Disclaimer: None of the information in this article constitutes medical advice. All statements are merely the opinion of the writer(s). We recommend that patients follow their doctor’s guidance in regard to medical procedures.
CoolSculpting is a medical device brand with an enticing premise: that using a physical device on the skin can reduce visible fat. This may sound impossible, but the device has been cleared by the Food and Drug Administration (FDA) for treatment of visible fat bulges.
In this article we’ll review the medical research on CoolSculpting to determine whether we believe it’s actually likely to reduce fat, or if it’s just a marketing gimmick. We'll share before-and-after images from a real user, and compare the treatment to more common fat reduction procedures like liposuction.
Does CoolSculpting Work?
CoolSculpting's effectiveness for fat reduction has been tested in several clinical trials published in legitimate medical journals. One clinical trial, published in the Dermatologic Therapy journal, tested the device on 28 middle-aged patients. Researchers found that skinfold thickness decreased significantly (40%), and there were no major side effects.
It's unclear to us from this study whether fat was truly eliminated or if it was just transferred elsewhere on the body, because no body composition data was collected. However, the study authors did describe a "significant improvement in body contour."
It’s also important to note that one of the study authors is a paid consultant to Allergan, the company which manufactures CoolSculpting devices. This adds bias to the study and makes the results weaker in our opinion.
A meta-review published in the Plastic and Reconstructive Surgery journal analyzed the results of 19 different individual clinical trials on cryolipolysis, which is the technology underpinning CoolSculpting.
The study authors found cryolipolysis to be a “promising procedure for nonsurgical fat reduction and body contouring.”
One of the authors of this meta-review is a consultant for the manufacturer of CoolSculpting, but the other four aren’t, so we see this publication as having less bias than the first one.
One medical trial found that manual massage immediately following CoolSculpting treatment made the treatment more effective for fat loss. The sites on the body which received targeted massage therapy post-treatment had a fat layer that was 68% reduced compared to sites which received CoolSculpting treatment without massage. This study had no funding bias.
Overall we will conclude that Coolsculpting is a promising treatment and likely effective for fat reduction.
We don’t yet recommend CoolSculpting for two reasons:
- The research is too early-stage. There aren’t enough unsponsored reviews of CoolSculpting proving it’s effective for us to recommend such a novel therapy. There is also a lack of standardization of treatment. In the meta-review linked above, researchers tested the device across a wide range of time frames, and a wide range of body parts.
- We don’t yet understand exactly how it works. Even the researchers in the meta-review stated “the mechanisms of fat reduction are not entirely understood." We believe that without a clear understanding of exactly what’s occurring biologically, it’s not yet time to recommend a treatment (even a promising one) to patients.
That being said, CoolSculpting does appear to be effective, and is backed by a lot more research than many fat loss treatments we’ve reviewed previously like Skald.
CoolSculpting Before-And-After Images
One of the most popular reviews of CoolSculpting on YouTube is published by a channel called "Amanda Castillo" and has achieved over 250,000 views at the time of updating this article.
The review appears unsponsored and shares before-and-after images of the creator's CoolSculpting experience:
How Does CoolSculpting Work?
As described in a medical review of cryolipolysis, extremely cold temperatures (-5° C) directly applied to targeted zones on the body creates a localized inflammatory response which causes apoptosis (cellular programmed death) of fat cells.
It’s unclear from a thermodynamic perspective exactly what’s occurring, but early research suggests that this process does not elevate cholesterol in the body or damage the liver in any way.
We need more research to determine optimal treatment frequency, and whether there are other areas of the body that can be successfully treated with CoolSculpting.
According to the brand's explainer page, CoolSculpting can reduce fat in nine different treatment sites: under the jawline, under the chin, the upper arms, back fat, bra fat, the flank area (love handles), abdomen, thighs, and under the buttocks (banana roll).
CoolSculpting Side Effects
CoolSculpting has a favorable side effect profile in our opinion. The risk of serious adverse effects is relatively low.
The meta-study we cited in the previous section analyzed data from hundreds of patients and found there to be "only mild, short-term side effects" such as reddening of the skin, swelling and pain. The majority of patients experienced no side effects at all.
