Journal of Nutrition & Weight Loss

In the early 1990’s, Leptin wasn’t discovered yet [1] and Brown Adipose Tissue was only noted to be present in babies [2]. Fat hormones (adipokines) that signal a person from eating too much [3] and uncoupling protein 1 (UCP-1) that facilitates calorie burning [4] was not part of the arsenal to fight too excess body fat and being overweight. Obesity wasn’t classified yet as a chronic disease directly linked to metabolic diseases [5]. The entire craze about losing weight was not for getting in shape for health and wellness but rather simply for vanity. One of the novel treatments to lose weight was by use of Cold Wraps more popularly known by its trademark “Fat Mobilisation System” or FMS [6]. It has been used by slimming centres in Switzerland since the 1960’s to lose weight. The treatment induces thermogenesis by artificially creating a mild form of hypothermia [7]. Being warmblooded, we need to maintain a homeostatic temperature so exposure to cold with resultant hypothermia would signal the body to burn fat. FMS boasts of being able to burn as much as a thousand calories for each treatment done for only several minutes but whose effect lasts for 2-3 days. This happens as brown fat is stimulated and calorie burning is increased [8] by Cold Acclimation [9]. It also provides a reduction in girth at the waist (decrease in Visceral Fat as well as subcutaneous Fat). But most dramatic of all is its ability to induce weight loss per treatment depending on the body’s response. Though a few studies have been done to show that Cold Exposure increases calorie Burning [7], there has been no documentation on its end result of producing actual concrete weight loss.

To determine and document the average weight loss induced by Cold Wrap treatments 5.

Subjects were existing patients several months to a couple of years before the data was collected in December of 1998. A sample of 325 patients represented by their index cards in the filing cabinet was randomly drawn. That is 13 patients per alphabet (A to Z, except X) corresponding to the first letter of their surname; in order to reach more than 300 patients as dictated by the statistician. The information written on the index cards were copied. These consisted of treatments done, documented weights, if given a diet, concomitant diseases related to weight, medications that induce weight gain, etc. Each client’s index card was designated a client number (names specifically excluded) and the pertinent data after application of the inclusion and exclusion criteria were tabulated. Inclusion Criteria:

1. Had 5, 10, 15 or 20 Cold Wrap treatments

2. Had the Cold Wrap treatments on a regular basis (at least 2X a week)

3. Had regular weight documentation

Exclusion Criteria:

1. Any concomitant disease related to weight gain/loss (Exdiabetes, hypothyroid, etc.)

2. Intake of medications that induce weight gain/loss (Exhormone replacement therapy, oral/injectable steroids)

3. Any specific diet with the purpose of losing weight in a short span of time (Ex-hypocaloric “crash” diets, etc.)

4. If other treatments are being done in the slimming centre (Extrans epidermal nerve stimulation, skin curving treatments using positive and negative pressure by suction/vacuum, etc.)

The actual Cold Wrap treatment is done by soaking elastic bandages in a solution that promotes convection once the subject is already wrapped with it. Convection is when air travels close to the body and attracts heat away from it [10]. The solution in the bandages while wrapped around the body of the subject (Figure 1) evaporates with time.

Figure 1: Cold wrap treatment (pre-soaked elastic bandages are wrapped around the body), lying down.

The actual Cold Wrap treatment is done by soaking elastic bandages in a solution that promotes convection once the subject is already wrapped with it. Convection is when air travels close to the body and attracts heat away from it [10]. The solution in the bandages while wrapped around the body of the subject (Figures 1 and 2) evaporates with time.

Figure 2: Cold wrap treatment, standing up.

Among the subjects, 64 patients had 5 Cold Wrap treatments, but only 46 continued to have 10 Cold Wrap treatments, 22 continued to have 15 Cold Wrap treatments, and 8 continued to have 20 Cold Wrap treatments (Table 1). Subjects were existing patients several months to a couple of years before the data was collected in December of 1998 (as indicated in the dates). Based on the existing protocol at that time, the patients had their weight documented every 5 treatments.

Table 1: Tabulation of weights per patient after 5,10,15,20 cold wrap treatments (CWT).

I. Average weight loss of 64 patients after 5 Cold Wrap Treatments (Tables 2 and 3)

Table 2: Weight loss after 5 CWT 64 pxs. (Mean Ave. of 64 subjects=3.22 lbs.).

Table 3: Weight loss after 5 CWT treatments by mode (mode Ave. of 64 subjects=2.0 lbs.).

Mode=weight loss of most number of patients = 2 lbs. (13 patients)

II. Average weight loss of 46 patients after 10 Cold Wrap Treatments (Tables 4 and 5)

Table 4: Weight loss after 10 CWT treatments per client (Mean Ave. of 46 subjects=5.51 lbs.).

Table 5: Weight loss after 10 CWT treatments by mode (Mode Ave. of 46 subjects=5.0 lbs.).

Mode=weight loss of most number of patients =5 lbs. (5 patients)

III. Average weight loss of 22 patients after 15 Cold Wrap Treatments (Tables 6 and 7)

Table 6: Weight loss after 15 CWT treatments (Mean Ave. of 22 subjects=9.67 lbs.).

