Magic Bullets for Fat?

I like magic bullets,” Dr. Rox Anderson declared while describing the latest fat dissolving technology that he invented. Apparently so do you. In response to my previous column on the types of fats we have in the body, readers wrote asking for more ways to quickly lose weight.

Principally, there are two approaches to weight loss. The first approach is called metabolic fat reduction and applies to those who have fat all over. This is the long way to lose weight and includes exercise, dieting, medicines and surgery. There are medicines that act on the brain to decrease hunger and others that affect fat absorption and metabolism. Surgical techniques for overall fat reduction include major bariatric surgeries for the obese that shrink the stomach or reroute the intestines to promote weight loss.

What is the safest metabolic fat reduction method? Not so exciting: A balanced diet and regular exercise. Unfortunately, every other approach has side effects. My kid nephew would find the ones from the fat malabsorption medicines particularly amusing.

The second approach to weight loss is called focal fat reduction. This is the quick shot to lose weight; caveat is that it is only for those who can basically lift in one hand the fat they want to lose. Some of the tricks to focally reduce fat are liposuction, the more invasive lipectomy with a tummy tuck or thigh tuck, lipolysis or fat breakdown through fat dissolving injections, and others. Now back to Rox and his magic bullets.

Dr. Rox Anderson is director of the Wellman Center for Photomedicine at Massachusetts General Hospital. The walls of his laboratory are not adorned with before-and-after photographs of his dramatic technologies at work — that he leaves for companies that license his work. His many patents cover his walls. A prolific inventor who invented laser hair removal, his latest technology freezes fat in its tracks.  

Anderson had the idea that cooling could kill fat cells based on his clinical observations. Anderson’s technology works by cooling subcutaneous fat close to freezing to selectively kill fat cells.  It has been commercialised as CoolSculpting by Zeltiq, recently approved by the FDA for focal fat reduction.  The company reports that it can cause permanent reduction of 20-24 percent fat in the areas sculpted.  

Another FDA approved non-invasive body sculpting technology called Zerona uses cool lasers to emulsify fats in the target area. Though we do not have the studies to talk about their long term safety, I predict many a love handle will soon fall prey to these new technologies.  

Dermatological surgeon Dr. Vandana Chatrath says that when Zeltiq becomes available in India, she would recommend it to patients.  “The clinical trials are impressive,” she says.  “I would use it for patients with localised areas of excess fat.”  Plastic surgeon Dr. Raman Sethi is less convinced: “The fate of lysed fat is not predictable in these non-invasive procedures. The damaged fat cells may stay or may incite excessive inflammatory responses that may not be desirable.”  What would he recommend?  “Liposuction is the safest of them all and the results are more predictable and consistent as there is actual removal of fat cells.”

A Zeltiq CoolSculpting session lasts about an hour, during which the device is placed on the target area that it cools. While the procedure is quick and easy, results are not snappy. It takes months for the body to resorb the destroyed fat cells and show a reduction of fat in the treated area. What do you need to do to ensure your tummy tucks those months later? Stay on a balanced diet with regular exercise. There is no way of escaping those!

Dr. Kumar, and our health team, can be contacted at health.forbesindia@network18online.com