Is CoolSculpting a Healthy Way to Get Rid of Stubborn Fat?
Over the years, it’s become clear that the best way to lose weight and keep it off is to alter your eating plan and activity level. So, when a procedure like CoolSculpting comes along that promises to help you lose weight in certain areas without surgery by freezing fat, it’s understandable to be skeptical. That’s why plenty of people have the same question: Does CoolSculpting work?
It’s important to point out that CoolSculpting isn’t exactly a magic weight loss elixir, but there is data to support its use—in the right person. OK but what’s the deal with CoolSculpting and how does this work, exactly? Here’s everything you need to know about this fat-freezing procedure.
How does CoolSculpting work?
During a CoolSculpting treatment, a physician places an applicator onto your problem area and it “sucks” up a bulge of skin, working to freeze fat below the surface, says Heidi Waldorf, M.D., an associate clinical professor at the Icahn School of Medicine of Mount Sinai University. CoolSculpting, also known as cryolipolysis, is FDA-approved for the chin area, thighs, abdomen, bra and back areas, underneath the buttocks, and upper arms.
During the treatment, you might feel an initial suction and coldness, but it quickly fades to numbness, notes Dr. Waldorf. After the application, radio waves or manual massage work to break up frozen fat cells which then die, and are eventually eliminated via your body’s normal processes, she says.
In the days following, you might be slightly sore—as if you exercised the area you had treated. A week later, your skin might feel a little itchy. Most people see results—say, a reduction in a jiggly area or slimmed down outer thighs—in one to three months, Dr. Waldorf says.
The biggest benefits are the lack of anesthesia, downtime, and the non-invasive nature of the process. That means less time for recovery (no need to take a day off) and you’ll be awake as it happens.
Who is CoolSculpting for?
CoolSculpting is cleared by the FDA to treat nine different areas of the body, including:
Under the jawline
Under the chin
Love handles
Abdomen
Thighs
Bra fat
Upper arm
Back fat
Banana roll (fat that accumulates under your butt)
“People concerned about excess fat in certain body areas might turn to CoolSculpting,” says Fatima Cody Stanford, M.D., M.P.H., M.P.A., an obesity medicine physician and clinical researcher at Massachusetts General Hospital.
But Dr. Stanford says this really isn’t a procedure for someone who has obesity. “Obesity is a chronic, relapsing, remitting disease characterized by excess fat storage in the body,” she explains. “To treat the disease, we must use strategies—behavioral, lifestyle, medication, and surgery—to address the body’s storage of excess adipose.” CoolSculpting, she points out, does not encourage the body to store less fat. Instead, she says, “it is a cosmetic procedure with no cardiometabolic benefit.”
How long does CoolSculpting take?
You’ll need to carve out some solid time for an appointment. Treatment sessions last between one and three hours on average, depending on the area you’re having treated, according to the CoolSculpting website. For most people, two or more treatments are recommended to help them reach their goals.
How much does CoolSculpting cost?
Since CoolSculpting is considered a cosmetic procedure, it’s not covered by insurance. Cost depends on the number of treatments you get and the areas being treated, but typically ranges from $2,000 to $4,000, which is around the same cost of liposuction. “Many patients return for additional treatment of the same or other areas in order to further sculpt their shape,” notes Dr. Waldorf.
Should you try CoolSculpting to lose weight?
CoolSculpting is actually safe when it’s done properly. One 2015 review of 19 studies on the topic published in Plastic and Reconstructive Surgery concluded that the procedure helps get rid of fat with limited side effects, like swelling, bleeding, pain, or scarring.
“Over six million treatments have been done worldwide and over 70 articles and abstracts published. No other noninvasive device has that degree of evidence or experience behind it,” says Dr. Waldorf.
But it’s not for everyone—nor is it a quick fix for weight loss. “CoolSculpting removes 10 to 20 percent of the fat targeted with each treatment,” says Dr. Waldorf. “That’s very different than liposuction, which can remove 70 to 90 percent of the fat.”
The ideal patient: Someone who is at a stable weight and just has some persistent stubborn areas of fat that don’t respond to normal exercise and diet, like an area on your tummy that just won’t budge no matter how healthy you eat or how many planks you do, says Dr. Waldorf.