Table 7: Weight loss after 15 CWT treatments BY Mode (Mode Ave. of 22 subjects=7 & 10 lbs.).Weight loss after 15 CWT treatments BY Mode (Mode Ave. of 22 subjects=7 & 10 lbs.).

Mode =weight loss of most number of patients =7 lbs. & 10 lbs. (3 patients for both)

IV. Average weight loss of 8 patients after 20 Cold Wrap Treatments (Tables 8 and 9)

Table 8: Weight loss after 15 CWT treatments per client (Mean Ave. of 8 subjects=10.39 lbs.).

Table 9: Weight loss after 15 CWT treatments by Mode (Mode Ave. of 46 subjects=5 lbs.).

Mode =weight loss of most number of patients =5 lbs. (2 patients)

V. Summary of average weight loss after 5, 10, 15, 20 Cold Wrap treatments by Mean (Figure 3)

Figure 3: Average weight loss after 5, 10, 15, 20 treatments.

Average weight loss after:

5 Cold Wrap treatments=3.22 lbs.

10 Cold Wrap treatments= 5.51 lbs.

15 Cold Wrap treatments= 9.67 lbs.

20 Cold Wrap treatments= 10.39 lbs.

VI. A3v.e2r2a ge w. eight loss per treatment for the: 9.75 .

=0.5195 lbs.

First of all, it should be noted that there were only 64 patients out of the 325 sample population who were included in the study. Most were excluded because they had other slimming treatments aside from the Cold Wrap while a few had medical problems related to their weight gain. However, some were excluded because they underwent a hypo caloric diet endorsed by the slimming centre itself. These were the clients who were losing weight slowly, not losing at all, or even gaining weight despite their Cold Wrap treatments. That may be a significant factor why not even 1 out of 64 patients posted a negative weight loss result (weight gain). So if you will look at the graph of the linear progress of weight loss (Figure 4), all the individual lines were going down and not even one went up although the Cold Wrap treatment has been “historically” proven since the 1960’s to induce weight loss because calories are burned by thermogenesis in response to hypothermia [7], there are other factors not in control of the slimming centre but definitely in control of the patient [10-12] (overeating, inactivity, stress, poor sleep) where the cold wraps may fail to induce weight loss. During formulation of the protocol for the study, patients who underwent a diet with a specific purpose of losing weight in a short span of time was excluded for the simple reason that any weight loss recorded may be due to the diet but wrongly attributed to the cold wrap. However, during the data collection/gathering period, it was noted that patients who would have posted a negative weight loss result, were inadvertently excluded due to their undergoing of a hypo caloric diet given by the staff of the slimming centre itself. Therefore, the results in the study are relatively higher than the true value.

Figure 4: Graph of all 64 patients that underwent 5-20 cold wrap treatments.

Second, the patient number in the population goes down as the number of treatments increases (there are more patients who underwent 5 Cold Wraps than those who had 20 Cold Wraps). The reason for this is because those who experienced satisfactory weight loss would already convert their remaining treatments to other “maintenance” treatments (body contouring or skin firming without weight loss). Also, some patients who reached their target weight would totally discontinue their entire slimming program and be lost to follow-up already.

Lastly, the weight loss for the fourth 5 Cold Wraps (16^th to 20^th) tends to plateau or level off with an average of 0.144 lbs. per treatment which is approximately only 25% of the overall (1^st to 20^th) average weight loss per treatment of 0.5195 lbs. The reason for this is so obvious. The first 15 treatments already did their job of inducing weight loss so during the 16^th to 20^th Cold Wrap treatments; there was not much excess weight to lose anymore. Another reason which is not so obvious is the same reason given in the previous paragraph. It’s possible that patients who underwent 20 Cold Wrap treatments are the problematic ones where weight loss is slow or are not satisfactory.

The subjects in this study are private paying patients who went to the centre in order to lose weight. So this is more of a Multiple Case Report where all of the subjects underwent the Cold Wrap treatment and their average results tallied. A randomized controlled trial (RCT) would have been better wherein the study group would be given the Cold Wrap with the original solution while the Control Group would be given a Placebo Therapy (ordinary wrap using the same elastic bandages but soaked in plain water). Then, both groups would be given the same advice on diet and activity. However, the objective of the study was met wherein the weight loss results of Cold Wraps were determined and documented.

It also would have been better if the subjects were weighed every time they came into the slimming centre for treatment and not every 5 visits. Body measurements, specifically the waist circumference should be included, since this is a better marker for determining Visceral Fat that is directly related to the patient’s health status [13-15]. It is recommended that a larger population be used in future studies. It should include epidemiologic/demographic data to determine which subgroups have better results (e.g. who has better weight loss: male or female, single or married, which age group, which weight range, etc.) Those who underwent diet or have medical problems should also be included already but in a separate group so as not to dilute or concentrate the results, in general.

There is weight loss after Cold Wrap treatments in a private Slimming Centre in the Philippines. The average weight loss per treatment is 0.5195 lbs.