How to “burn” belly fat?

“Doctor, I do what I can, and my stomach still is not flat. What should I do?”

That question comes up in the clinic regularly. It is asked by women who exercise several times a week, who run, and who in summer swim or tear about on a wakeboard instead of lying on the beach. They eat well and regularly, they drink plenty of water.

And even so they cannot deal with abdominal obesity or cellulite on the thighs.

So let us begin with a sentence there is no getting around: no treatment will replace diet and exercise. Aesthetic medicine treatments support the process; they are not a shortcut past it. If you are looking for a way to lose weight without changing your lifestyle — you will not find it in this text, because no such way exists.

What does work is a well-made diagnosis, a plan of action and consistency.

Before you think about a treatment: diet

If, despite intense effort, you are not happy with your body, the first address is not a treatment room but a dietitian — or possibly a session of dietary coaching.

Also worth considering is a genetic test, which makes it possible to check how the genes influence metabolism and what supplementation is worth using.

Sometimes one thing is enough: achieving a calorie deficit, that is, burning more calories than you take in with food. A properly balanced reduction diet plus exercise that burns fat can work wonders.

It is good to train under the eye of a personal trainer who will build a plan for you rather than for an average.

One more distinction worth knowing before you start measuring the fold on your stomach. The treatments described below act only on subcutaneous fat — the kind you can take between your fingers. They do not act on visceral fat surrounding the organs inside the abdominal cavity, and it is that fat which is responsible for metabolic and cardiovascular risk. Only diet, exercise and sleep act on the visceral kind. That is why in some people a hard stomach that cannot be pinched is not an indication for a treatment at all.

When a treatment makes sense

Sometimes, despite the right diet and exercise, results come slowly. Or there remain places from which the excess fat simply does not want to disappear.

And that is the right moment for aesthetic medicine. Not instead of working on your body — after it. The treatments we write about below are a tool for closing the effect, not for replacing it.

Injection lipolysis

One of the most popular treatments among our patients.

It is performed by a doctor, under local anaesthesia. We administer locally sodium deoxycholate — a substance that causes the local dissolution of fatty tissue. This makes it possible to get rid of unwanted fat from selected parts of the body: the abdomen, the saddlebags or a double chin.

Qualification is the key. Lipolysis gives exceptionally good results in slim people, meaning those who have already done the work on their body but struggle with a local accumulation of fat. This is not a treatment for excess weight — it is a treatment for a stubborn spot.

Usually what is needed is a series of several treatments at intervals of 4–6 weeks.

What to expect after the treatment:

• tenderness to the touch — up to 24 hours,
• swelling — up to a week,
• sometimes bruises and post-injection haematomas — up to 2 weeks.

Who we will not qualify for lipolysis: pregnant and breastfeeding women, people with an infection or inflammation at the site of the planned injection, with clotting disorders and undergoing anticoagulant treatment, and also people with obesity — for them working on body weight makes more sense. With a treatment on the chin I also give warning of a rare, transient weakening of the nerve responsible for the movement of the lip: the smile can then be asymmetrical for a few weeks. It resolves on its own, but it is better to know about it in advance than to see it in the mirror.

LPG endermologie — an ally during weight loss

To patients who are only starting to work on their figure we recommend one thing straight away: take care of the firmness of the skin during the weight-loss course, not after it.

The reason is practical. After rapid weight loss you may notice a drop in skin density and increased visibility of cellulite.

LPG endermologie is a vacuum massage acting on the skin and the subcutaneous fatty tissue. It stimulates microcirculation, helps remove water retention and improves the appearance of orange-peel skin.

For physically active people it has an added advantage: it massages the muscles and speeds up their regeneration.

It can also be combined with injection lipolysis. The result of such a combination is the dissolution of stubborn fatty tissue together with firmer skin and less water retention in the treated area.

Coolshaping cryolipolysis

For local reduction of stubborn fatty tissue we today use Coolshaping cryolipolysis — non-invasive reduction with controlled cold — and the injection lipolysis described above. We work on the firmness of the skin with LPG Alliance® endermologie and shockwave therapy.

What to expect from cryolipolysis. In the treated area the layer of fatty tissue usually decreases by roughly a fifth, and the effect builds over two to three months — this is not a treatment with an effect the next day. For a few days to a few weeks the area can be numb and tender. Very rarely, in fewer than one person in four hundred, instead of a reduction a hard thickening of the fatty tissue appears in the treated area; it does not resolve on its own and requires surgery — which is why we mention it before, not after.

Which treatment for what — in brief

• Injection lipolysis — Sodium deoxycholate locally dissolves fatty tissue · Slim people with stubborn, local fat — abdomen, saddlebags, double chin · A series of several treatments every 4–6 weeks.
• LPG endermologie — Vacuum massage acting on the skin and the subcutaneous tissue · People in the middle of losing weight, physically active, with cellulite and water retention · In a series; can be combined with lipolysis.
• Coolshaping cryolipolysis — Reduction of fatty tissue with controlled cold · Stubborn fatty tissue · According to the plan agreed at the consultation.

Finally

If you were to take one thing away from this text, let it be the order.

First the diagnosis and the plan — best with a dietitian involved. Then consistent work: diet, exercise, regularity. And only at the end a treatment that closes what could not be achieved by the work alone.

And the thing almost every patient asks about: will the fat come back. The fat cells removed in the treated area do not regenerate, but the ones that remain — and those in the other parts of the body — get larger as body weight increases. That is why the effect lasts as long as the weight is stable. The treatment does not release you from anything; it only changes the proportions in a place that diet alone did not shift.

The reverse order is also possible — but what for. A treatment carried out without changing habits solves the problem in one place and for a while. Changing habits plus a treatment solves it for longer.

We reduce local fatty tissue with cryolipolysis and injection lipolysis — which method to choose will be suggested by the doctor at the consultation.

This article was prepared by the team of Dr Kuschill MEDESTETIS clinics. Medical supervision: Joanna Kuschill-Dziurda MD PhD — specialist in allergology and internal medicine, physician in aesthetic medicine.