BACKGROUND: The question of whether or not abdominoplasty is associated with permanent weight reduction remains controversial. In coalition, should abdominoplasty be used as an adjunct for weight reduction in the overweight/obese patient? METHODS: This retrospective patient case series attempts to determine the most important factors associated with weight reduction. RESULTS: All patients undergoing abdominoplasty had weight loss beyond that of their resected pannus, with a minimum body mass index reached 11.6 ± 1.7 weeks after surgery. Weight loss is attributed to an increase in satiety by 75 percent (n = 15) of patients. Preoperative body mass index greater than or equal to 24.5 kg/m can be used to predict long-term weight loss with a sensitivity and specificity of 92.9 percent and 83.3 percent, respectively. Patients above this threshold achieved significantly more weight loss (-4.5 ± 1.4 percent body mass index) at 1 year compared with their lower body mass index counterparts (p = 0.014), as did those with pannus resections weighing greater than 4.5 lb (p = 0.01). CONCLUSIONS: Abdominoplasty performed on patients with a body mass index greater than 24.5 kg/m appears to be linked to sustained weight loss at 1 year. Satiety appears to be a prominent contributing factor, as does the amount of fat resected. Possible neurocrine mechanisms are discussed. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.