Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
18 Feb

Weight Loss Shortcuts: Pills, Suction and Now… Lasers

Imagine a world where you could stroll into a clinic, spend fifteen minutes reading a magazine while a doctor’s assistant points a bizarre contraption at your backside, and skip out the door, down a few thousand bucks and twenty pounds lighter. Provided you had the money and the extra weight, would you do it? Would you be willing to take the ultimate weight loss shortcut? With less invasiveness than liposuction and fewer complications, it would be tough to say no. Just make sure you save money for new pants and a new belt on the same trip.

Low-invasive weight loss technology is getting there, believe it or not. Zeltiq Aesthetics, out of Pleasanton, CA, and Erchonia Medical, out of Texas, have both developed a fat-zapping cold laser gun which they say can and will realize a realm of weight loss heretofore claimed only by late night fitness infomercial charlatans: spot reduction. Yes – Erchonia’s Zerona anti-fat laser offers targeted weight loss by using low-level beams to cause “fat to seep out of a cell, almost like a balloon being struck by a needle,” into the lymphatic system, where it can be used as energy by the body. (Hmm, fat as an energy source? Now that’s just crazy talk.) Zeltiq’s system utilizes “selective cryolipolysis,” or cold-enabled fat cell homicide. Weight loss doesn’t happen immediately, though. It takes up to six forty-minute sessions to work (for Zerona), and a Zeltiq session kills fat cells over a two-month period. Patients in Zerona’s clinical trial lost an average of 3.5 inches total (give me two months and I’ll get you more than that). Okay, so it’s not quite strip mall insta-fat burn clinic territory just yet, but it appears to work on some level, enough to dethrone the likes of Suzanne Somers’ epic Thigh Master collection or the amazing electric ab stimulator.

I’m undoubtedly an enormous fan of lifehacks – of shortcuts that get you to your health or fitness destination without compromising the integrity of the trip. It’s why I’m partial to sprints (because they work both the anaerobic and aerobic energy pathways in a short amount of time), intense strength training using compound movements (because it promotes the best anabolic hormonal response without requiring hours in the gym), and the Primal Blueprint diet (I hate counting calories and stressing over food) itself. These shortcuts are proven to work without shortcutting the actual results or the many benefits. They’re only shortcuts compared to what Conventional Wisdom is peddling (Chronic Cardio, meticulous calorie counting, etc). My kind of shortcut isn’t really a shortcut; it just describes the simplest, quickest way to achieve a health or fitness goal. Does this laser technology represent a viable shortcut to weight loss?

It’s absolutely a shortcut, technically, if fat loss is your only goal. If it works, the lasers remove fat without resorting to scalpels in your flesh or vacuum cleaners embedded in your adipose tissue. In that respect, it seems to be a far better, safer choice than liposuction.

I’ve got to say, though, this certainly doesn’t qualify as a Primal shortcut. As a guy who’s mostly concerned with health, long-term sustainability, and fat loss as an ulterior benefit, rather than ultimate, expressed goal, I’m a bit dubious of the new technology. Provided they actually work as advertised – and there’s decent evidence that they do – I worry about the implications of a readily available, incredibly effective band-aid that completely covers up the symptoms of a problem. Traditional weight loss confers a number of benefits beyond just visible abs or looser pants. It also results in improved lipid numbers, increased lean mass, healthier organs, increased energy levels and longevity, and improved insulin sensitivity. Will killing your fat cells with a laser confer the same added benefits? Prohibitive pricing aside (and I’m sure this stuff will be pretty damn expensive, at least for the foreseeable future), if fat loss required absolutely no dietary modification and no exercise commitment, it isn’t a stretch to suggest that fat loss via technology won’t be as beneficial as fat loss via the old fashioned way. Tech-assisted weight loss probably wouldn’t be as sustainable, either, simply because bad dietary habits are best curbed by changing lifestyle behaviors. If you can simply kill your fat cells in a clinic without resorting to surgery, what’s stopping some people from eating just as poorly as before?

