Lose Fat, Not Hope

by Dr Shuyan ( RJ CLINIC)

Are you frustrated by the stubborn fat that won’t seem to budge, despite your efforts at the gym? Do you find yourself dreading your workouts because they feel like a chore instead of a rewarding experience? If so, we have good news –

Aqualyx may be the solution you have been searching for.

Aqualyx is an injectable fat dissolving solution that can target areas like chin, abdomen, thighs, love handles, hips, knees and arms to help you achieve a more toned and sculpted appearance. However, it is important to note that Aqualyx does not provide a one-session solution for permanent or complete fat removal. Why? Let’s look into it in details to understand more.

How does Aqualyx work?

Aqualyx contains a compound called deoxycholic acid, basically a bile acid. It is one of the secondary bile acids that are formed by intestinal bacteria from their metabolism. Naturally, its function is to emulsify and solubilize fats from our diet in the intestine. Research started in 2002 implied that deoxycholic acid is responsible for the lysis of fat cells, and in 2007, Professor Pasquale Motolese developed this preparation and technique to perform this treatment. Aqualyx is injected subcutaneously (fat layer) to disrupt cell membranes in fat cells and destroying them over time- in a process called adipocytolysis. After the breakdown of fat cells, they will be drained by lymphatic system to the liver to be metabolised and then excreted by the kidneys.

Before deciding a treatment plan, we will assess your suitability for the treatment and discuss your expectations.

Suitability depends on few factors:

- Will you be able to accept the downtime?

- How much fat do you have? Or is it just loose skin?

- Any contraindications?

- Can you accept injections and some pain?

- Will you be able to stick to post procedure care?

Your expectations:

- Are you looking for a one-time treatment with immediate result?

- Are you aiming to lose just subcutaneous fat or visceral fat as well?

Let’s address these questions one by one.

1. Will you be able to accept the downtime?

Immediately after treatment, treated areas will appear red, swollen with possible bruising and itching. Do not worry, this is because Aqualyx works by triggering inflammatory response in your fat cells. Noticeable swelling indicates treatment progression and will last for around 5 days.

After swelling has gone down, you will return to look normal, but may not feel normal upon touching as there will possibly be small lumps and bumps that are not usually visible under the skin and may take a week or more to resolve. These lumps and bumps may be bruises or dead fat tissues that are still pending to be taken away by your lymphatic system.

All these effects also depend on the amount of solution injected. For example, the face only requires a small amount of fat dissolving solution, so side effects are minimal and requires shorter recovery period.

It is better to avoid strenuous exercise for the first week while your body is still processing. But overall, downtime for Aqualyx is pretty tolerable and you can still head back to work after treatment.

2. How much fat do you have?

Aqualyx is effective in reducing localized pockets of fat. If you have excessive amounts of fat or are significantly overweight, exercise and healthy diet to lose weight should be your main aim, while Aqualyx can be used for stubborn fat that are resistant to diet and exercise.

Sometimes, you might mistook loose skin as fat. Loose and flabby skin will not benefit from Aqualyx injection. Instead, Ultherapy will be the choice of treatment for loose skin at face, chin and neck and radiofrequency for the body.

3. Any contraindications?

There are few conditions when Aqualyx is contraindicated, which means if you have one of these conditions, you should not go for Aqualyx injection.

- Pregnant

- Breastfeeding

- Autoimmune disease- Treatment may exacerbate the conditions.

- Diabetes- Aqualyx is contraindicated in individuals with uncontrolled diabetes because it can potentially increase blood sugar levels from the inflammation and tissue damage. Furthermore, individuals with diabetes may have impaired healing, hence higher risk of infection.

- Allergic or anaphylactic reaction to Aqualyx

- Skin disease on treatment area- Treatment may exacerbate the conditions.

- On blood thinning medications, in particularly warfarin, as there is risk of severe bruising

- Severe liver and kidney disease- Deoxycholic acid is primarily eliminated from the body through liver and kidneys. In people with kidney disease, the function of kidneys is compromised, which can lead to build up of toxins and waste products in the body. Extra fat could also overwork the liver, which can be problematic for people with liver disease.

4. Can you accept injection and some pain?

Aqualyx treatment involves multiple injections to the target areas. Numb cream and ice pack application before injection can minimize pain and discomfort. Local anaesthesia will also be mixed together with the fat dissolving solution. You may still experience minimal discomfort, more of a burning or stinging sensation upon injection, but most people find it tolerable.

5. Will you be able to stick to post procedure care?

After Aqualyx treatment, you should consume low-fat diet to reduce additional stress to your liver by having to cope with processing two sources of fat, which are fat from your usual diet and fat destroyed by Aqualyx injection. As Aqualyx dissolves the fat, manual massage is encouraged not only to ensure even distribution for better result, but also to aid lymphatic system in eliminating the waste products. You should also drink plenty of water after treatment to help flush out the waste products.

