I get this question a lot: “Ever since I had my babies, my trouble spots have only gotten worse. I have tried everything- diet, exercise, more crunches than I ever thought I could do. Doctor, what do you think about CoolSculpting? “

Fat is such a complicated thing to get rid of. Of course, there is liposuction, tummy tucks and lifts for everywhere. Most of these procedures require surgical intervention in the operating room by a plastic surgeon (unless, of course, you want to end up on the latest reality tv show that specializes in botched outcomes). These procedures unfortunately require time to perform, down time from work and are rather expensive.  Who has time for that? Recently we have seen the advent of non-invasive fat reducing procedures such as CoolSculpting and Sculpsure. The purpose of these procedures is to get rid of those trouble spots that the crunches aren’t touching. 

First- what is CoolSculpting? Coolsculpting is an FDA-approved treatment that involves freezing fat cells. There is an applicator that applies suction to the area that you want to target and the applicator brings the temperature of the fat cells down to the point where they are irreversibly damaged. These cells eventually die and are then eliminated by the body, which is why it takes a few weeks to see the final effects of the procedure. This technology is really for specific trouble spots that are large enough to adhere to the applicator- tummy fat, love handles, thighs, bra fat, banana roll (fat underneath your butt).

Instead of freezing fat cells, Sculpsure uses heat to kill fat cells and then the body eliminates those cells within a couple of weeks. Because it is using heat to kill fat cells, this can be a more painful procedure especially for people with sensitive skin.

The biggest advantage of these minimally invasive fat reducing procedures is that there is very little down time and the risks are minimal compared to more comprehensive surgical procedures like liposuction and tummy tucks. The biggest disadvantage is that they only target specific areas, the results take weeks to appreciate, and can be very variable: up to 15% of participants did not see any improvement after treatments. At $1500 per trouble spot, that can be pretty frustrating.

If you are considering a fat reducing procedure, of course we always recommend that you give that cheap, old-fashioned option a try first- diet and exercise.  If that doesn’t work, we recommend that you consult with a board-certified plastic surgeon to discuss your options before making a decision.  While Coolsculpting may be the perfect remedy to eliminating fat in certain areas, there may be certain instances in which a more traditional surgical approach would help you achieve your desired goals.  While this is not a service we offer, we hope this information is helpful!

Dr.  Pam

​We’ve talked about the recommended amount of exercise in the past, so I’ll just take a moment or two to review the guidelines.  You should generally get 150 minutes of moderate aerobic exercise (swimming, brisk walking, push mowing, etc.) or 75 minutes of vigorous aerobic exercise (i.e. running) each week in addition strength training at least twice per week.  In order to see significant weight loss, this amount should increase to closer to 300 minutes per week, or about an hour a day for 5 days per week.  We often get really excited about our workout goals in the beginning, but sometimes, those workouts can begin to feel like even more “work” than usual.  Here are a few signs that you may benefit from a day off:

1. Ever feel so exhausted that you just can’t fall asleep?  That means your sympathetic nervous system may be working overtime.   Pushing too hard for too long can sometimes cause constant release of stress hormone that keep you wired for “flight or fight,” and that imbalance can totally throw off your sleep.  Another sign may be the disappearance of your menstrual cycles.
2. Constantly sick?  Either you have a toddler, or your immune response could be lowered due to inflammation and stress from overtraining.  Make sure you’re getting adequate breaks between hard workouts.
3. Reached a plateau in your workouts that no amount of training can push past?  Sometimes a short break for either a rest day or simply changing your preferred workout activity can help you resume making gains in your 5K pace or your weightlifting one-rep max.
4. Are you so tired that every day feels like a blur?  After sleep and dietary change, constant stress, either from workouts or even daily life, can really wreck your body.  We’re made to undergo cycles of work and rest, so being constantly “ramped up” can keep you from reaping some of those down-time benefits and even make it harder for you to rest when you finally have a chance.
5. Does that walk from your car to the gym make you tired just thinking about it?  The reason that people often begin to look forward to their daily workout involves the brain’s own reward system.  Dopamine, the body’s feel-good hormone that provides positive feedback for everything from workouts to intercourse, and endorphins, the body’s natural painkillers, are both released during and after exercise.  That being said, excessive training can blunt that response, and thus, blunt your satisfaction with your workout routine.

The bottom line:  working out and exercise are good, but be sure not to overdo it.  This is especially common when just beginning more intense exercise.  If you notice any of the symptoms of burnout listed above, it may be time for a little break or a change in your routine.  If those symptoms persist, then it may be wise to check in with your doctor to see if these symptoms are a sign of something else.  Before you do that, though, you might consider one last try for some fun exercise outside where you can really enjoy this lovely spring weather 😉
Dr. Nick