Tuesday, August 09, 2011

Please Pass the Fat Cream

Not quite psychiatry, but all my life I've been waiting for the magic pill that will let me eat all I want and be thin.  By the way, I want to eat a lot.  This, however, while not a magic pill, caught my eye.  Over on KevinMD, there is an article about Magic Fat Cream.  You rub in on and the fat goes away.  Well maybe not quite, but it's a start.  Okay,  Dr. George Lundberg doesn't quite call it Magic Fat Cream, but hey, this is Shrink Rap.  What I really want to know is can you use it in solitary confinement

A cream to fight obesity is being ignored


Turns out that there are two decent published studies from reputable places that report that a person may rub a cream on their skin over the fat spots and make the fat go away.
Wow, what a deal.
The first study addresses fat thighs, with each person in the study using one thigh as the test and the other as the control.

This 1995 study from UCLA included renowned obesity researcher Professor George Bray as an author, is published in the journal called Obesity Research.
The second study is from LSU in Baton Rouge and addresses waist circumference.
All participants were placed on a diet of restricted calories and required to exercise. The test group rubbed a cream on the waist and the control group did not.


Anonymous said...

congrats in bringing your blog down to its least common denominator. my iq lost a couple points reading that, my love.

Anonymous said...

One question Dinah. If patients are expected to live with the weight gain, metabolic changes and possible diabetes that are frequently side effects of psychiatric medications,wouldn't it be fair to ask that the side effect of "fat cream" be psychosis?

jesse said...

What is the cream, hydrochloric acid?

Love that Cat.

Roia said...

1) I am all for fat cream! In fact, I give it a big huzzah!

2) So...does this mean that the test subjects ended up with one thigh fatter than the other? And wouldn't that lead to more therapy? Which would lead to more overeating? And yet more fat cream?

3) But I digress. Thanks for the good news! Ahem.

P.S. What was the outcome of the second study, by the way?

Anonymous said...

jesse, you're surely a trooper, but think twice about getting in on this one, man.

Sunny CA said...

As a fat-thighed gal, I would love a cream that made thighs thinner, but as a scientist and skeptic, I have a great deal of disbelief. Have you ever joined a gym or hired a personal trainer intent on convincing you that it is worth continuing to pay for their services because they are making miraculous changes to your body? THEY measure you before and THEY measure you after a few weeks and regardless of weight loss or exercise, the waist, thighs, butt get smaller. Why? Soft squishy fat is very difficult to accurately measure and a motivated person can leave the measure a bit slack at the beginning and tighten it in the end. Would a drug company have a reason to introduce measuring error? Yes. I challenge any person who actually has fat butt or thighs to measure your thighs 10 times in a row and compare the numbers. Hand the tap measure to someone else and see what they get. What you will get is tremendous variability. I sometimes am at a loss as to what number to use when ordering clothes because there is so much squish it is hard to know the size accurately. There is also the difficult decision of where to measure the thigh. I heard once that standard is 7" lower than "the natural waist" which sound precise bu is not. Then there is the "measure the widest part" school of thought. What is the exact widest part and exactly what angle do you put the tape?

Anonymous said...

This is from the girl who thought Spinal Tap was a "real band" and so am now cursed to be married to a jazz musician. But to quote Spinal Tap: "The looser the waistband/ The deeper the quicksand/ Or so I have read/ My baby fits me like a flesh tuxedo" And I guess that is about all that needs saying in this lovely living room.
Going on vacation very soon!

Maggie said...

"All participants were placed on a diet of restricted calories and required to exercise. The test group rubbed a cream on the waist and the control group did not.
After 12 weeks, both groups had lost waist circumference but the cream group lost a lot more."

So the control group didn't rub anything on their waist? A couple years ago when that "Nivea My Silhouette Redefining Gel-Cream" came out, I did some poking around. I'd always believed that topical fat-loss stuff could never work, but I'd certainly LIKE to believe that there could be a topical fat-dissipating cream. What I encountered were articles noting that massage itself stimulates the blood flow to that particular area of the skin, so that the act of rubbing the stuff in could easily be creating the effect that the ingredients are purported to have.
For the study to measure the potential of that particular chemical to dissipate fat when applied topically, there would have to be another control group rubbing something into their waists that's known not to have any fat-dissipating properties.

And as someone who has spent the last couple of days making alterations to the Simplicity 2700 "Amazing Fit" pants pattern, I agree wholeheartedly with Sunny CA!

Sarebear said...

It's her blog, she can post whatever she likes.

I wonder what the lifting of the legs to get the cream ion all sides of the leg, if that played a factor. I know back when I left physical therapy, my thighs were noticeably thinner than before (yes I had lost some weight after each surgery) but later, when I reinstated some leg lifts. I noticed that my legs slimmed a little vs. when I wasn't doing them. I was doing these mostly for pain management; it turned out I had less pain in my legs (went from a lvl 7 getting up to a lvl 5.5) when I did these.

