Is abdominal CoolSculpting effective on visceral belly fat (Lipodystrophy) caused bY HIV meds and if so will it last?

Question

Have been taking regimen for hiv therapy for 14 yrs. Belly fat is a side effect. It just won't seem to go away and is pretty rigid. It's getting hard to even tie my shoes sometimes. Exercise has done nothing. Could this be considered medically necessary to get insurance coverage?

Michael I. Echavez, MD · Answer

CoolSculpting will not treat visceral abdominal fat.  It will only treat the superficial fat that is just below the skin.  Unfortunately, there is not a safe a reliable method to remove visceral fat in the abdomen.  For some people, diet and exercise can help.

Julie A. Maughan, MD · Answer

Unfortunately, CoolSculpt only treats the fat above the abdominal wall.  There is no procedure that can safely access visceral fat to treat it.  Hope this helps!

Maurice M. Vick, Jr., MD · Answer

CoolSculpting will not reduce visceral fat. It only works on superficial fat. I have never heard of an insurance company that covers CoolSculpting. Best Wishes, Maurice Vick MD

Gerald Pierone Jr., MD · Answer

Hello and thanks for posting.
Cool Sculpting or cryolipolysis is a technique that targets subcutaneous fat for permanent reduction in the treated areas. 
  
People living with HIV who have long-term exposure to antiretroviral therapy have an increased risk of metabolic abnormalities, including visceral fat deposition. There is also increased risk of unusual subcutaneous fat accumulations – the classic example is a cervico-dorsal fat pad or “buffalo hump”.  The constellation of these findings are known as lipohypertrophy.  
  
Unfortunately, Cool Sculpting does not address visceral fat. I have used it successfully in HIV-infected patients with subcutaneous fat deposits, including a buffalo hump.  
  
There is a medication call liraglutide, also known as Victoza and Saxenda that is FDA approved for diabetes mellitus and obesity. This medication has been found to reduce visceral fat in diabetics.  Based on this observation, it might be useful in the treatment of excessive visceral fat in patients with lipohypertrophy. 
  
I hope that this information helps and best of luck to you!

Marguerite A. Germain, MD · Answer

Unfortunately, Coolsculpting cannot treat your visceral fat.  This fat is very deep and is in your peritoneal cavity so Coolsculpting applicators cannot reach it.  Unfortunately, lipoosuction cannot treat this fat either.  Diet does work for some people. Wishing you the best.

Drew Varano, MD · Answer

Coolsculpting  will not treat visceral fat. HIV Meds can cause accumulation of visceral fat . It will help with subcutaneous fat only

Shareef Jandali, MD · Answer

Hello,
CoolSculpting, unfortunately, does not target visceral fat, as this type of fat is within the abdominal cavity. It is a great procedure for reducing subcutaneous tissue, which the soft fat that lies directly underneath the skin. Consultations are the best to evaluate the area of concern to see what type of fat is present and if coolSculpting would be an appropriate treatment option for the area(s). At our office, we do offer complimentary consultations for coolSculpting which allows us to asses the area or areas of concern and create a customized treatment plan specific to your body. CoolSculpting is not covered by insurance. 
Diet and exercise can be helpful in reducing visceral fat.

Is abdominal CoolSculpting effective on visceral belly fat (Lipodystrophy) caused bY HIV meds and if so will it last?

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