However, if you’re looking to shed serious pounds, freezing fat isn’t the best game plan. “It really works for a very niche population,” says clinical exercise specialist Charlie Seltzer, M.D., a Philadelphia-based physician who is board-certified in obesity medicine. CoolSculpting is not meant to treat your back, then your love handles, then your stomach, and then your arms as an end-all-be-all for weight loss.
Even though the two are related, body fat is mainly determined by how much fat is in your fat cells themselves, not by how many fat cells you have. If you’re overweight and you try to freeze away a bunch of fat cells (eliminating the sheer amount of fat cells you have), but you don’t change your unhealthy habits, the fat cells you do have will still pick up excess calories and store extra fat if you keep overeating, he notes.
“If you’re doing the procedure as a means to improve body composition, you’ll end up right where you were before unless you change your habits,” says Dr. Seltzer.
And if you do makes some serious lifestyle changes? You might not need the procedure at all. Exercise, healthy eating, and eventual weight loss will help your existing fat cells hold less fat.
Dr. Waldorf does note, however, that people actively trying to lose weight do report feeling better at the gym and in their clothes with CoolSculpting treatments. “Coolsculpting isn’t a method of weight loss but can reduce those jiggly areas and the areas that make clothes feel tight,” she says.
Overall, though, Dr. Stanford says that it’s “important for people to realize that CoolSculpting does not destroy fat cells.” Instead, she says, “CoolSculpting temporarily shrinks fat cells.”
Who should avoid CoolSculpting?
Safety information for the treatment notes that there are some people who should steer clear of CoolSculpting. Those include:
People with metal, electrical, or electronic implants or devices like pacemakers, implanted hearing devices, defibrillators, neurostimulators, drug pumps, or hearing aids
People who are menstruating (the procedure has been linked to increased cramping)
People with epilepsy
Those who had recent surgery
Pregnant people
People with seizure disorders
Those with active bleeding disorders
What are the risks and side effects of CoolSculpting?
Even though CoolSculpting is considered to be a relatively safe procedure, your treatment may come with a few side effects. During the process, you might experience a tugging or pinching sensation, intense cold, aching, or cramping around the area you’re targeting.
In the days after your procedure, you may experience some redness, swelling, pain or tenderness, bruising, stinging, soreness, itching, or skin sensitivity, all of which should improve within a few days, but can persist for a few weeks. You might also notice a feeling of fullness in your throat if you decide to target the area around your neck or chin, or diarrhea as your body tries to get rid of the dead fat cells.
And remember, this is still a cosmetic procedure, and things can go wrong. One writer revealed that her treatment actually left concave indents on her outer thighs. That can definitely happen, Dr. Stanford says.
CoolSculpting merely shrinks fat cells—it doesn’t obliterate them, she explains. “When these fat cells re-expand, they may do so unevenly—hence the dent in one’s thighs,” she says.
More serious complications include frostbite, hyperpigmentation of the treatment area, and scarring. These are rare and typically occur when the procedure is done incorrectly or with an inauthentic CoolSculpting device, says Dr. Waldorf. If you’re worried about the side effects, make sure you discuss them with your doctor before you commit.
And again, this shouldn’t be considered a solution if you have obesity. “I do not recommend CoolSculpting to my patients because it does not address the underlying issue, which is excess fat in undesirable areas,” Dr. Stanford says. “It is inevitable that these areas will persist and need constant manipulation. I treat my patients with excess weight to accomplish health, not vanity goals.”
How to ensure your CoolSculpting treatment is safe
There will be a little bit of homework on your end. First, your doctor should be using the real CoolSculpting device (not a copycat device). The real thing includes technology that moderates the temperature to keep it at an appropriate level to reduce the risk of any side effects, says Dr. Waldorf.
To ensure your technician is using a legit device, search your doctor’s name using the CoolSculpting website’s find a provider tool and ask your doctor if you’re unsure.
It’s also wise to have the procedure performed at the office of a board-certified dermatologist. While nurses or technicians often are the ones who do the treatment, Dr. Waldorf notes that she’s a believer in seeing every patient herself and doing a second physical exam before treatment. “As the physician, I’m responsible for that patient’s safety and expectations,” she says.
The bottom line: If you’re looking for general weight loss, start with exercise and healthy eating. “You’re better off taking the thousands of dollars and getting a dietitian or a trainer,” says Dr. Seltzer. The procedure should only be an option if you’re still noticing stubborn pockets of fat after hitting your goal weight and making long-term lifestyle changes.
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