Anyway, granted lifting your leg and shimmying around to get cream everywhere isn't three sets of ten leg lifts but it's something, done consistently every day, and was it done more than once a day? Plus the fact that they may have been looking/checking their thigh several times a day to try to notice differences, thus more leg-lifting.

Can't of course say whether or not the cream did anything, but it's a thought.

Dinah said...

Jesse: Aminophylline, 0.5%. You should get some. More variables in this article:

PDF doc said...

As an MD, I would say that these studies show that you can prove anything if you work the statistics well.

As a former elite endurance athlete (therefore well atuned to disordered eating), I could give you many ways to lose weight for real.

A colleague, when asked by patients if there was an exercise to help lose weight would answer with a definitive "yes". He would then show a manouver with the arms pushing away from the body, like doing a push-up. The exercise? Pushing yourself away from the dinner table!

Anonymous said...

But, come on people, think of the rock lyrics BEHIND (or emblematic of a culture of) female body hatred which leads to more obesity. For example Led Zepplin (I'm really not that old):

I don't know, but I've been told/
A Big legged woman ain't got no soul/
Oh yeah, oh yeah, oh, oh, ah/
Oh yeah, oh yeah, oh, oh, ah/
All I ask for, All I pray,/
Steady lonely woman gonna come my way

Now that is some misogynistic, binge/bulimia/anorexia inspiring pop culture in the Zeitgeist. More interesting to talk about than some patently flawed study.... (Don't make me dig in for the AC/DC--b/c I don't know any....)

PDF doc said...

I love Led Zeppelin - now I'll be humming all day!

I certainly didn't mean to imply that disordered eating was the only way to lose weight. I'm sure that we would all agree that more of our patients suffer from pathology caused by obesity than pathology caused by eating disorders. Eating disorders are a serious problem, but there are also people who use the spectre of eating disorders to avoid eating responsibly. I see a lot of MSK stuff, and several times a day hear "I can't lose weight because my knee hurts and I can't exercise"...so frustrating...it is simple math - calories out > calories in will result in weight loss. Our culture is so ingrained in sedentary lifestyle and way too much food, especially high fat comfort foods. Think of the average nursing station - you can always find chocolate, donuts etc to eat!

Even though I'm not an elite athlete anymore and am on enough crazy person drugs to make me a beached whale, I still maintain a normal weight - daily exercise (running with the hyper border collie helps), and just paying attention to what I eat. I drag a huge bag of food to work every day, fruit, veggies, low fat yogourt...all filling and nutritious, and much less than 500 cals. That's not too little for me, having hit the time of life when I can apparently metabolize air into energy. Portion control, small plate, small bites, slow eating takes care of the rest. I fall off the wagon too, but try not to panic and resort to past unspeakable behaviours or just throw in the towel and give up, I just carry on.

Sorry about the rant, this is just one of my pet peeves!

Anonymous said...

PDF doc
I hear you in many senses of the word. But as a shrink I have to remind you to keep your peeve to yourself when dealing with patients. Nothing shuts an obese patient down faster than if they feel judged in a negative rather than an assessing way by their doctor about their weight. My peeves are dependent/"helpless" women and narcissistic men. I just want to put them out of my misery. Fortunately, euthanasia is not about this provider's comfort! So glad I got that first degree in philosophy because sometimes it takes ethics and not just psychoanalytic training to do the right thing.
Did I mention I am going on vacation soon? Giddy. I might be giddy.

rob lindeman said...


Anonymous said...

Being giddy and trying to avoid my paperwork I followed your YouTube link to Joe Tex on Soul Train singing "I ain't gonna bump no more with that big fat woman." And I thought that maybe you just thought it was funny but I think that despite the disco trappings, the lyrics of the song were in the traditional blues repetition pattern. And that is how it felt to me, like he was going to miss "that big fat woman" and like with the blues you sing passionately about how you aren't gonna miss that woman anyway. But then why sing a song about her? Oh, Rob, I bet you are a great pediatrician and I am glad that you are a pediatrician. I couldn't do it myself--some of the the parents would make aggro....

Anonymous said...

Sideways: maybe Rob did just think it was funny. Maybe you thought your comments, about putting patients who peeve you out of their misery, was funny. I will take Rob's funny if I have to choose. You believe that you do not to let on that they peeve you so, but if they bother you so much, do them a favor and don't assume they are too dumb to pick up on your negative feelings. If they do sense it, do you tell them no, it is their transference issues? Or is it that the men you mention feel so charming by nature of their soon to not be personality disorder (post new DSM) and the women are so clingy that they will not dare ask you a challenging question?Have a good vacation.

Dinah said...

Sideways Shrink: It's time to take that vacation.

PDF doc said...

sideways shrink - your reply made me chuckle, we all have our problem patients that make us cringe when we see the list!

