Chill Out Your Flab

Wednesday, June 1, 2011

Illustration by Stephen Sauer.

More Info

Dermatology & Skin Health, Dover: www.doverskinhealth.com

Massachusetts General Hospital Dermatology Department: www.massgeneral.org/dermatology

American Academy of Cosmetic Surgery: www.cosmeticsurgery.org

Give your love handles the cold shoulder.

In our never-ending quest to be slim, human beings try just about everything, from the sensible (a balanced, low-fat diet and regular exercise) to the merely hopeful (hello, all-cheeseburgers-all-the-time diet). When stubborn bulges continue to defiantly stare us down in the mirror despite our best efforts, it can be maddening. Even folks who are very fit often have a frustrating flabby area or two - perhaps a lower belly that refuses to lie flat or hip-height jiggly spots that create the dreaded muffin-top look.

Maybe you've decided to wave the white flag and love yourself just the way you are. Bully for you. But if you're mad as heck and determined to rid yourself of those annoying little lumps once and for all, you might want to check out the latest high-tech way to smooth your silhouette: CoolSculpting, a non-invasive procedure that chills fat cells, rendering them senseless and leaving them for the body to naturally process and flush away.

CoolSculpting was developed by Massachusetts General Hospital dermatologists. The technology was at least partly inspired, believe it or not, by a phenomenon called "popsicle panniculitis," which results when kids frequently suck on popsicles or ice and end up chilling - and killing - some of the fat cells in their cheeks. (Over time, dimples can result.) In case you're tempted to load up on cartons of popsicles at the supermarket, we don't recommend trying this at home, though. The cooling process that makes CoolSculpting effective is a very controlled one, says James L. Campbell Jr., M.D., M.S., a dermatologist at Dermatology & Skin Health in Dover.

The innovative technology featured in CoolSculpting procedures was approved by the FDA just last fall, says Campbell. Indeed, CoolSculpting is so new that no long-term studies can vouch for its effectiveness or safety over the long haul - but, considering the scientific basis and methodology behind CoolSculpting, as well as research results thus far, experts do not anticipate any problems.

How does it work?

During a CoolSculpting procedure, a hand-held applicator is placed on the targeted area of fat. Campell affectionately calls the handpiece a "Twinkie remover." "We match the size of it to the fat that the patient wants to have removed," he says, with procedures calling for a bigger handpiece being more costly than those that require the smaller applicator.

Once in place the applicator suctions up the fatty spot and the cooling process, called "cryolipolysis," begins. The skin is typically held in place for one or two hours, while the applicator chills the fat cells without harming nearby tissue, organs or skin. "The process does not actually freeze, but chills the tissue to 40 degrees," Campbell says, killing the local fat cells.

The patient can rest comfortably throughout the painless procedure - napping, reading, watching TV or even working on a laptop. "It feels like tugging at first, then you really don't feel anything," Campbell says. The applicator and CoolSculpting system automatically adjust the cooling process as necessary during the session.

"It's computer-programmed and basically monitors itself," Campbell says. That's about it; patients can immediately resume their normal activities, with no downtime required. The process is completely noninvasive, with no needles, cutting or anesthesia involved. "There's really nothing else like it," Campbell says.

CoolSculpting patients can expect about a 20 percent reduction in fat, although results are not immediate. "Two to four months later, the patient will see a difference," Campbell says. Most patients will first notice a change in the fit of their clothing two months after having the procedure, he says, as the dead fat cells break down and are eliminated naturally by the body. Some patients opt for a follow-up treatment, which can result in another 20-percent reduction in fat, while others are happy with just one session.

The best results occur in people who are not overly heavy. Like liposuction, CoolSculpting is best used for smoothing localized bulges, not for removing large amounts of fat. It is not meant to be an obesity treatment or a kind of weight-loss method. "It is meant for people who are close to their ideal body weight who just want to get rid of a problem spot or two" that seem to resist a low-fat diet and exercise, Campbell says.

However, CoolSculpting does permanently eliminate fat cells, so as long as you maintain a reasonable diet and exercise, the fat cells should not come back, which means that pesky bulge should be gone for good. Even if you gain a moderate amount of weight after undergoing CoolSculpting, the fat most likely will not accumulate in that problem area as quickly as it used to, Campbell says.

As for the price, remember that the fee charged for CoolSculpting usually depends on the handpiece used, Campbell says: $750 is typical for the smaller size; $1,500 for the larger size. And because there's no surgery or anesthesia involved, it carries none of the risks or fees associated with some other fat treatment procedures, he says. "There are no risks, no compression garments and it costs less than liposuction," Campbell says. NH

DIETING: What Works and What Doesn't

Myth: Fad diets work for permanent weight loss. Fact: Fad diets are not the best way to lose weight and keep it off. Fad diets often promise quick weight loss or tell you to cut certain foods out of your diet. You may lose weight at first on one of these diets. But diets that strictly limit calories or food choices are hard to follow. Most people quickly get tired of them and regain any lost weight. Fad diets may be unhealthy because they may not provide all of the nutrients your body needs. Also, losing weight at a very rapid rate (more than 3 pounds a week after the first couple of weeks) may increase your risk for developing gallstones (clusters of solid material in the gallbladder that can be painful). Diets that provide less than 800 calories per day also could result in heart rhythm abnormalities, which can be fatal.

Myth: High-protein/low-carbohydrate diets are a healthy way to lose weight. Fact: The long-term health effects of a high-protein/low-carbohydrate diet are unknown. But getting most of your daily calories from high-protein foods like meat, eggs, and cheese is not a balanced eating plan. You may be eating too much fat and cholesterol, which may raise heart disease risk. You may be eating too few fruits, vegetables, and whole grains, which may lead to constipation due to lack of dietary fiber. Following a high-protein/low-carbohydrate diet may also make you feel nauseous, tired, and weak. Eating fewer than 130 grams of carbohydrate a day can lead to the buildup of ketones in your blood. Ketones are partially broken-down fats. A buildup of these in your blood (called ketosis) can cause your body to produce high levels of uric acid, which is a risk factor for gout (a painful swelling of the joints) and kidney stones. Ketosis may be especially risky for pregnant women and people with diabetes or kidney disease.

Myth: Certain foods, like grapefruit, celery, or cabbage soup, can burn fat and make you lose weight. Fact: No foods can burn fat. Some foods with caffeine may speed up your metabolism (the way your body uses energy, or calories) for a short time, but they do not cause weight loss.

Myth: Natural or herbal weight-loss products are safe and effective. Fact: A weight-loss product that claims to be "natural" or "herbal" is not necessarily safe. These products are not usually scientifically tested to prove that they are safe or that they work. For example, herbal products containing ephedra (now banned by the U.S. Government) have caused serious health problems and even death. Newer products that claim to be ephedra-free are not necessarily danger-free, because they may contain ingredients similar to ephedra.

Myth: Eating after 8 p.m. causes weight gain. Fact: It does not matter what time of day you eat. It is what and how much you eat and how much physical activity you do during the whole day that determines whether you gain, lose, or maintain your weight.

Myth: Starches are fattening and should be limited when trying to lose weight. Fact: Many foods high in starch, like bread, rice, pasta, cereals, beans, fruits and some vegetables (like potatoes and yams) are low in fat and calories. They become high in fat and calories when eaten in large portion sizes or when covered with high-fat toppings like butter, sour cream or mayonnaise. Foods high in starch (also called complex carbohydrates) are an important source of energy for your body.

Source: http://win.niddk.nih.gov/publications/myths.htm