What Is CoolSculpting Fat Loss Surgery?

It was probably about two years ago that I began to see tons of posters, ads, and popups about a fancy new fat loss surgery process called “CoolSculpting.” At first, I thought it was some kind of a exciting new ice sculpting competition, but it turns out that it’s more like carving off parts of your love handles with an icy cold surgical tool, and in today’s episode, you’re going to discover whether this fancy fat loss surgery actually works.

What Is CoolSculpting?

CoolSculpting is an alternative to liposuction in which a physician uses a non-invasive, tissue-cooling applicator. The way that it works is that the applicator is a vacuum that the medical professional puts over the area of tissue in which you want to lower body fat, like, say, your butt.

The applicator holds the butt between two cooling panels, takes all the heat out of that area and theoretically causes fat cell apoptosis (also known as fat cell death) fat cell reduction and loss of subcutaneous fat. But the way that the vacuum suction is set up is that it doesn’t actually cause damage to the skin, which means you get loss of subcutaneous fat without skin burns or frostbite. The idea is that you go in for a few sessions of fat layer reduction using this cool sculpting treatment and it would be something that you use instead of a comparitvely “outdated” surgical method such as liposuction.

So I looked up studies on this and there’s a few ones primarily done on animals. The technical term for this procedure is cryosurgery, which is surgery performed at very low temperatures and is a protocol usually used for tissue destruction (in this case, fat tissue destruction).

For example, one study that was done back in 2008 in (of all things) black yucatan pigs found that, when researchers did about ten minute long treatments of this fat based cold exposure to the pigs, the lipid area underneath the skin was significantly lower, and there was a loss of adipose tissue without actual injury to the skin and without scarring. So the results of the study indicate that you can actually get a localized loss of subcutaneous fat through this type of cooling.

What’s perhaps even more interesting, and something I talked about with Dr. Cate Shanahan on the episode How to Use Food As Your Body’s Fat Loss Language, is that in most cases, fat cells are ususally going to become other cells such as nerve and muscle cells or they’re going to shrink, which means you’re either going to get fat cell conversion or shrinkage of fat cells, but those cells still possess a capability to refill with energy from food that you eat and to still be able to enlarge if you begin over eating. For example, the muscle cells and bone cells or nerve cells that were converted from fat cells can get converted back into fat cells, and because of this, actual, true fat cell death (apoptosis) is something that can be pretty difficult to achieve. As I discussed in that episode, you can pull it off with exercise and healthy eating and very low levels of inflammation, but fat cell apoptosis or cell death is not the easiest thing to achieve. So why am I telling you all this? The thing that’s interesting about cryolipolysis is that it does actually cause controlled cell death of the fat tissue itself, so it’s as if you get rid of fat tissue and you don’t actually risk it coming back! Of course, this is assuming that after you’ve done the surgical procedure, you actually pay attention to your diet and your exercise plan and don’t necessarily use your fancy CoolSculpt as an excuse to eat Twinkies and sit around watching reality TV shows all day long.

Of course, the downside of any surgery such as this is how expensive it may be for you, whether it can be covered by insurance, and, ultimately, whether it is something that is going to be superior to just doing something like cold showers, cold thermogenesis, or the use of body cooling gear. Or you can consider simply going out in the morning in your backyard if you live in a cool area and doing some yoga on your back porch while it’s still a little bit cold. Another cooling technique is “shiver walks,” in which you go out for a walk in the brisk air in a t-shirt and shorts while it’s cold outside. All of these things can cause lipolysis, upregulation of  the fat burning enzyme lipase and a host of other cool (sorry, I couldn’t help myself) effects that this freezing cousin of liposuction doesn’t cause. For example, CoolSculpting can’t cause upregulation of adiponectin, a fat burning hormone that can reduce systemic inflammation, can increase burning of fatty acids as a fuel, can increase metabolism, can have some effects on risk of diabetes by elevating the burning of glucose and insulin sensitivity, can cause a decrease in inflammatory cytokines, an increase in pain tolerance, and an improvement in nervous system stability and the tone of the vagus nerve.

In other words, there’s all sorts of effects you can get from simply incorporating temperature fluctuations in to your day-to-day routine—effects that you’re not going get from something like CoolSculpting.

Ultimately, although proven to be efficacious for temporary spot reduction,

CoolSculpting surgery seems like a quick fix that doesn’t offer quite as many benefits as frequent cold showers, being OK with shivering every now and again, and engaging in other forms of cold thermogenesis.

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