Rest assured that I don't vent at my patients; in fact, I'm probably oversensitive about rude, arrogant physicians (3 of 4 years in an ortho residency will do that!). That combined with time on the wrong side of the table (or couch) have given me a small degree of empathy.

Often physicians don't bother to discuss obesity with their patients, whereas I do; but I try to listen, and to give some brief, helpful advice.

Wish I'd done philosophy as a first degree - mine was kinesiology - good for sport and ortho, not much else.

Most envious of your upcoming vacation!

Dinah said...

PDF doc, has your advice helped any obese patient to lose a notable amount of weight and sustain that weight loss? If so, do right a book and get rich quick!

Roia: I also wondered about the one-thigh fatter than the other result!

PDF doc said...

Thank you dinah, well said!

Unfortunately, my information and hand holding approach usually only results in modest weight loss, except for a few real converts (as you no doubt suspected).
But, I can afford to take the time to hand hold on my clinic day, as I usually spend 4/5 days a week in the OR! Having said that, the best weight loss results I've seen have been thanks to the surgeons!

Perhaps if you shrinks find a way to bottle willpower, you'll be the one writing the book...

Anonymous said...

I think this discussion illustrates the reason why side effects like weight gain, diabetes, etc were ignored for so long with drug like Zyprexa. Many psych meds have the side effect of weight gain, so you also have to consider your contribution to their weight problem.

I didn't have any weight issues until I was put on psych meds, and I don't have weight issues now that I'm off. That tells me something.

It's like putting a patient on megace and then encouraging them to watch their calorie intake.


Anonymous said...


See, I don't think narcissistic men are charming. If you do you are lucky. And I don't think my patients can't tell how I feel, that's why I refer the patients who consistently trigger negative counter-transference in me (which is rare) to someone else. I don't play God and think I can treat everyone. Rob does have a great sense of humor!

See you all at the beach!

rob lindeman said...

My goodness that's a nice send-off! (I'm going on vacation today too, just in case anybody wonders why I've wandered out of the living room)

wv = cledge; architectual element one walks off after 51 weeks without a vacation.

Anonymous said...

Sideways: I asked whether those men "felt they were so charming... Not sure how you read that as an implication that you found them to be charming. I wish you only charming and pleasant, well adjusted patients.

snore stop said...

I would love a cream that made thighs thinner, but as a scientist and skeptic, I have a great deal of disbelief. Have you ever joined a gym or hired a personal trainer intent on convincing you that it is worth continuing to pay for their services because they are making miraculous changes to your body? THEY measure you before and THEY measure you after a few weeks and regardless of weight loss or exercise, the waist, thighs, butt get smaller. Why? Soft squishy fat is very difficult to accurately measure and a motivated person can leave the measure a bit slack at the beginning and tighten it in the end. Would a drug company have a reason to introduce measuring error.

mem said...

Perhaps some more information would be helpful...Scroll down..lots of scholarly stuff in #1...











mem said...

Oops...forgot one of the most important links...

Here's a snippet:

"As readers will recall, the biology of the post-weight loss state is nothing like the biology of someone who has never lost weight. There are countless ways in which the psychoneurobiology, energy physiology and metabolism in anyone who has lost weight are remarkably different from someone ‘naturally’ of that weight.

Simply stated, someone who was 150 lbs and has lost 20 lbs cannot hope to maintain that weight loss by simply eating the same amount of food or doing the same amount of exercise as someone who is ‘naturally’ a 130 lbs.

The 150 lbs person who has lost 20 lbs, to maintain their new 130 lbs, has to actually now live like someone who is ‘naturally’ a 110 lbs; just eating like someone who is 130 lbs but has never lost weight, will simply result in rapid weight regain."


aek said...

What an interesting thread - and a complex topic. Thanks, mem, for thelinks and excerpt - I read all of those authors/blogs, and the Canadian folks are really the leaders in this.

Dinah, I read the Lundberg piece on Medscape, too, but I reacted differently. My question is why the use of therapeutic diets has gone out of favor and why physicians and nurses' biochem/nutrition education is so weak - and mostly wrong (speaking as a former nursing educator also tasked with occ teaching nutrition)

I also reacted as an n=1 self experimenter when I gained 20+ pounds and suffered iatrogenic dyslipidemias, a B12 deficiency and metabolic syndrome while on meds and wasn't aware of it (no scale/oversized clothes).

Mem's ref. list comprises a great deal of where I read as a launch into PubMed and the primary literature. Without consciously restricting calories and choosing the most nutrient and taste (as opposed to reward) dense foods, I re-regulated my appetite, hunger and satiety (No more food cravings or overeating), dropped into the middle of the normal BMI, have optimal labs and haven't regained any of the lost weight - again without restriction.

What it didn't do was change menopausal sx, pain, mood or sleep, but many others report differently. And on paper, I look golden. No meds or medical intervention, hence no healthcare costs. While doing this, I received absolutely no support, coaching or advice from my physicians. They never expressed any interest.