Trying to Freeze Your Fat Cells Away Could Wind Up Backfiring

Imagine this for a minute: There’s an area of fat in some part of your body that you can’t seem to get rid of. Diet and exercise has worked everywhere else. But that stubborn pocket of fat just won’t shift no matter what you do. Wouldn’t it be great if there was some way to kill off those fat cells? To get rid of that stubborn fat once and for all without going under the knife and having liposuction?

According to conventional wisdom, your fat cells are with you for life. They might shrink during weight loss, or expand in size when you gain weight. But they never go away completely. In fact, that’s only partially true: While the selective destruction of fat cells is not easy, it can be done. So how do you go about it? You kill a fat cell by making it cold.

The concept of “freezing your fat away” without diet or exercise sounds like the sort of nonsense you might see on the "Dr. Oz" show. However, there is some science behind it. The idea of using cold to kill cells isn’t a new one. Cryosurgery, as it’s known, is used to treat several types of cancer, as well some precancerous or noncancerous conditions.

The technical term for the use of cold to destroy fat cells is cryolipolysis. The term ‘cryo’ is the ancient Greek for cold, while ‘lipolysis’ refers to the breakdown of fat. Essentially, cryolipolysis is a nonsurgical alternative to liposuction, so there are no needles, scalpels, or scars. It’s often referred to as a “lunchtime procedure,” as there’s very little downtime. No skin is sliced and no blood is shed.

Instead, your “problem flab” is sucked into what looks like a big vacuum cleaner, which draws a roll of skin and fat between two cooling plates. These cooling plates then gradually lower the temperature of your fat cells.

Fat cells are more sensitive to the cold than skin. While the plates aren’t cold enough to freeze your skin, they are cold enough to chill the fat cells just enough to trigger a process called apoptosis, or cell death. In short, cryolipolysis selectively destroys fat cells without damaging surrounding tissue. Your body then naturally clears out the dead fat cells over the following weeks and months.

The most common treatment areas for men are the lower abs and love handles. For women, it’s the thighs. Cryolipolysis also been used to get rid of submental fat, which refers to the fat under your chin. A typical treatment lasts between 30 minutes and one hour, and promises to reduce the number of fat cells in the treated areas by 20 to 25 percent. Now, the important question: Does cryolipolysis work? While I can’t talk from experience—I've never used it myself—the research does appear promising.

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A blinded comparison of pre- and post-cryolipolysis treatment photos of 50 subjects shows that physician reviewers were able to differentiate the two sets of photographs 92 percent of the time. In a review of cryolipolysis, published in the journal Plastic and Reconstructive Surgery, researchers report that the average reduction in fat volume in the area being treated ranged from 10.3 to 28.5 percent.

Here’s how they sum up their findings: “Cryolipolysis is a promising procedure for nonsurgical fat reduction and body contouring and presents a compelling alternative to liposuction and other, more invasive methods. This procedure appears to be safe in the short term, with a limited side effect profile, and results in significant fat reduction when used for localized adiposities.”

All things considered, cryolipolysis does appear to be a relatively safe and effective way to reduce the size of small, localized deposits of stubborn fat. Most people who use it report being “extremely satisfied” or “satisfied” with the results.

However, there is a darker side to cryolipolysis—one that reminds me of the scene in Star Wars: A New Hope when Darth Vader strikes down Obi-Wan Kenobi. Vader was warned that doing so would leave Kenobi “more powerful than you can possibly imagine.” But Vader paid no attention, and did it anyway. Attempting to “strike down” your fat cells may end up backfiring in an equally spectacular fashion. It's possible for the whole procedure to go wrong, leaving you with even more problem fat than you had before the treatment.

One case report involves a 41-year old man who had a single cycle of cryolipolysis performed on his abdomen. Three months later, the area that had been treated started to grow, a phenomenon dubbed paradoxical adipose hyperplasia, or PAH for short.

With PAH, the treated area becomes larger rather than smaller, leaving a "painless, visibly enlarged, firm, well-demarcated mass" under the skin.

In other words, cryolipolysis may end up doing the exact opposite of what you want it to do. Instead of the treated area shrinking, the bulge ends up bigger and firmer than it was before, looking remarkably similar to a “stick of butter” that’s been shoved under your skin. You may end up needing liposuction, or even an abdominoplasty (tummy tuck), to get rid of it.

Problem is, nobody is sure exactly how common PAH is, or even why it happens. The manufacturers estimate that PAH affects 1 in 20,000 treated patients, with some reports suggesting that men are at greater risk than women. However, recent studies suggest that PAH occurs far more often. One study found that the incidence of PAH is 1 in 221 treatments, while another puts it as high as 1 in every 100 treatments. That’s 200 times higher than what the device manufacturer reports.

One woman who had cryolipolysis likened it to Russian roulette: She had three treatments to get rid of her stomach roll and muffin top. But instead of getting smaller, the areas ended up looking three times bigger than they were before the treatment.

The bottom line is that while cryolipolysis isn’t going to help you lose large amounts of fat, it may help you shift those pinchable, hard-to-lose deposits of “stubborn” fat. The amount of fat lost, however, is relatively modest. At best, you’re only going to lose a thin layer of fat under the skin.

What’s more, there is a small possibility that the whole thing could go wrong, leaving you with a hard, unsightly lump of flab that’s bigger and more prominent than it was before. You may well end up wishing you hadn’t bothered.

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