This side effect profile is significantly superior to that of liposuction, which is a more invasive medical procedure for fat loss, as we'll discuss below.
CoolSculpting Vs. Liposuction
Liposuction is one of the most common surgical treatments for fat reduction. It's more invasive than CoolSculpting because it involves tubing, penetration of skin and physical removal of fat.
A medical review of liposuction side effects, published in the Aesthetic Surgery Journal, reported the rate of minor side effects to be 11.62% and the rate of major surgical complications like pulmonary embolism and deep vein thrombosis to be 3.35%.
Liposuction can remove significant quantities of fat in one single treatment, so it may be a more effective option for patients with greater obesity. CoolSculpting is a more minor, non-invasive approach that's typically used for body contouring and slight aesthetic improvements rather than the removal of a significant percentage of body fat.
While we don't currently recommend any medical procedures for weight loss, because we recommend lifestyle interventions alone, we would recommend that patients considering medical treatment for weight loss to speak with their doctor about CoolSculpting rather than liposuction, because it appears to have a better safety profile.
There is no data we can locate on severe side effects of CoolSculpting, while lipo can cause severe side effects.
CoolSculpting costs an average of $3,200 according to the brand's website.
It's unclear to us whether that's the total price or the price per-procedure, because for both CoolSculpting and CoolSculpting Elite, the brand states that "two or more treatment sessions are recommended." We would urge CoolSculpting to clarify whether these cost figures are total cost or otherwise.
Because CoolSculpting is an aesthetic and not a functional procedure, it's unlikely to be covered by health insurance in the U.S. However, it can never hurt to check with your insurer, and we would certainly recommend that prospective CoolSculpting patients do so.
An argument can certainly be made that reducing fat levels in overweight patients improves overall health, and obesity is a medical condition.
CoolSculpting has a Cost Savings page on their website that customers can explore to receive discounted offers.
CoolSculpting Gone Wrong
While we haven't come across much medical evidence of severe CoolSculpting side effects, a model named Linda Evangelista claims that the treatment left her disfigured.
In a popular YouTube video, a plastic surgeon explains what may have gone wrong:
Our Weight Loss Supplement Recommendations
There exist several over-the-counter (OTC) weight loss supplements with significant clinical backing in terms of both efficacy and safety.
We recommend dietary fiber as a safe and effective weight loss supplement, especially when combined with caloric restriction.
A landmark medical study found that moderate caloric restriction (750 calories per day below baseline) combined with dietary fiber intake (a minimum of 20 grams per day) caused an average weight loss of 16.03 pounds over 6 months. That’s a pace of 32 pounds per year of weight loss in overweight individuals simply by adding fiber to a moderately-restricted-calorie diet.
The fiber supplement we recommend is SuperGut Fiber Mix. It contains a clean and effective formulation: a blend of three different types of unflavored dietary fiber and zero additive ingredients. It can be mixed into liquids or foods. Interested consumers can buy SuperGut fiber at this link.
We recommend using two fiber mixes per day, which provides 16 grams (g) of total fiber. Diet should provide the remaining fiber necessary to meet the 20 g minimum threshold.
Medium-chain triglyceride (MCT) oil is another dietary supplement which has been shown in clinical trials to cause weight loss.
MCT oil is quickly absorbed by the body and increases metabolic rate, which causes fat loss. A meta-study on MCT oil documented weight loss of 1.12 pounds over 10 weeks. This equates to a potential annualized weight loss of 5.84 pounds with MCT oil supplementation.
We recommend Bulletproof MCT Oil as our top MCT oil product, because it has a clean and effective formulation. The only ingredient is MCT oil derived from coconuts, and the product has no questionable additives. Interested consumers can buy Bulletproof MCT Oil at this link.
The effective dose range of MCT oil for weight loss (based on the medical review) is 1.7 g to 10 g per day. Bulletproof's MCT oil provides 14 g in one tablespoon, so around two-thirds of one tablespoon should be a maximally-effective dosage.
We are not suggesting that these products are as effective as CoolSculpting; just that it may be worthwhile for an overweight patient to discuss these options with their doctor given their research backing. These supplements may also be used in addition to medical procedures like CoolSculpting.