Geschatte leestijd: 4 minutenCoolsculpting is a method where localized cooling is used to cause fat cells to die. Is this just another hype or does it really work?
Coolsculpting
Frankly, my attitude towards these kinds of methods is: “Nonsense unless proven otherwise.” However, I must say that this method of localized fat destruction seems fairly well substantiated.
Coolsculpting is a treatment where an area is locally cooled with a machine attached to the skin with a sort of suction cup. That part of the skin is sucked into an attachment (different shapes for different body parts) and then cooled. This method is called cryolipolysis, the breakdown of fats by cooling or freezing. This process takes several weeks to two months after the treatment for the body to remove the dead fat cells.
Fat cells are more sensitive to cold than skin cells. The cold induces apoptosis (natural cell death) which leads to an inflammatory response. In response to this inflammation, macrophages become active, which uptake or ‘eat’ the dead cells (macrophage means ‘big eater’) [1,2,3]. You won’t notice any immediate effect after the treatment. The macrophages respond to the inflammatory reaction after about three days. The amount of macrophages peaks after 14 days, and in the following two weeks, they surround and uptake the dead fat cells. After about three months, the inflammatory process has decreased further, and the macrophages have largely completed their work.
Several studies on the effectiveness of cryolipolysis have shown similar, positive results. A study from 2009 showed a decrease of 20.4% and 25.5% in fat layer, respectively 2 and 6 months after the treatment [5]. A later study from 2014 showed that 86% of the 518 participants benefited from the treatment [6]. The most effective places for cryolipolysis were the abdomen, back, and sides (love handles). Participants filled out a questionnaire afterward, and 73% reported being satisfied with the outcome.
In a study conducted at a private clinic, only 6 out of 528 participants were dissatisfied with the result. Of those six, four were satisfied with the outcome after a second treatment [7]. In another study, a 3D camera was used to compare the difference between a treated and untreated side of the body [8]. Two months after treatment, the amount of fat had decreased by almost 56cc on the treated side. On the untreated side, it was 16cc.
The long-term effects have only been studied once in a very small-scale study [9]. Not exactly a strong study considering only two men participated. They were treated on one side each and then followed for five years based on photos. The fat reduction turned out to be sustainable, despite fluctuations in body weight. Although this is not a very strong study, there is no indication that the effects of cryolipolysis are short-lived or disappear when you gain weight.
Coolsculpting is Big Business
Coolsculpting is, of course, a more commercially viable name than cryolipolysis. It is heavily advertised in the US. It appeals to the desire of many to get rid of localized fat without surgery.
The trigger for this article was a piece in the NY Times that mainly focused on the commercial opportunities that Coolsculpting clinics offer. A treatment for a specific body part such as ‘love handles’ or a double chin can easily cost hundreds of euros. $600 for a single treatment while a treatment plan for multiple body parts could go up to $4,000.
Very interesting all, and the article in the NY Times mainly discussed the hundreds of thousands that clinics can earn per year by purchasing 2 or more Coolsculpting machines. This must be the case, considering a single device can cost up to one and a half tons quickly. In passing, it is mentioned that the FDA has declared the method safe and there is a brief reference to the research showing its effectiveness. This FDA approval is important. This approval concerns the use of the equipment developed by the company Zeltiq.
A quick Google search shows various clinics in the Netherlands offering Coolsculpting. I contacted Coolsculpting Centers myself. It’s not very surprising that this company has branches in three major cities, but also in Het Gooi and Vught. It indicates a bit what apparently the target group is. I asked them some questions about costs by email and got a quick response. This explained what results could be expected, but also that in a small portion of people the result could be less.
Exactly as the above studies showed. I can always appreciate such an honest message. Moreover, an explanation was given for the fact that I saw others offering prices that allow them to focus more on the average thrifty Dutch person. This price difference would be explained by the fact that such cheap providers do not use FDA-approved equipment and method. So you wouldn’t know what results to expect.
Why and for Whom is Coolsculpting?
Coolsculpting is not an alternative to a good diet and sufficient exercise. However, it does offer the possibility to target and address certain problem areas locally. For example, some people notice that despite having a low body fat percentage, they still see a layer of fat over their abs, others suffer from stubborn belly fat or a double chin. If everything else is in place in terms of training and nutrition, but certain areas remain problematic, then Coolsculpting could be a good method.
Personally, I would never do it. First of all, because I don’t have a ‘Gooi salary.’ The choice between a tropical vacation with love handles or a vacation in the garden without love handles would be quickly made.
But well, I don’t have love handles or a double chin, so I might be lacking some empathy on this point.
References
- Krueger N, Mai SV, Luebberding S, Sadick NS. Cryolipolysis for noninvasive body contouring: clinical efficacy and patient satisfaction. Clinical, Cosmetic and Investigational Dermatology. 2014;7:201-205. doi:10.2147/CCID.S44371.
- 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;40(9):595–604. [PubMed]
- Zelickson B, Egbert BM, Preciado J, et al. Cryolipolysis for noninvasive fat cell destruction: initial results from a pig model. Dermatol Surg. 2009;35(10):1462–1470.
- nytimes.com/2017/07/12/business/fat-freezing-helps-doctors-enhance-physiques-and-their-revenue.html?
- Coleman SR, Sachdeva K, Egbert BM, Preciado J, Allison J. Clinical efficacy of noninvasive cryolipolysis and its effects on peripheral nerves. Aesthetic Plast Surg. 2009;33(4):482–448. [PubMed]
- Dierickx CC, Mazer JM, Sand M, Koenig S, Arigon V. Safety, tolerance, and patient satisfaction with noninvasive cryolipolysis. Dermatol Surg. 2013;39(8):1209–1216.
- Stevens WG, Pietrzak LK, Spring MA. Broad overview of a clinical and commercial experience with CoolSculpting. Aesthetic Surg J. 2013;33(6):835–846.
- Garibyan L, Sipprell WH, Jalian HR, Sakamoto FH, Avram M, Anderson RR. Three-dimensional volumetric quantification of fat loss following cryolipolysis. Lasers Surg Med. 2014;46(2):75–80.
- Longitudinal evaluation of cryolipolysis efficacy: two case studies.Bernstein EF J Cosmet Dermatol. 2013 Jun; 12(2):149-52.
