I’m sure there are a few of you who are happy with your figures. The other 250 million adults out there most likely have a little fat that could be trimmed from your tummy… or your thighs…or your neck. Myself included. In fact, despite a decade of Drs. Oz’ and Roizen’s preaching about the merits of weight loss and exercise, we’re in a losing battle against our genes.To understand why this is, let’s go back in time a little. Way before iphones, before radio and even before the scribes handwrote books. Let’s go back to the time when we hunted in groups and drew paintings in caves. About 10,000 years ago. Back then, after killing some unsuspecting prey, we would stuff ourselves until we couldn’t move. We would eat and eat and eat, because we didn’t know if our next meal would be tonight…or next month. So, the fatter we were, the more likely we were to survive. Of course, we didn’t worry about diabetes, heart disease or cancer, since if infection didn’t kill us by age 20, some other predator would likely make us his meal. And if that didn’t knock us off, then our loss of teeth and vision would signal our end.MORE: Your Body Wants to Be FatAnd that brings us back to fat. There’s a reason fat tastes so darn good. That fatty bacon is the most calorically dense substance known to mankind. We’re programmed to like the taste so that the transfer of calories between the prey and the predator is most efficient. Which is exactly why a wolf will eat the fat from a deer first.Fast forward to 1983. Hopefully we won’t face a famine again and we are determined to trim off every fat cell in our body. So after dieting and exercising, those last few pounds, the ones intended to save our lives, are the ones that bother us the most. While we squeeze into our jeans and eat salads for dinner, we are defying our genetic destiny. And that is why those last few pounds are so hard to lose. That fat that sits on our hips and thighs, even when we’re so thin our ribs are showing. We’re saving those last few pounds for the time when we won’t see a meal for many days. And if we have those saddlebags that we hate so much, we may survive.QUIZ: How is Your Health?For the last three decades, the final arbiter of our battle with our genes has been the liposuction machine. The most popular cosmetic surgical procedure over the past 28 years, liposuction, is an outpatient procedure that removes up to 10 pounds of fat through a few tiny incisions. Performed by board certified plastic surgeons, liposuction is an incredibly safe procedure, as long as you are healthy and as long as not too much fat is removed. But, like all surgery, liposuction does have its risks, and there have even been deaths with this procedure. More common problems include an unattractive cosmetic result.MORE: Will Cosmetic Surgery Make You Happier?So while hundreds of millions of people could benefit from liposuction, only hundreds of thousands of people actually have it. While many people cannot afford the surgery, many others simply can’t fathom the idea of going under the knife for purely cosmetic reasons. And others are afraid of complications.Fast forward to 2012. Liposuction goes on the endangered species list. The first noninvasive technologies that can destroy fat without surgery are introduced. Zeltiq freezes fat, killing and subtly removing some. Zeltiq came in with much publicity, but the results may be too subtle to make this technique commercially viable. Another technique uses high-energy focused ultrasound, a space age technology that harnesses the energy in sound like the laser harnesses light. Liposonix has won the FDA’s approval first, and soon you won’t be able to turn on the television without hearing about this new technology. That sound energy sears right through belly fat, and in about three months, you’ll be about an inch smaller around your waist. A competing technology, Ultrashape, has yet to receive FDA approval.MORE: Weight Loss Tips That Help Increase Your Body ConfidenceThese new techniques won’t zap off 20 pounds—you’ll still have to listen to Dr. Oz to do that. But if you’re close to your ideal weight, Liposonix might be right for you. In about an hour, you can have your tummy treated, and you’ll see the results in about three months. As the technology progresses, it may well be used to remove even more fat and even tighten loose skin.As a surgeon I love performing surgery. But I see the handwriting on the wall of the cave. Invasive fat removal is going the way of the mastadon…
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