I wonder how this compares to bariatric surgery, which is usually used on only the most morbidly obese patients. Bariatric surgery isn’t so much about aesthetics so much as it’s about fighting the progression of obesity-related diseases (cardiovascular disease, diabetes, hypertension, etc). Most accounts say it works pretty well; there are a relatively high number of complications arising from invasive bariatric surgery, but the ones that work, seem to work quite well. People lose weight and reduce the impact of metabolic syndrome. If Zeltiq and Zerona can manage to do that, I’d be impressed. I doubt they do, though. Here’s why:

Bariatric surgery is still akin to going on a diet – albeit an extreme, forced, calorie-restriction diet. Whether your stomach is stapled or your nutrient absorption is surgically impaired, the end result is similar: dietary modification leading to fat loss and health improvements. The fat loss laser technology doesn’t require dietary modification, but it does burn fat. Where’s the ultimate benefit coming from? Is it from the loss of fat tissue, or is it the change in nutrition? The track record of liposuction – targeted fat loss and spot reduction without the need for changing your diet or exercise habits (sound familiar) – doesn’t bode well for the laser. There is a possibly minor, perhaps major difference between liposuction and Zerona tech, though, that should be noted; whereas liposuction breaks down the fat and physically removes it from the body, Zerona spurs the breakdown of fat cells and allows it to be used as fuel by the body. If the health benefits derive from the internal consumption of body fat stores for energy, Zerona might have an advantage over liposuction.

I’m not against technology. I love the stuff. I’m just immediately suspicious and skeptical of definitive claims by companies promising to use technology to streamline a millions-of-years-old physiological process as basic (and yet incredibly complicated and complex) as adipose tissue mobilization. Could it work? Sure, it could, and I’ll be paying close attention. I’m not going to hold my breath, though, and I’d advise anyone who’s struggling with their weight to do the same.

Remember – there are already proven, time-tested methods to lose weight and ensure you obtain the multitude of accompanying health benefits. It may require some actual commitment, plus the shunning of Neolithic foods like sugar and grains, along with a few bits of regular, intense exercise, but it isn’t hard. And best of all, it’s been working for hundreds of thousands of years. It’s not often that you’re privy to the results of an ongoing case study of billions as it evolves before your eyes.

That’s me, though. What do you guys think? Would you try this technology out if you had the money and a few stubborn inches to lose?

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. BOOM! First Comment!

    Ben wrote on February 18th, 2010
  2. lol I love the Boom first comment by Ben…

    This is pretty interesting stuff. Technology has always amazed me. But then again… we’re human and we’re over-reliant on it.

    Hopefully this gets used correctly instead of making a lot of skinny fat people who have heart attacks left and right.

    Randy wrote on February 18th, 2010
  3. I guess this would be appealing for the “I need to have my stomach stapled in order to learn portion control” crowd…

    Peggy wrote on February 18th, 2010
  4. This is a “great” option for those who just want to look good, not actually fell good. I would put it in the same category with face-lift, breast implants…

    There is nothing wrong with it, however it’s not for health reasons.

    TomGreenwald wrote on February 18th, 2010
  5. If it isn’t invasive, I see nothing wrong with using something like this to help you along. It goes without saying that lifestyle changes are much more beneficial, but the synergy of both?

    Allbeef Patty wrote on February 18th, 2010
  6. I hear you. Yes, clearly there is a distinction between cosmetic and health motives for this and related weight loss methods. Unfortunately, the distinction often gets blurred (maybe purposefully in some cases).

    Mark Sisson wrote on February 18th, 2010
    • The Dr. I work for has one of those! I think he works for erchonia though. He knows them well or teaches seminars for them. It looks cool. Not sure how well it works. He would not buy something that didn’t work though he tests everything. However; if people just do that to get rid of the fat they are still in a position to gain the fat back once it is off because they will most likely eat the same crap food and not fix the problem.

      kev wrote on February 19th, 2010
    • I have a friend who has been overweight for a while (even having switched to mostly Primal – actually to battle MS), and I have to say, sometimes it’s their own feelings of insecurity which prevents them from taking that next step and doing HIIT or Crossfit or the like. If this makes them feel more comfortable in a gym or in yoga pants, and THAT leads them to squats, KB swings, the like, then so be it. My two cents.

      Love the article!

      SemperViator wrote on April 24th, 2012
  7. Thousands of dollars for a 3.5 inch reduction? Jeez. I’ll take the sprints. And the bacon.

    Meghan wrote on February 18th, 2010
    • I’m with you. Bacon and sprints all the way.

