Week of 11/26/18

When I taught health Promotion at the University of North Carolina at Charlotte the curriculum included a section on weight loss. I told the students each semester that in terms of body fat you can’t bounce, wiggle, or jiggle it off. Apparently, you can kill it off. On Monday November 26th, NBC’s Today Show reported on cool sculpting, a procedure performed on individuals to eliminate body fat by freezing it.

Evidence for the effectiveness of freezing fat away was provided by an article entitled “Popsicle Panniculitis” published in the New England Journal of Medicine on April 23rd, 1970. It reported cases of babies faces thinning in response to their cheeks freezing from eating popsicles. That phenomenon provided the idea behind Cool sculpting, or Cryolipolysis, which is the destruction of fat tissue by controlled cooling. It works because lipid (fat) rich cells are more susceptible to death by freezing than the surrounding tissues made of cells that contain water [1]. The treatment is performed by placing a roll of skin and fat tissue between two cooling plates. The temperature of the tissue roll decreases to about 0 °C causing fluids in the fat cells to crystalize, killing the cells. This results in a decrease in fat layer thickness [2].

This procedure works but it’s not for everyone. The procedure is only able to work smaller, targeted areas of the body making the treatment impractical for severely overweight individuals. The Today Show reported that “it works on smaller problem areas for people in relatively decent shape struggling with small areas of stubborn fat.” I agree with that assessment. They also reported that fat decreased in the treated areas by about 25%, a number that I was unable to verify. The “Today Show” also reported “in a small percentage of the people” body fat returned to the area in amounts greater than that previously deposited there. Excessive fat return is considered a side effect which I investigated. The actual number is excess fat return in 0.0051% of treated subjects [3]. That’s a very, very, very, small percentage of the population.

I rarely recommend these types of procedures. I report on them because it’s important that I research and share the objective truth. Cool sculpting appears safe and effective enough that I wouldn’t have a problem with a client considering undergoing this procedure if they understood all the pros and cons.

1. Manstein D, Laubach H, Watanabe K, Farinelli W, Zurakowski D, Anderson RR. Selective cryolysis: a novel method of non-invasive fat removal. Lasers Surg Med. 2008 Nov;40(9):595–604.

2. Jalian HR, Avram MM. Body contouring: the skinny on noninvasive fat removal. Semin Cutan Med Surg. 2012 Jun;31(2):121–125.

3. Jalian HR, Avram MM, Garibyan L, Mihm MC, Anderson RR. Paradoxical adipose hyperplasia after cryolipolysis. JAMA Dermatol. 2014;150(3):317-9.

Wayne Coolidge Jr., M.Ed., CHES is a scholar-practitioner, author, and speaker. He owns Healthy Dynamic Living, an innovative health promotion consulting firm.