Cool Sculpting: What it Is and What It’s Not

cool-sculptingRecent media attention (at least in Canada) has focussed on a procedure called cool sculpting (or cryolipolysis) that promises weight loss and fat removal. This prompted me to request one of my colleagues (Cindy Grand, PT) to look into the literature to see what all the fuss is about.

The following is a brief summary of what Cindy found out based on the published literature on this technique (citation list available on request).

Here is how it works: A proprietary coupling gel is applied to the skin and the fat deposit (e.g. “love handle” or “muffin top”) tissue is suctioned up with a vacuum that positions it between two cooling panels. It is then held there and cooled for a 30-60 minute exposure that apparently results in a cold-induced inflammatory response leading to the localised death of fat cells in the underlying tissue. Over the days and weeks that follow, the dead fat cells are absorbed by the healing process resulting in an about 20% reduction in skin fat in the treated area. There is some evidence showing that this “removal” may well last up to two years.

Here is what it is: A largely cosmetic technique that can remove (or reduce) discrete localised fat pockets (such as “love handles”). The treatment is apparently best suited for individual with normal weight, who have “troublesome” fat bulges or deposits.

Here is what it is not: It is most definitely not a treatment for obesity or even a reasonable technique for weight loss. The few studies that have looked at this, find no health benefits of cool sculpting (in terms of metabolic improvements) – nor would you expect a treatment that simply removes skin fat to have any such effect.

Cryolipolysis is approved by the US-FDA and Health Canada for the localised removal of fat and, as such, is generally deemed as safe. Common adverse effects include (mostly transient) pain, bruising, sensation changes and edema. Contraindications include but are not limited to: cold-sensitive disorders, including Raynaud’s phenomenon, cold urticaria, cryoglobulinemia, and paroxysmal nocturnal hemoglobinuria, and those with neurologic disease.

While I can perhaps see the value of such a non-invasive procedure for dealing with cosmetically “relevant” circumscribed fat deposits, the notion that such a procedure can be a meaningful part of managing overweight or obesity appears rather doubtful.

To their credit, this is not what the researchers who have worked on this have ever claimed.

As for how this procedure is sometimes advertised and marketed – well, that’s another story.

If you or someone you know has experience with this “treatment”, I’d love to hear about it.


Hat tip to Cindy for gathering and summarizing the literature on this.