      Ben K wrote on February 22nd, 2010
  8. I guess it would be appealing to those looking for a quick fix or another option. Then again, if you haven’t learned how to control your eating and to exercise effectively, you will only keep shelling out grand after grand to maintain.

    For me natural is better.

    Pamela wrote on February 18th, 2010
  9. Me, too, Meghan. I’ll stick to my workouts and good meat :)

    Organic Gabe wrote on February 18th, 2010
  10. Can’t say I’m a fan at all.

    More money wasted to develop things that will spur people to waste more money – instead of inspiring people to live more simply, eat real food, get out and about, we create high-tech gadgetry that draws like moths to a flame.

    It does us absolutely no good in the end, simply creates more waste and reinforces a dependence on monetary systems that do not work in our favor. Whereas concepts espoused by the WAPF, Mark here, Richard Nikoley, the Slow/Real Food movements, etc. can bring us closer to independence and self-reliance, along with long-lasting, REAL results.

    Aaron Fraser wrote on February 18th, 2010
    • Thank you! I completely agree. It’s just another wasteful service to perpetuate and worsen the status quo.

      Kristin J wrote on February 18th, 2010
    • a men brotha

      Krista wrote on February 22nd, 2010
  11. Hmmm… metabolizing all that fat. I wonder who will be the first CW health expert to say that all that arterycloggingfat that’s suddenly being unleashed on your system from the laser treatment is bad for your heart? Probably nobody. That would hurt profits. But forgoodnesssakes don’t EAT the stuff they say.
    These people contradict themselves at every turn.

    Dave, RN wrote on February 18th, 2010
  12. Mm I’m reminded of people who smoke with one hand whilst using their ventiliser with the other.

    Mark Tyrrell wrote on February 18th, 2010
  13. I don’t think the psychological effects of “earning” your health can be over-stated.

    Hard work, accountability and giving are truly the building blocks of self-esteem.

    Shortcuts do nothing to build character.

    But when faced with a workout that you don’t want to do, or perhaps one that is even a little intimidating and you overcome it, or you are tempted to “just eat like everyone else” and go back to grains and sugar but you refuse to give in, choose to ENJOY “primal” foods and reap the rewards of those choices, then you not only grow fitter- you also gain mental toughness and confidence that can carry through to every other aspect of your life.

    The workouts and good nutrition choices cover the hard work and accountability. Give freely to others what you are able, and you have all the ingredients of healthy self-worth.

    None of these benefits are to be gained from an effortless shortcut.

    PXT Cody wrote on February 18th, 2010
    • The psychological effects of realizing some size reduction can’t be understated either.

      I think most fat people- and former fat people- would agree with me that slow progress can suck the inspiration right out of you.

      Allbeef Patty wrote on February 18th, 2010
  14. I see the point, but unfortunately *most of those who seek “quick fix” weight loss surgeries are those people who have NOT put in the years of hard work to become a healthy individual by adopting a perfect diet and daily exercise routine / lifestyle habits. It’s not an excuse to eat crap and be lazy.

    This alternative makes perfect sense for a person who has put in the long hard work of a healthly lifestyle, who is physically fit, moderate/low BF%, and is in great health….but wants to change the particular SHAPE of their body. We all have a unique shape and some (moreso women) will try everything to change what is genetically given to them. Regardless of perfect diet, exercise and the like, if you’ve got hips – CONGRATS! you’re a woman.

    I get it. They should tailor it more toward people who already have a health and fitness though.

    CrashDummy wrote on February 18th, 2010
    • I’m with you CrashDummy. I’ve been working long & hard on myself via the PB principals but as a hypothyroid patient there is nothing more frustrating that having all my efforts amount to very little in the fat loss dept. So I will probably do this procedure once my doctor (one of the best in NYC) offers it. I know most people refuse to take any responsibility for their health and will flock to this, but that’s not true in my case. Besides there are just some areas of fat that will not go away, no matter how much I Grok on, sadly. This looks like it could help and continue to keep me motivated, so I say bring it.

      marcib wrote on February 18th, 2010
      • amen, marcib…. i’m hypothyroid, too, AND a middle-aged woman — talk about finding it hard to lose pounds OR inches! and since i’ve been eating low-carb for about six years now, just switching to a purely primal diet didn’t give me that initial loss that’s so encouraging. if i’m lucky, i’m able to lose a pound every couple of weeks. a procedure like this would be awfully tempting, since i CAN keep it off, if i’m able to GET it off in the first place.

        tess wrote on February 18th, 2010
        • Hey ladies!
          There is a new book I want to bring to your attention, because it might help you finally get your thyroids working properly!!
          Most hypothyroid conditions are not being adequately treated. If you can’t lose weight, I’d wager you’re not really being properly treated.

