Multi-colored pile of tape measures

The new procedure promises a non-surgical method of removing unwanted body fat from problem areas, but does Zeltiq live up to the promise?

How Does Zeltiq Work?

The procedure takes advantage of a simple fact - fat cells are more susceptible to cold temperatures than skin cells. The Zeltiq device works by way of a process called cryolipolysis. It uses a suction applicator to draw the fat and skin in the area being treated between cooling plates, and the tissue is held there for approximately an hour. This lowers the temperature to the point where fat cells solidify. This cooling triggers a body process called apoptosis, which is simply a cell death. Once the fat cells die, the body absorbs them naturally, and the treated area shrinks. It takes two to four months for the effects to be visible.

This procedure is non-invasive, so there are no incisions. It's done without anesthesia, and there's no need for pain medication afterwards. There is also no recovery time needed, and patients are able to return to normal activities immediately. So far, there seem to be few side effects from the cryolipolysis. Some patients have said that the treated areas remain cold to the touch afterwards, and occasionally redness, tenderness or swelling are reported. It's sometimes compared to the sensation of a sunburn.

Is Zeltiq Safe and Effective?

There have only been limited clinical trials, but researchers have reported promising results. In March 2009, results of a small trial were reported in the Aesthetic Device Review. In this study, the patient's "love handles" were treated on one side, while the other side was left untreated. Results were compared two months after the procedure, and again six months afterwards. At six months, the patients averaged a 25 percent fat loss in the treated areas, and the minimum loss was approximately 10 percent. A second study showed similar results, with an average 22.4 percent fat loss.

The study reported in the Aesthetic Device Review also looked at one of the commonly reported side effects, numbness at the treatment site. Researchers found no serious or long-lasting effects. One of the patients complained of pain at the site after several minutes of treatment, and the procedure was stopped; this patient did not continue with the trial. For the remaining patients, numbness was reported at almost all of the treatment sites initially, and researchers checked with the subjects weekly by phone. All reported improvement by one week after the procedure, and the problem had resolved by the two month follow-up visit.

Doctors point out that this procedure is designed only for body contouring, removing fat deposits from problem areas like the belly, thighs, or back. It is not a weight loss procedure, and has not been tested on obese patients. And while it's true that fat does not return to treated areas after the fat cells have been removed, this does not prevent weight gain. Body weight still needs to be maintained through diet and exercise.

Is It Available Now?

The Zeltiq device itself is already in many doctor's offices, and it has been approved by the Food and Drug Administration (FDA) for some dermatologic uses. Its use for fat reduction has not been approved, although it can be offered by doctors taking part in one of the trials under way. There are also doctors that have been using the machine "off-label," which means using an approved device or medication for a different purpose.

The cryolipolysis procedure has been approved for body sculpting and fat removal in Canada and in Europe, and application has been made with the FDA for approval in the United States. Check with licensed plastic surgeons or dermatologists in your area for availability, and be careful of potential scams. There have been reports of people offering similar-sounding treatments and even full-body immersion in cold chambers as a means of fat reduction. These alternative treatments have not been studied for either effectiveness or safety.

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