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Zap or Chill? Targeting Fat Without Surgery

February 04, 2010

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RATING:

News on devices to cool-treat "offending jiggle"  or to "zap your belly, flanks and hips."   Reasonable balance, but doesn't emphasize potential harms and the total lack of evidence for health benefits.

Our Review Summary

This story does a solid job describing two newish treatments purported to dissolve targeted fat--the Zeltiq cooling system and the Zerona laser. The story manages to deliver the most important facts while maintaining some tongue-in-cheek distance. This is, after all, a purely cosmetic procedure for people bothered more about how their bodies look than their unhealthy lifestyles or disease risks. This cocked-eyebrow approach serves readers well.

Having said that, the story fails in one important way: It should have discussed potential harms. Technologies that claim to have such profound effects on lipid tissues cleary have potential risks, but the story doesn't explore them. The question for consumers is not merely whether the techniques work--it's whether they work and without significant risks [aside from wasting money]. The story leaves that important matter unexplored.

It would also have been useful for the story to positively state that there are no known health benefits associated with either technique. It's easy to imagine people who are overweight showing interest in these techniques in the hope they might benefit their blood pressure, diabetes and heart disease risk and so on. They would likely be sorely disappointed.


Why This Matters:

The idea of losing visible fat quickly is sufficiently compelling that consumers spend many millions of dollars on treatments ranging from surgical removal of fat to topical creams. With two new technologies with plausible scientific validity entering the spot-fat marketplace, the New York Times provides a useful service by explaining what is known and not known about them.  

 

Click on Criteria for definitions.

The story explains that Zerona is available nationwide through medical spas, chiropractors, dermatologists and plastic surgeons. Zeltiq, the story says, is available at over five dozen clinics identified on a website.

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Discuss costs? - SATISFACTORY

The story states the price for the Zerona device: $1,700 to $3,800 for six sessions. The price of Zeltiq is also reported but is not as clear: We learn only that one doctor charges "$700 per spot"--but not how many treatments are provided or needed, what constitues as "spot," and so on. 

The story does not medicalize the fat-melting treatments; it makes clear they are elective and cosmetic. No claims are made for medical benefits of the treatments or the risks of love-handles or muffin-tops. Still, a positive statement that there are no known health benefits would have been useful. 

The story does a solid job describing the amount and type of evidence supporting the devices' efficacy--it's mainly anecdotes, doctors' casually reported cases, and some preliminary research. The story is usefully framed with the following statement: "It is too early, however, for consumers to know how effectively either device works."

About Zerona, we learn that an article showing some benefit has been published in a journal called Lasers in Surgery and Medicine. An independent source later calls the validity of those findings into question. We also learn that the FDA has not approved marketing the device for its claimed benefits of fat-zapping.

About Zeltiq, we learn that data has been submitted to the FDA for approval. We also learn that promising data was reported at a medical meeting.

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The story fails to point out the potential harms of these devices. 

The devices claim to be based on scientific principles involving the cellular destruction of lipids and their elimination from the body. This is serious metabolic stuff, presumably with serious potential risks. The story fails to acknowledge this.

The story correctly suggests these two new technologies lie somewhere between the invasive, surgical liposuction and highly questionable infomercial products. It also says they'll shortly be joined in the market by competitors that use ultrasound technologies.

The story duly reports that unpublished research showed Zeltiq resulted in 22 percent body fat loss in targeted areas. It reports that published, funded research showed patients lost an average of 3.5 inches after six sessions of Zerona laser work.

Given the thin body of research, this is adequate reporting of benefits.

The story does not draw from a news release.

The reporter interviewed ten sources--two patients [one with good results, one with poor], one federal spokesperson, and seven doctors. Six of those doctors are not objective due to financial interest in the devices' efficacy. But one is fully independent.

With a story like this, which features new technologies, it's hard to find sources who know the devices well enough to understand them but have no interest in them. The reporter did a good job with sourcing under these circumstances. 

The article could have devoted more space to comparing these procedures to the process, benefits, and risks of liposuction. It could have distinguished between the two new treatments and the existing heat treatments and topical creams also sold by some of the same dermatologists, chiropractors, plastic surgeons and web infomercials that support Zeltic and Zerona. It does get points, however, for mentioning two new ultrasound products about to enter the market.  

Total Score: 8 of 10 Satisfactory

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