          Dr. Datis Kharrazian ha written a book outlining 6 different subtypes of low thyroid function, how to identify them by blood work patterns and what to do about them. He says very few people actually need thyroid medication and more thyroid patients have autoimmune disease than we realize- very serious stuff!
          I’ve NEVER come across this depth of info in any other thyroid books!
          http://www.thyroidbook.com/

          PS- he recommends a gluten-free, low carb diet, so you’re already on the right track;-)
          You might want to look into HCG also. It truly does work when your metabolism is totally shot (it reprograms the hypothalamus, which also benefits the thyroid). I’ve used it and know several people who have successfully used it.

          Erin wrote on February 19th, 2010
        • I second Erin’s recommendation. Dr. Kharrazian’s book is essential for anyone with hypothyroidism because he explains the root cause and how to handle it. His is the most cutting edge protocol for thyroid problems, and it’s the one I use in my practice. What I learned from him goes way beyond what’s taught in school.

          Next, as far as the Zerona or other lasers for fat loss, I agree with most people here that it can be used as a way to lose fat in lieu of eating well. That said, while I do not own one, I do like the option of referring my patients who HAVE changed their diets and ARE addressing their blood sugar, thyroid & adrenal issues to someone who can help them accelerate their weight loss. If it helps keep these people motivated & “on the wagon,” I’m ok with it.

          And last, these lasers do not release fat cells to be used as fuel. The way they work is by creating holes in the cell membranes of fat cells – and ONLY fat cells – allowing the contents to flow out. The body then uses it’s multiple pathways to excrete the contents as it would any other unwanted material. The trick is to make sure all of your elimination pathways are working efficiently!

          Hope that helps,
          Dr. C.

          Avery Carpenter wrote on February 22nd, 2010
        • Dr. C,

          I would like to know why the body excretes the fat instead of burning it. That it is excreted and not burned is what the company reps say when they are marketing the machines, but they can’t say why.

          Is it because the fat was not released from the cell using the normal metabolic pathways so that the body then doesn’t recognize it as fuel?

          And once it is released, where does it go? I assume it is into the lymph system which dumps it back into the blood stream which would send it back into the liver, but then what?

          As you can see by the other comments, I’m not the only one that wonders about this.

          Julie wrote on February 22nd, 2010
        • I’m grossly overweight, fatigued, but have have no interest in food. I only eat it when I have to (or socially). My diet is 50% fats, 30% carbs, 20% protein. BUT my average calorie intake is 1200.

          Unfortunately, I have tachycardia when WALKING…slowly so can’t do any sprints etc.

          I can’t exercise more, nor can I eat less. This laser may be the thing I need.

          What I am worried about it fat redistribution. I have heard that lipo from the main areas result in fat gain in other areas like the back of the neck!

          gina wrote on June 2nd, 2012
  15. I am reminded of post on Stephan’s blog
    http://wholehealthsource.blogspot.com/2010/01/body-fat-setpoint-part-iv-changing.html
    about people who have been obese having trouble with weight set points due to leptin resistance. A woman replied that actually the leptin problems are caused by the fat depleted cells that are still there after the weight loss. It would seem to me that a procedure such as liposuction or these laser technologies might be useful to someone who has made the lifestyle changes and needs to get rid of some of the bazillion shrunken but present fat cells still hanging around. If these vestiges of an unhealthy lifestyle are still there causing havoc on your endocrine system AFTER you’ve made the lifestyle changes, I’m all for anything that truly annihilates them.
    Have I missed something in the science here?

    Christine wrote on February 18th, 2010
  16. Soooo, it kills the cells so fat is released to be used as fuel. What happens if you don’t need to use that fuel? Does it simply get stored again as fat in a new cell? Sounds like this treatment would have to be used with major diet/exercise changes anyway.

