Obesity and the weight loss market

With global obesity rates rising, the demand for weight loss products and services has increased. The weight management industry was worth USD 232.4 billion in 2023 and is anticipated to show an 8.6% compound annual growth rate from 2024 to 2032. The weight loss market can be broadly categorized into supplements, prescription medicines, noninvasive procedures, and surgical procedures. Unlike traditional Liposuction or other surgical procedures, supplements, medications, and noninvasive fat reduction techniques are gaining popularity because of convenience and cost ^1,2.

Types of fat (Visceral, subcutaneous)

Visceral fat is beneath the abdominal muscles and cushions the internal organs, such as the liver, pancreas, and intestines. High visceral fat level is strongly linked with insulin resistance and associated pathologies ³.

Subcutaneous fat lies underneath the skin and is distributed throughout the body. While this kind of fat is less metabolically active and provides insulation and energy storage, excessive amounts can lead to aesthetic dissatisfaction and even health risks ³.

What are ‘fat burners’?

‘Fat burners’ are topical and consumable supplements that claim to promote fat metabolism. Some popular fat burners include caffeine, carnitine, green tea, conjugated linoleic acid, forskolin, chromium, kelp, and fucoxanthin. While the role of topical fat burners is limited to subcutaneous fat metabolism, evidence suggests that consumable fat burners increase overall fat metabolism. However, the benefit of adding thermogenic dietary supplements appears to be limited in reducing body mass index and improving cardiometabolic health for overweight individuals ^{4, 5}.

How does ‘fat freezing’ work?

‘Fat freezing’ or Cryolipolysis uses controlled cold temperatures for targeted destruction of subcutaneous fat cells. Since Lipid-rich tissues are more susceptible to cold injury than water-rich tissues, the skin and other surrounding structures remain safe during the procedure. This is one of the most popular nonsurgical subcutaneous fat reduction treatments, with over 450,000 procedures performed worldwide. Various Cryolipolytic devices such as CoolSculpt, CoolContour, Zeltiq, CoolTech, and Pleasanton are FDA approved for subcutaneous fat reduction from the flanks, thighs, and abdominal region ^{6, 7, 8}. 

Is it safe?

While Cryolipolysis is considered a low-risk procedure, some minor and self-limited adverse events include bruising, swelling, redness, pain or discomfort, and skin discoloration. Cold burn, which was considered to be an unlikely complication, has also been reported recently. Certain contraindications for the procedure are cold-sensitive, severe varicose veins, dermatitis, and a history of hernias.

One of the most distressing and common adverse effects of Cryolipolysis is paradoxical adipose hyperplasia (PAH), where the treated area paradoxically grows larger instead of shrinking. This condition typically develops two to five months after Cryolipolysis and may need surgical alleviation. A higher incidence of PAH is observed among men, Hispanics, treatment of the abdominal region, and the use of larger handpieces ^{7, 8}.

Has Cryolipolysis replaced Liposuction?

Though Cryolipolysis is a nonsurgical option for targeted fat reduction, Liposuction remains a preferred choice for larger volumes of fat removal, more significant body contouring, and faster turnaround time. However, Liposuction, being invasive, comes with a longer recovery time and the potential for more complications ⁹.

Do we still need bariatric surgeries?

Bariatric surgeries are weight-loss procedures for individuals with significant obesity. The goal of such procedures is to aid in shedding overall weight and treat obesity-related conditions. Fat freezing and Liposuction are aesthetic procedures that don’t target overall weight or underlying health issues ¹⁰.

So, burn or freeze the excess fat?

The choice between burning or freezing excess fat depends on the individual and their goals. The old-school way of burning fat, through diet and exercise, is a holistic approach that can lead to overall weight loss and improved health. Fat freezing, an FDA-approved noninvasive procedure for localized subcutaneous fat reduction, has more of a cosmetic role for targeting specific stubborn subcutaneous fat that doesn’t respond to traditional methods. While consumable “fat burners” are often promoted for weight loss, including visceral fat, the most effective strategies for reducing visceral fat involve a combination of lifestyle changes, including diet, exercise, and stress management, rather than relying solely on supplements. 

References

1. Global Market Insight. Weight Loss and Obesity Management Market [Internet]; 2024May. Available from: https://www.gminsights.com/industry-analysis/weight-loss-and-obesity-management-market[cited 2025 May 07]
2. Obesity and Overweight [Internet]. Geneva: World Health Organization; March 2024. Available from: URL https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight [cited2025 May 07].
3. Ibrahim MM. Subcutaneous and visceral adipose tissue: structural and functional differences. Obesity reviews. 2010 Jan;11(1):11-8.
4. Clark JE, Welch S. Comparing effectiveness of fat burners and thermogenic supplements to diet and exercise for weight loss and cardiometabolic health: Systematic review and meta-analysis. Nutrition and health. 2021 Dec;27(4):445-59.
5. Escalante G, Bryan P, Rodriguez J. Effects of a topical lotion containing aminophylline, caffeine, yohimbe, l‐carnitine, and gotu kola on thigh circumference, skinfold thickness, and fat mass in sedentary females. Journal of cosmetic dermatology. 2019 Aug;18(4):1037-43.
6. American Society of Plastic Surgeons. Nonsurgical fat reduction [Internet];Available from: https://www.plasticsurgery.org/cosmetic-procedures/nonsurgical-fat-reduction/cryolipolysis#:~:text=Cryolipolysis%2C%20commonly%20referred%20to%20as,structures%20are%20spared%20from%20injury.[cited2025 May 07].
7. Kania B, Goldberg DJ. Cryolipolysis: A promising nonsurgical technique for localized fat reduction. Journal of Cosmetic Dermatology. 2023 Nov;22:1-7.
8. Krueger N, Mai SV, Luebberding S, Sadick NS. Cryolipolysis for noninvasive body contouring: clinical efficacy and patient satisfaction. Clinical, Cosmetic and Investigational Dermatology. 2014 Jun 26:201-5.
9. Ingargiola MJ, Motakef S, Chung MT, Vasconez HC, Sasaki GH. Cryolipolysis for fat reduction and body contouring: safety and efficacy of current treatment paradigms. Plastic and reconstructive surgery. 2015 Jun 1;135(6):1581-90.
10. Angrisani L, Santonicola A, Iovino P, Formisano G, Buchwald H, Scopinaro N. Bariatric surgery worldwide 2013. Obesity surgery. 2015 Oct;25:1822-32.