May 2020 Issue

Ask the Expert: Body Sculpting Treatments
By Toby Amidor, MS, RD, CDN, FAND
Today’s Dietitian
Vol. 22, No. 5, P. 6

Q: My clients have been asking me about body sculpting treatments such as CoolSculpting and SculpSure. Can you explain what body sculpting is and the research behind these different methods?

A: Body sculpting procedures claim to destroy fat cells, either through laser energy or freezing. Research generally has shown the treatments’ efficacy and safety, but ongoing research and anecdotes show possible concerns.

Popular Treatments
CoolSculpting, also known as cryolipolysis, is an FDA-approved noninvasive treatment for visible fat bulges in areas of the body such as under the chin and in the thighs, abdomen, buttocks, and upper arms. The procedure freezes fat cells, which eliminates them permanently in one to three months (depending on how many areas are being treated), with a 20% to 25% reduction of fat in the treated areas, according to the company. During the procedure, clients may experience sensations of pulling, intense cold, tingling, and pain at the treatment site. After treatment, temporary redness, pain, swelling, bruising, firmness, itching, and skin sensitivity may occur. According to Melina B. Jampolis, MD, a physician nutrition specialist and owner of The Body Sculpting Studio in the Los Angeles area, CoolSculpting is appropriate only for clients who are within about 30 lbs of their ideal weight.

SculpSure, also referred to as WarmSculpting, is an FDA-approved procedure that uses targeted laser energy, heating fat cells under the skin without affecting the skin’s surface. This damages the cells’ structural integrity and eliminates them permanently. Patients can see results as quickly as six weeks, with optimal results typically seen at 12 weeks. Most patients need multiple treatments to achieve optimal results.

Safety and Efficacy
Numerous studies have investigated the safety of body sculpting procedures. A 2013 study investigating cryolipolysis in 518 European subjects showed no significant side effects or adverse events. Eighty-nine percent of respondents perceived treatment positively, and 96% reported minimal to tolerable discomfort.1 A 2016 study involving 60 subjects showed a 2-mm reduction in subjects’ layer of body fat via ultrasound, and more than three-quarters of subjects were satisfied with the procedure on measures including comfort and visible fat reduction and would recommend the procedure to a friend.2

In a 2017 study of the effects of noninvasive hypothermic treatment on subcutaneous fat, such as that used by SculpSure, subjects experienced 14% to 18% fat loss by two to six months post treatment. Participants reported mild tenderness as a side effect, but this resolved after about one week post treatment.3

Safety concerns still exist, however. A 2018 study found an association between cryolipolysis and paradoxical adipose hyperplasia, wherein hardened fat develops around the treated area. The authors of this study say this adverse effect may be more common than not.4 In addition, over the past few years there have been several lawsuits against body sculpting providers and manufacturers of the technology. Some of these have been dropped, but a 2018 lawsuit claiming second- and third-degree burns and blisters as a result of cryolipolysis is pending in Manhattan Supreme Court.5

Recommendations for Clients
Although RDs don’t perform these various sculpting techniques, dietitians can offer support and discuss body image issues with clients inquiring about them. Malina Malkani, MS, RDN, CDN, a spokesperson for the Academy of Nutrition and Dietetics and creator of Solve Picky Eating, recommends that RDs can help clients consider the cost, risks vs benefits, and likelihood of lasting results of body sculpting. Most importantly, RDs can help clients connect the dots between a healthy body and a lifelong commitment to healthful lifestyle habits.

Alissa Rumsey, MS, RD, owner of Alissa Rumsey Nutrition and Wellness, believes RDs need to ask their clients why they’re interested in altering their bodies. “Homing in on the root causes of body dissatisfaction and then working to alleviate or improve those negative feelings—without necessarily changing their bodies—will help the client much more in the long run.”

— Toby Amidor, MS, RD, CDN, FAND, is the founder of Toby Amidor Nutrition ( and a Wall Street Journal best-selling author. Her cookbooks include Smart Meal Prep for Beginners, The Easy 5-Ingredient Healthy Cookbook, The Healthy Meal Prep Cookbook, The Greek Yogurt Kitchen, and the recently released The Best Rotisserie Chicken Cookbook and The Create-Your-Plate Diabetes Cookbook. She’s a nutrition expert for and a contributor to U.S. News Eat + Run and Muscle&


1. Dierickx CC, Mazer JM, Sand M, Koenig S, Arigon V. Safety, tolerance, and patient satisfaction with noninvasive cryolipolysis. Dermatol Surg. 2013;39(8):1209-1216.

2. Kilmer SL, Burns AJ, Zelickson BD. Safety and efficacy of cryolipolysis for non-invasive reduction of submental fat. Lasers Surg Med. 2016;48(1):3-13.

3. Decorato JW, Chen B, Sierra R. Subcutaneous adipose tissue response to a non-invasive hyperthermic treatment using a 1,060 nm laser. Lasers Surg Med. 2017;49(5):480-489.

4. Kelly ME, Rodríguez-Feliz J, Torres C, Kelly E. Treatment of paradoxical adipose hyperplasia following cryolipolysis: a single-center experience. Plast Reconstr Surg. 2018;142(1):17e-22e.

5. DeGregory P. Fat ‘freezing’ procedure leaves NYC woman with third-degree burns: suit. New York Post. December 18, 2019.