    Jennifer wrote on February 18th, 2010
  17. What would be wrong with doing both? Quick fix augmented with a change in diet and exercise?

    Emily wrote on February 18th, 2010
  18. You’re not being entirely clear; does the treatment ‘kill’ fat cells or deplete them?
    Having no (or less) fat cells would make you diabetic within a month.

    Naomi wrote on February 18th, 2010
  19. When will people realize that it’s so much easier and less costly and healthier to just not put on the weight in the first place?! And you’re completely right – this procedure doesn’t do much to improve your health or teach you any lessons about your body. Just a band-aid for a huge problem. No pun intended

    Hugh wrote on February 18th, 2010
    • When people learn that they shouldn’t have stepped in front of that bus.

      Allbeef Patty wrote on February 18th, 2010
      • It must be so wonderful to be so perfect like you, shame you cant see further than your own little world.

        michiela wrote on March 21st, 2010
  20. 1. If the fat is just released and used as fuel, would you have to eat less in order to make up for the sudden influx of your own fat calories? If you’re still in a surplus, won’t that fat just get stored somewhere else?

    2. Some people say that our fat cells are holding all sorts of stored toxins (environmental, etc.). If true, how will a massive jolt of these make you feel?

    3. That being said, I’m under 9% body fat and still have annoying fat deposits from when I was very fat (7 years ago) while the rest of me is as lean as I ever need to be. If this is laser “spot reduction,” that would be tempting…

    4. You gotta love yourself, I think, before you can effectively lose the fat you want.

    5. There really is no fifth element.

    Roland wrote on February 18th, 2010
    • “That being said, I’m under 9% body fat and still have annoying fat deposits from when I was very fat (7 years ago) while the rest of me is as lean as I ever need to be. If this is laser “spot reduction,” that would be tempting…”

      I have to admit I know a lot of people (including myself) in a similar position: they changed their lifestyle, lost weight, got way healthier but still have a couple fatty areas that aren’t up to par with their fitness standards (or even the rest of their bodies). I can see how a quick-fix would be tempting. But at the same time, it is better to just learn to love yourself (as you said, Roland), and stop trying to achieve perfection in an imperfect world. Easier said than done, sometimes, though.

      Elizabeth wrote on February 18th, 2010
  21. So they are losing fat… But without muscle underneath they will still be just as gross looking. Being skinny-fat is not attractive… But if all they are going for is having less inches of gut sticking out of their business suit, and they have a ton of money, and no desire to FEEL healthy, then heck, let them.

    Boon wrote on February 18th, 2010
  22. “low-level beams to cause ‘fat to seep out of a cell, almost like a balloon being struck by a needle,’ into the lymphatic system, where it can be used as energy by the body” — If the energy that got converted to fat in the first place wasn’t used to begin with (why it got stored as fat), when it gets re-released into the system by these lasers what will prevent it from just getting re-stored as fat immediately after the “surgery”? Seems like a very quick energy overload that could cause a lot of harm.

    J Turnage wrote on February 18th, 2010
  23. Keep in mind adipose tissue doesn’t just surround the belly, butt and thighs – it also surrounds our internal organs. While a device to effectively spot treat visible fat deposits on more superficial areas of the body may offer a cosmetic boost, it won’t do much to help internal organs strangled by fat. These fat deposits carry all the same risks as the more visible forms of obesity and a treatment like this might just make this problem worse.

    Zac wrote on February 18th, 2010
    • Visceral fat is worse, actually. Subcutaneous fat is relatively benign.

      Kim wrote on February 20th, 2010
  24. Unless the person who is having it done is willing to change their eating habits forever, it’s just a high tech version of bulimia. Very sad.

    Suzan wrote on February 18th, 2010
  25. Perhaps the problem is that so many people think surgery is the only possible way for them to lose weight. After all, they’ve tried the CW for years and it never worked, so it’s understandable if they conclude that their body composition is inherent flawed and needs surgical correction.

    People simply don’t realize how they can change their genetic expression just by tweaking key elements of their environment. I never did before coming here. We can only hope that more people discover the Primal Blueprint, or something like it, before they resort to these dubious surgeries.

