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Withdrawing Fatty Deposits

Treatments: A new FDA-approved therapy offers temporary relief for cottage-cheese thighs. But it's no quick fix.


Given all the products that have come and gone over the years claiming to rid the body of cellulite, it's OK to be skeptical about the latest miracle treatment.

Yes, you read it right--there is a new noninvasive treatment for that patchwork quilt of skin and fat that is the bane of thighs worldwide. And unlike some of its more dubious cousins, the new therapy--called Endermologie--earned approval from the Food and Drug Administration last month as "an effective treatment for temporarily reducing the appearance of cellulite."

It is the first time a treatment for cellulite has been granted the official right to make this claim.

But before you burst into tears of joy or run for your credit card, there are caveats to consider.

The effectiveness of Endermologie--a mechanical device that administers a deep massage--varies widely among patients.

And, the effects are only temporary.

And the therapy seems to work better among patients who are also exercising and dieting.

"It's safe. No one is having bruising, hematomas or welting. But, in terms of efficacy, the key words are 'temporary' and 'the appearance of.' We can't lead people to believe, by any stretch of the imagination, that this is permanent," says Dr. Deborah Sarnoff, a dermatologist in New York City who has independently studied Endermologie.

UCLA plastic surgeon Dr. Peter B. Fodor has also studied the treatment and concludes that it is the combination of diet, exercise and Endermologie that produces a modest smoothing of the bumpy cellulite surface. Women often have cellulite on the thighs, abdomen and buttocks, while men can accumulate cellulite in the "love handles" area of the abdomen.

It's not a quick fix for anyone.

"One or two treatments is of little value. We do 14 initial treatments, usually twice a week, and we tell them to stay on a diet and do an exercise program. And I'm sure that has something to do with it too."

The recent FDA action, however, may send Endermologie hype through the roof. An estimated 300 doctors--typically gynecologists, dermatologists and plastic surgeons--are installing the $25,000 units. The average cost per initial treatment is $100 for 35 minutes, and many doctors offer packages of $1,500. Because Endermologie is a medical device, it can be offered only by MDs. Trained technicians administer the treatment.


Endermologie was developed in France and introduced in the United States in 1996. The U.S. distributor of the device, LPG USA of Fort Lauderdale, Fla., was authorized by the FDA to market it as a muscle relaxer. However, the company quickly raised the ire of plastic surgeons by making claims that doctors thought were exaggerated.

"In the early photos of Endermologie [results], people had significant weight loss or also had adjuvant liposuction or a tummy tuck and were giving all the credit to Endermologie," Sarnoff said.

Some plastic surgeons were also irritated by the company's initial claims that Endermologie was a noninvasive form of "body sculpting," says Fodor.

"We had our reservations of whether that was the case," he says, acknowledging: "We have a tendency to be somewhat pessimistic. But enough things have gone down the pipeline that look like a novel treatment for cellulite that have not panned out."

Since liposuction--the surgical procedure that removes fat and can help the appearance of cellulite--is the most popular cosmetic surgery, plastic surgeons may have been worried about protecting their turf, says Dr. Harold Lancer, a Beverly Hills dermatologist who offers Endermologie.

"If liposuction is your No. 1 income producer, you don't want to see that suppressed with Endermologie," he says.

Ultimately, LPG USA pulled its ads and gathered scientific data to present to the FDA to substantiate the claim that Endermologie temporarily reduces the appearance of cellulite.

"What we had cleared it for initially was as a muscle relaxer for relieving minor aches and pains," says FDA spokeswoman Sharon Snider. "Then the company submitted specific information on cellulite. If a company wants to make a different claim, other than the one approved, we want to see the data, and we want to make sure it's effective."

Snider confirmed that Endermologie is the first technique to gain permission to make a claim about cellulite.

"The consumer pays a lot of attention to what the FDA does. And I think this will have a big impact," says Lancer.

Consumers are generally very skeptical of products that claim to help cellulite, says Dr. Richard Frieder of the Physician's Body Care Center in Santa Monica.

"Everyone knows that nothing has worked for cellulite," he says. "There are all sorts of procedures and machines that the FDA has turned down, and skepticism is a big obstacle. The FDA approval carries credibility with the general public."


Cellulite consists of pockets of excess fat that usually form among women as they age. The fat is essentially trapped and becomes a reserve against starvation. It cannot be lost by diet or exercise.

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