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Recent Advances in Slimming Treatments

By Karen A. Costa-Strachan, PhD
Posted: August 22, 2007, from the September 2007 issue of Skin Inc. magazine.

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       Impacting adipose tissue. One class of ingredients commonly seen in slimming treatment products includes xanthines and xanthine derivatives. Xanthines are a class of pharmacological actives called beta-adrenergic agonists. Although xanthines have a number of well-known pharmacological effects, the main reason they are included in slimming product formulations is because of their ability to stimulate lipolysis, the breakdown of fat stored as triglycerides. More specifically, xanthine and xanthine derivatives work by inhibiting phosphodiesterase, which ultimately leads to the conversion of triglycerides into free fatty acids and glycerol. Examples of xanthine derivatives include caffeine, theobromine, theophylline and aminophylline.
       Xanthine and xanthine derivatives can be found in natural sources such as coffee beans, kola nut extract, guarana seeds, Chinese black tea, chocolate and plants such as yerba mate. Xanthines are also known to possess mild diuretic effects, so they can be included in slimming product formulations for this reason, as well. Xanthine derivatives are not the only materials used to target lipolysis. Milk thistle is an herb that has been used medicinally for its lipotropic ability to help remove fatty substances from the liver.22 Cayenne extract has been associated with increased thermogenesis.23 A new use for cinnamon may gain more popularity as recent research in adipocytes notes its lipotropic ability as well its insulin-mimetic effects that are due to a water-soluble chemical constituent called methylhydroxychalcone polymer (MHCP).24-25
       Other popular ingredients in the supplement arena that may have potential in targeting lipolysis in slimming treatments include Citrus aurantium (bitter orange) and green tea extracts. Franchi et al. describe how advances in adipocyte physiology and metabolism have led to a greater ability to demonstrate active ingredient efficacy in slimming formulations.26 It is noteworthy that at least one contract laboratory with a facility in France offers a full range of in-vitro screening for the efficacy of actives targeting lipolysis and lipogenesis through the implementation of human adipocytes/preadipocytes.

Mesotherapy
       Slimming formulations can and have drawn from a vast repertoire of active ingredients to produce desired effects. However, the newest method of body contouring to reach the United States may begin to influence not only the ingredients contained in slimming treatments, but also the delivery system of these ingredients.
       Mesotherapy was first pioneered by the French physician Michel Pistor in 1958 and was employed traditionally for pain relief.27–29 It has since evolved as a means of weight reduction without liposuction. The theory behind mesotherapy, or any microinjection, is that the fat-dissolving ingredients are administered directly to the body areas that require treatment. The procedure is touted as risk-free, painless and clinically targeted at areas to slim such as the abdomen, thighs and hips. It is believed that the mesoactive substances that are directly administered stimulate the metabolism of fat cells and accelerate their elimination.
       Mesotherapy is described as a minimally invasive procedure targeting problem areas of the body using microinjections of homeopathic medicines, vitamins, minerals and amino acids. Specifically, mesotherapy has been used to target cellulite, weight reduction and to help eliminate localized fat deposits.
       A similar treatment for localized fat reduction was popularized in Brazil. The Brazilian treatment utilized injections of a combination of phosphatidylcholine and deoxycholate as an emulsifier to dissolve fat and remove small pockets of adipose tissue.30 Such injections have since become synonymous with mesotherapy, although their history and technique are distinct.
       A recent article by Rotunda and Avram notes that experimental studies using individual mesotherapy ingredients for other conditions suggest a number of mechanisms—including lipolysis, disruption of CT and augmentation of circulation—which theoretically may improve cellulite; however, according to the article, peer-reviewed studies have not evaluated whether these effects translate clinically.31
       Whether mesotherapy is effective or not, the concept of targeted slimming may find its way into product formulations, just as the beauty industry has creatively and elegantly borrowed technology from other invasive dermatological procedures resulting in products such as Botox*-in-a-bottle or laser treatments without a laser. Perhaps a creative combination can be made from both mesotherapy and Botox? This is not such a far-fetched a concept. Lim and Seet note methods whereby the denervation of adipose tissue results in lipoatrophy, leading to the theory that chemodenervations using botulinin toxin may achieve the same result—fat loss.32
       One compelling reason for the development of a cosmetic equivalent to mesotherapy is given in a recent report by the Centers for Disease Control that describes an outbreak of mesotherapy-associated skin reactions.33 An effective, noninvasive cosmetic substitute for any invasive treatment, slimming included, might provide a safer, more marketable, alternative.

*Botox is a registered trade name of Allergan Inc., Irvine, CA.

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