    Timothy wrote on February 18th, 2010
  26. “That being said, I’m under 9% body fat and still have annoying fat deposits from when I was very fat (7 years ago) while the rest of me is as lean as I ever need to be. If this is laser “spot reduction,” that would be tempting…”

    I do understand this, but it saddens me that someone is so bothered by a shape that is very healthy (I assume, if you are PB-ing it) and clearly reflects a huge personal achievement (you go!) but just doesn’t fit with what society has decided is in proportion with the shape du jour.

    I’ll bet lots of your friends are so envious of your body – love it girl and don’t let some nasty doctor peddle you such an INVASIVE (don’t call it non invasive, that is a misuse of the word) treatment.

    I dream of a world where one day people look at this kind of treatment and go ‘hell no!’, I’m as healthy as can be, I am not messing that up because Cosmo has decided a new skirt length is fashionable (I’ll bet there is an era your body is just perfect for).

    Spend the money on higher quality meat… or a trip to go trekking… or give it to charity and have psychological health glow to go with your physical one.

    Just my 2c (probably motivated by having the WEIRDEST body shape myself).

    Lekki Wood wrote on February 18th, 2010
    • It would have to be extremely inexpensive and pretty foolproof to actually tempt me. I’m happy with my body and performance, I’m just not thrilled with the “loose skin” caused by residual fat hanging out under there. :)

      Roland wrote on February 18th, 2010
  27. What is interesting if you read the clinical report, is that 2 weeks after the procedure, the test subjects gained back almost 1/3rd of an inch, so unlike a real life-style change, or a surgery, this is at best a very short term fix and probably not sustainable. Furthermore to qualify for the study (according to clinicaltrials.gov) the subjects had to have a BMI of 30! I would have a hard time believing this technology will endure or prove to have any lasting health effect

    Tom wrote on February 18th, 2010
  28. This just drives me crazy. It is in total alignment with our take no responsibility for thyself world. Have a problem? No problem. Someone else will bail you out. Working hard is by far the better way.

    Greg wrote on February 18th, 2010
  29. What a joke. I know this truly isn’t a joke but damn… what has this world come to?

    This will only cause more people to become fat. There is only one true way to lose weight… live healthy!

    There is one true way to cure most of the chronic diseases that are killing millions of people each year… live healthy! It’s that simple :) Mark knows a little bit about living healthy and so do thousands of others! Hooray!

    Time to go live life instead of sitting in front of the TV for 5 hours because I know that technology can allow me to just go back to normal weight. Toodles.

    Todd wrote on February 18th, 2010
  30. You should look at some of the comments at realself.com. It has reviews of the Zerona laser. Terribly ineffective, only 23% of people who have done it say that they have any result. I do not think this is the answer. Also, of those that have had results, they were given liquid diets, wraps and all sorts of other things. The cost is just outrageous for such poor results. Liposuction is still the “gold standard” for “spot reduction”. Like it or not.

    Tracey wrote on February 18th, 2010
  31. You should look at some of the comments at realself.com. It has reviews of the Zerona laser. Terribly ineffective, only 23% of people who have done it say that they have any result. I do not think this is the answer. Also, of those that have had results, they were given liquid diets, wraps and all sorts of other things. The cost is just outrageous for such poor results. Liposuction is still the “gold standard” for “spot reductio

    Tracey wrote on February 18th, 2010
  32. I am nurse and I work at an anti-aging clinic that my sister (a doctor) owns. We have an aesthetic side (hair removal, peels, skin rejuvenation etc) as well as a bioidentical hormones side.

    Coincedentally, we have been researching these machines for the past couple of months trying to make the decision on whether to buy one or not. I have done the research on the Zerona, but we are leaning towards another device that uses radio frequency called Lipo Ex.

    We are a small clinic so a purchase like this (upwards of $100,000) is huge and we have learned from prior mistakes not to just take the company rep’s word for whether they work or not. So I have called and spoken to clinics around the country that have bought one and are already using it to see if they really do work. Conclusion: most of the time yes.

    But I’m like many of the commentors and I wonder a)why it sometimes doesn’t work and b)what exactly happens to the fat once it is released. In an effort to get an answer to the second question, just last night I emailed Peter over at Hyperlipid in the hope that he can shed some light on the topic. I’m still eagerly awaiting his response.

