and watch those pounds melt away.
Liposuction is generally used in an attempt to change the body's shape.[1] Weight loss from liposuction appears to be of a short term nature with little long term effect.[2] After a few months fat typically returns and redistributes.[2] Liposuction does not help obesity related metabolic disorders like insulin resistance.[3] It can also be used to remove excess fat in the chronic medical condition lymphedema.[8]
There is debate regarding whether obesity or insulin resistance is the cause of the metabolic syndrome or if they are consequences of a more far-reaching metabolic derangement. A number of markers of systemic inflammation, including C-reactive protein, are often increased, as are fibrinogen, interleukin 6, tumor necrosis factor-alpha (TNF-α), and others. Some have pointed to a variety of causes, including increased uric acid levels caused by dietary fructose.[18][19][20]

Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009 Oct 20. 120 (16):1640-5.
Although it is not essential to suction the sub-dermal layer of fat in large-volume lipoaspiration, the author concurs with the Massive All Layer Liposuction Mall[24] concept as it helps reduce the thickness and consistency of the superficial fat and enhances skin retraction. This however is better indicated in cases where there is only a limited correction for body contouring rather than volume reduction [Figure 9].
sdLDL. This is a measurement of the number of small dense low-density lipoprotein molecules a person has. LDL varies in size, and the smaller denser molecules, which tend to form when elevated triglycerides and VLDL are present in the blood, are thought to be more aggressive in causing atherosclerosis. This test is now commercially available, but is not performed by many laboratories and is not ordered frequently. Its ultimate clinical utility has yet to be determined. It may be evaluated in a LDL particle testing.

You will need to wear a snug elastic dressing, girdle, or body stocking over the treated area to aid healing. These are provided free of charge for patients at Skin Specialists. Dr. Schlessinger purchases these garments from the inventor of the tumescent technique, Dr. Jeffry Klein, because they are the best garments possible. Some patients prefer to have a second pair on hand, and this extra pair may be purchased for a small extra charge if so desired at the time of surgery.
In the absence of glucose, which is normally used by cells as a quick source of energy, the body starts to burn fat and produces ketone bodies instead (it’s why the keto diet is often referred to as the ketone diet). Once ketone levels in the blood rise to a certain point, you enter into a state of ketosis — which usually results in quick and consistent weight loss until you reach a healthy, stable body weight. See this keto diet review, a before and after trying keto for 30 days.
When we have “beer bellies” or “tires” of fat, they are actually early indicators of heart diseases, diabetes, and other serious health concerns. According to a Harvard Medical report, as women age, their proportion of fat to the body weight tends to go up much more compared to men and even if they may not gain weight, their waistline could grow by inches due to the visceral fat that pushes out against the abdominal wall.
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]
A clinical trial at Great Ormond Street Hospital in 2008, and other studies since then, showed that the diet significantly reduced the number of seizures in a proportion of children whose seizures did not respond well to AEDs. After three months, around 4 in 10 (38%) children who started the diet had the number of their seizures reduced by over half, and were able to reduce their medication. Although not all children had better seizure control, some had other benefits such as increased alertness, awareness and responsiveness.
Hi Gigi, Low carb and keto is about the balance of macronutrients eaten (fat, protein and carbs), not specifically meat or lack thereof. Most people on keto do eat meat, though some people do vegetarian keto. Fat is actually necessary for many body processes. There is no issue for the kidneys with a high fat diet, but if you eat too much protein that isn’t great for the kidneys. It’s a common misconception that keto is high protein (it isn’t). Keto is great for diabetics as it naturally helps stabilize insulin. All of this being said, please know I’m not a doctor and you should consult your doctor on any medical questions or before starting any diet. If you have more questions that aren’t medical questions, I recommend our low carb & keto support group here.

Removing saturated fat (the kind found most often in animal products like meat) and replacing it with monounsaturated fat in moderation is undoubtedly a good thing. It helps lower LDL “bad” cholesterol and the chance of heart attack and stroke. So it’s a good approach for anyone with diabetes, high blood pressure, high cholesterol, or heart disease.


