Patient is a pleasant 38-year old mother of 4 children, studying to become an attorney, who hated her hanging belly. She stated that she remained overweight despite keeping food journals, exercising and seeing specialists to rule-out ‘metabolic syndrome’ or other causes. She did have hypothyroidism and took medications daily. Her very large, overhanging abdominal pannus further impeded her ability to exercise, and also did not allow her to fit into clothing, which was very distressing psychologically to her. She underwent Abdominoplasty with removal of the large pannus (panniculectomy). Also, the large panniculus behaved as a “metabolic parasite” per se, and once removed, she was able to lose a significant amount of weight in other areas postoperatively. Exercise became much more comfortable and manageable for her, and her overall body image did improve.