    As for clients who experience mixed results, I wonder if it has anything to do with the amount of insulin they have circulating in their body. I too don’t see any reason why the body wouldn’t just suck it right back up into the fat cells if there was any insulin hanging around. (That’s actually one of the questions I asked Peter about.) These types of treatments are expensive and I want to ensure the highest success rate possible if I’m going to recommend them to people. (To me, the answer seems simple, tell the clients to eat low carb/no carb during treatment to keep insulin production minimized. And yes, that in itself would cause weight loss, but with the added benefit that you get to decide which part of the body the fat comes from.)

    For the record, even though I am (partially) in the aesthetic field, I have a serious weight problem. At 5’9″ and 280 lbs, I am morbidly obese. This despite the fact that I have been a nurse for 20 years and have read and tried every diet that came down the pipe since the 1980’s – including Atkins in the 90’s and Cordain’s version of Paleo just last year. (Atkins gave me severe indigestion so I had to stop and I feel Paleo didn’t work last year because of the low fat emphasis. I have been Primal now for 3 weeks, lost 10 lbs and no longer care about carbs, sweets or junk food.)

    So I know what it is like to want desperately to lose weight and to pour your heart and soul into trying to understand the science with the only result being that I got fatter and fatter every year. I agree with Gary Taubes that it isn’t fair to accuse obese people of sloth and gluttony as the cause of their obesity. What a coincidence that would be if I just happened to develop a ‘stronger character’ at the exact same time I began a Primal lifestyle. (Nah, hormones have nothing to do with it. But I digress.)

    My sister and I would love to have an effective diet to recommend to clients at our clinc, but since nothing has worked for us (my sister too is overweight, but only about 30 lbs or so)we have been at a loss. In fact it was my sister who gave me the PACE Program book by Dr. Al Sears that very quickly led me to finding Mark’s blog.

    I now know without a doubt that through the Primal lifestyle I have found that diet that we can recommend to our clients. However, I have a lot of weight to lose before anyone will even start to listen to me when I tell them they need to eat fat to lose weight. (Not even my sister. She’s letting me be the guinea pig.) So adding diet/lifestyle changes to the services we offer at the clinic is at least a year down the road.

    But even then, there will always be people who want to spot reduce for one reason or another. Right now we offer Lipo Dissolve in order to accomplish that, but it is a very painful procedure that gets mixed results for a variety of reasons. But because I am already treating clients that want to spot reduce, I can say that none of them have the belief that spot reducing will have any affect on their health. Most of them are Chronic Cardio kings/queens so are skinny fat with the typical stubborn areas that just won’t lose the fat. I would love to offer those that want it something that is noninvasive and safe. (And yes, it is non-invasive.)

    As for the reviews on RealSelf that one commenter mentioned, I go on there a lot when I’m researching something because it’s a good place to find out what the downside is, but the reviews on RealSelf are always scewed towards the negative. Most people that are happy with the results don’t go back to report their experiences, not like those that are unhappy and mad.

    So, to end this very long post, I personally am excited about this new non-invasive spot reducing technology. Unlike liposuction or lipo dissolve, there is no downside. And it does make people feel better about their appearance because, for whatever reason, the minor imperfections drive a lot of people crazy. But like I said, people don’t do it to get healthier. (Oh, by the way, speaking of getting healthier, the Lipo Ex that we are looking at does treat visceral fat so there is a possibility that it might have some health benefits – while clients transition to a Primal Lifestyle if I have my way.)

    Julie wrote on February 18th, 2010
    • I appreciate the lengthy post, good to have some history. We’re glad to welcome you to the community. Best of luck living life as it should.

      wd wrote on February 19th, 2010
      • Thank you WD. It took a few decades, but I’ve finally found the answer.

        Julie wrote on February 19th, 2010
  33. Hi Mark and everyone else! I just read your article on weight loss plateaus and saw that many people commented on lossing fat by cutting nuts and berrys…those make us the majority of my snacks! No wonder! Any suggestions on what I can replace them with. What are some snack alternatives??

    Eric wrote on February 18th, 2010
  34. I don’t think this kind of substitute can (or should) be a substitute for going primal. However, there are some benefits in specific cases. For example, the fat that accumulates on the stomach below the waist has been found to be exacerbate insulin resistance in Type II diabetes. Removing the fat may provide some assistance in glucose control.