In the absence of glucose, which is normally used by cells as a quick source of energy, the body starts to burn fat and produces ketone bodies instead (it’s why the keto diet is often referred to as the ketone diet). Once ketone levels in the blood rise to a certain point, you enter into a state of ketosis — which usually results in quick and consistent weight loss until you reach a healthy, stable body weight. See this keto diet review, a before and after trying keto for 30 days.
Sleep enough – for most people at least seven hours per night on average – and keep stress under control. Sleep deprivation and stress hormones raise blood sugar levels, slowing ketosis and weight loss a bit. Plus they might make it harder to stick to a keto diet, and resist temptations. So while handling sleep and stress will not get you into ketosis on it’s own, it’s still worth thinking about.
Your most immediate and best option is to combine aerobic exercise and exercise involving lifting weights, as you will not only burn body fat but tone your muscles as well, positively changing your hip to waist ratio, and working quickly towards a healthier body in ever aspect. As you burn belly fat, you'll burn fat where it doesn't need to be elsewhere, too!
Liposuction (also known as lipoplasty and body contouring surgery) sculpts your body, eliminating unwanted pockets of exercise and diet-resistant fat from the buttocks, hips, love handles, saddlebags, thighs, calves, ankles, breasts (including male breasts), back, arms and neck. Liposuction is often combined with other procedures to create a desired shape and is one of the safest and most popular cosmetic procedures. While it doesn't remove cellulite or loose skin, it can change your shape dramatically. 
You’ll see many doctors advertising liposuction as part of their practice; however, just because liposuction is readily available does not mean that just anyone can perform it well. You need to vet potential doctors carefully to find a cosmetic surgeon who can perform liposuction safely and achieve the results you desire. Pay attention to 3 key factors when choosing a cosmetic surgeon for your liposuction procedure:
Board Certification in Cosmetic Surgery: all ABCS board certified cosmetic surgeons have had specific training performing liposuction as part of their American Academy of Cosmetic Surgery certified cosmetic surgery fellowship. Also, by choosing a board certified cosmetic surgeon, you can take comfort in knowing your procedure will be performed in an accredited surgery center.
^ Ketogenic "eggnog" is used during induction and is a drink with the required ketogenic ratio. For example, a 4:1 ratio eggnog would contain 60 g of 36% heavy whipping cream, 25 g pasteurised raw egg, saccharin and vanilla flavour. This contains 245 kcal (1,025 kJ), 4 g protein, 2 g carbohydrate and 24 g fat (24:6 = 4:1).[17] The eggnog may also be cooked to make a custard, or frozen to make ice cream.[37]

Use fat as a lever.  We’ve been taught to fear fat, but don’t! Both keto and low carb are high fat diets. Fat is our source of energy as well as satiety. The key to understand, though, is that fat is a lever on a low carb or keto diet. Carbs and protein stay constant, and fat is the one you increase or decrease (push the lever up or down) to gain or lose weight, respectively. So if your goal is weight loss, eat enough fat to be satisfied, but there’s no need to “get your fats in” once you’re satisfied.


Moving more . Even if you’ve never exercised before, you can start now and markedly reduce your risks. Even moderate amounts of activity will make a difference with heart markers. Walking is a good starter plan for many people. “I tell my patients to get an activity tracker,” Ndumele says. “Aim for 5,000 steps a day and work up to at least 10,000 steps a day.” Talk to your doctor to get the go-ahead on the types of workouts you want to try.
Insulin resistance. Insulin is a hormone that helps your body use glucose -- a simple sugar made from the food you eat -- as energy. In people with insulin resistance, the insulin doesn't work as well, so your body keeps making more and more of it to cope with the rising level of glucose. Eventually, this can lead to diabetes. Insulin resistance is closely connected to having excess weight in the belly.
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