A very interesting article in yesterdays Personal Journal section of the Wall Street Journal, pertaining to FDA approval of two new devices to attack fat cells. One by deflating them, another by destroying them. Both methods are less invasive than liposuction. Zeltiq grabs onto love handles and belly pouches and freezes the fat cells, causing them to self-destruct. Zerona is a low-level laser which forces the fat cells to dump their fat in a matter of weeks. In both cases, no incisions, no anesthesia, and no downtime. The fat is basically reabsorbed by the body. But, these new devices can only target subcutaneous fat, which is located under the skin in places like the hips, thighs and lower belly. They cannot touch the deep, visceral fat cells, located deep in the body, and around organs like the heart and liver. These are the fat cells that release fat into the bloodstream (triglycerides) which raise the risk for diabetes, heart disease, stroke, and Alzheimer’s. As we age, the amount and distribution of fat changes. “People tend to gain subcutaneous fat through middle age, and then it starts to diminish, first on the back of the hands, then in the lower legs and elsewhere,” says James L. Kirkland, a professor of aging at the Mayo Clinic. That subcutaneous fat piles up as visceral fat instead, and eventually appears in muscle, liver, and even bone marrow, where fat is substituted for new bone. “Losing fat is not good, paradoxically,” Dr. Kirkland says. Obesity experts are worried that if people have these procedures done, and continue to consume more calories than they burn, they may hasten that process of accumulating harmful fat. Some of these experts also worry that forcing fat out of fat cells can increase the level in the bloodstream. “Fat is very toxic; it is not something you want in large amounts floating around free-you want it wrapped inside a cell, protected,” says Dr. Michael D. Jensen, an endocrinologist at the Mayo Clinic in Rochester, Mn.

Fat cells are not just passive storage deposits for surplus calories. They are busy chemical factories that send signals all over the body, helping to regulate growth, puberty, healing, disease-fighting, and aging. There are over 100 hormones that fat cells secrete, including adiponectine, which regulates metabolism, and leptin, which  tells the brain to eat more or less (the brain doesn’t always listen). Another worry is that by losing fat cells could lower leptin levels, causing the body to eat more. It’s very dangerous to fool Mother Nature, and these new devices seem like more of a cosmetic bandage than an actual health benefit. Bottom line: you may get rid of your love handle, but you won’t lose weight unless you change behavior.

Stay well, John R Blilie, M.S.