    Personally, I’ve had to deal with the impact of insulin stimulating drugs on my attempts to go Primal. The laser procedure could be a help in this respect if it reduces the need for drugs like Glyburide.

    BTW – I’d appreciate any information about going Primal for diabetics.

    Paul wrote on February 19th, 2010
  35. I am absolutely against it for a quick fix, lazy way out. There are no health benefits to this. As someone who can’t seem to get rid of the belly fat, even when all the rest has gone, not so opposed to it. But I’m not one to spend that kind of money on something like that, so I’ll have to keep trying the old-fashioned way and what could be older than Primal?

    Just got my “Primal Blueprint” book on the mail yesterday!

    Melissa wrote on February 19th, 2010
  36. I haven’t seen a response yet to Christine’s comment about the bodyfat setpoint thread at Stephan’s blog… basically the idea that people who have been very overweight end up with LOW leptin after they lose weight b/c if they do reach their goal weight, all of those extra fat cells that were created are now emaciated and therefore not able to do THEIR hormonal job, one of which is to signal leptin. Either that or the person is not able to get to their goal weight b/c of all of the extra fat cells that are created. So by getting rid of some of these ‘xtra’ fat cells, the remaining fat cells can re-inflate to normal levels and therefore act normally. So could this technology help with that?

    Tracy wrote on February 19th, 2010
    • I haven’t read Stephan’s stuff about extra fat cells and leptin, but I can say that these newer technologies that Mark wrote about (as opposed to liposuction or lipo dissolve) do not destroy the fat cell. They only cause the cell membrane to open a pore and let the fat out. The pore then closes and the fat cell goes on.

      (Well, except for the newest one – Zeltiq I think – that does freeze the cells, but I considered it the worst of the choices.)

      Julie wrote on February 19th, 2010
    • I think I’m going to ask Stephan directly what he thinks about this.

      Christine wrote on February 22nd, 2010
      • I read Stephan’s stuff on body fat set points this weekend. I’m looking forward to hearing his take on it. Please let us know!

        Julie wrote on February 22nd, 2010
  37. I’m just immediately suspicious and skeptical of definitive claims by companies promising to use technology to streamline a millions-of-years-old physiological process as basic (and yet incredibly complicated and complex) as adipose tissue mobilization”

    Sorry to be this brusque but when you follow their claims with “give me two months and I’ll get you more than that” you seem to fall squarely into the self same trap they do.

    simon fellows wrote on February 19th, 2010
    • I’ve been following Mark’s Primal lifestyle for less than two months and I am down 20+ lbs and feel better than I ever have. I am 46 and am amazed at my energy and general better outlook on life. So yes, I think he can say he can give us more than that.

      pecanmike wrote on February 19th, 2010
    • I do understand that some clinics get carried away with their advertising. That is unfortunate. These devices are not meant for overall weight loss. They are for sculpting discreet areas. However, these new machines work well enough that a few pounds can be lost. Maybe up to 15 lbs in exceptional cases, but I doubt those exceptional cases were real thin to start with.

      Julie wrote on February 19th, 2010
  38. Ever since I found out that fat cells are not just storage depots but metabolically active I don’t think I could seriously consider something like this. I think our hormones are messed up as they are and we don’t need to exacerbate the situation especially in relation to Leptin. I also think the big problem with most overweight people such as my self is not the fat the but skin that sags after you lose fat. I would like to see someone work on that other than just surgery. I know I am dreaming.

    thecarla wrote on February 19th, 2010
    • Well, just to once again emphasize, these machines are not a weight loss program. They are for sculpting problem areas. That said, we are interested in the Lipo Ex more than any of the others because it does heat the collagen in the skin during the treatment to a high enough degree that remodeling can occur. That means that it can accomplish some skin tightening. How much each patient achieves depends on various factors such as genetics and nutritional status.

      Julie wrote on February 19th, 2010
  39. I have a cousin who did the gastric bipass thing. That was several years ago and she lost a lot of weight. Over the years, she has stretched her new stomach back out and is now nearly as large as she started.

    Leathermarshmallow wrote on February 20th, 2010
  40. Eat fewer calories than you burn and you’ll lose weight — that’s the magic bullet. Eating primally is an added benefit of doing it the right way. The masses want shortcuts.

    Sterling wrote on February 20th, 2010

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