You should avoid exposure to extreme temperature, including saunas, steam rooms and sunbathing until the initial swelling has resolved, which takes about a week. Strenuous exercise should also be avoided for a week as you may still feel tender and uncomfortable. You can resume gentle exercise when you feel ready.

6. Are you looking for a one-time treatment with immediate result?

If you are in a hurry to lose fat or if you prefer a one-time treatment with immediate result, then Aqualyx is not a suitable choice of treatment. Unlike liposuction, in which fats are sucked manually and removed as much as possible, Aqualyx depends on the action of deoxycholic acid that disrupts cell membranes in fat cells and destroying them over time. The action of deoxycholic acid is variable as it can be influenced by multiple factors. You can expect to see a noticeable reduction in size and contour of treated area within a few weeks after treatment, with optimal result typically visible after few sessions depending on areas being treated. Sessions required can range from 3 to 8 treatments, with the least required for smaller areas with lesser fat and vice versa.

Hence, if you have just undergone the first Aqualyx treatment and no visible improvement yet, don’t need to feel demotivated. Be patient and continue with the treatment plan and you will see improvement eventually.

However, there are ways to help Aqualyx work better. This include massaging the treated areas to allow dispersion and even distribution of Aqualyx throughout the fat tissues, and avoiding anti-inflammatory medication that will counteract the effect of Aqualyx.

7. Are you aiming to burn subcutaneous fat, or visceral fat as well?

Subcutaneous fat is the fat underneath you skin, whereas visceral fat is the fat that lies deep within your abdominal walls and wraps around your liver, stomach, intestines and other important organs. The most obvious sign of visceral fat is a growing belly, but it can indicate subcutaneous fat as well.

Sedentary lifestyle and poor diet with high intake of saturated fats and carbohydrates increase visceral fat. Surprisingly, stress contributes to the build up of visceral fat too.

This is because stress activates cortisol, which is a hormone in your body. High cortisol level activates your body’s fight or flight response that triggers buildup of visceral fat.

Some levels of visceral fat are healthy and act as protection to your organs. However, too much visceral fat can be dangerous, and is more dangerous than subcutaneous fat as it can increase the risk of certain health problems, such as heart disease, stroke and diabetes. If you have too much subcutaneous fat, it is often a sign that you have too much visceral fat as well. It is important to note that health is more than beauty. It is true that aesthetic and surgical procedures can help to reduce your subcutaneous fat and achieve your ideal body shape, but healthy diet and exercise should not be forgotten to ensure healthy level of visceral fat.

While Aqualyx can be effective at reducing subcutaneous fat, it is NOT designed to target or eliminate visceral fat.

If you are looking to reduce visceral fat, it is important to focus on healthy diet and regular exercise. This can help to decrease overall body fat and improve your overall health. Treatment like Redustim can also help to burn up to 8% of visceral fat.

Redustim is an aesthetic medical device that uses BioStimology technology, in which low frequency alternating BioEnergetic field stimulates calcium pump in the muscle cells. Calcium pump causes contraction of muscles, and uses energy in the form of ATP that is derived from visceral fat, thereby reducing visceral fat. Treat

ment takes 45 minutes per session, and effect is comparable to heavy exercise. On top of that, ReduStim has micropressure that follows the direction of lymphatic drainage. This helps to eliminate toxins and metabolic wastes including broken down fat cells from the body through lymphatic drainage. In short, Redustim helps you to lose weight while improving your health.

ReduStim treatment is completely painless. It only involves you slipping into the special suit connected to the device, and relaxing yourself in a lying down position for the entire procedure. However, treatment requires 2 to 3 sessions per week with a total of 12 sessions. Maintenance treatment is advised for continuous improvement.

There are also some common questions regarding Aqualyx:

1. Is Aqualyx harmful to the body?

Aqualyx is composed of naturally occurring ingredients, deoxycholic acid, which is a secondary bile acid. After it is injected and fat cells are destroyed, the remains are processed and eliminated from the body through the lymphatic system. Therefore, Aqualyx itself is not harmful to the body. However, when there is pre-existing disease that may complicate Aqualyx treatment, such as liver or kidney disease and as mentioned in “contraindications” earlier, Aqualyx should be avoided.

2. Is the result permanent?

Not exactly. Fat cells that are destroyed are lost permanently. Results can be maintained as long as you commit to healthy lifestyle alongside treatment. If you have inactive lifestyle and consume diet high in saturated fats and carbohydrate (sugar), fat cells that were not destroyed by Aqualyx will begin to grow with time.

In conclusion, Aqualyx is an innovative and effective non-surgical treatment to reduce stubborn fat in specific areas of the body to help you achieve a slimmer and more contoured appearance without the need for surgery or long downtime. However, treatment is a choice and a shared decision making between you and the doctors. The information given above should have more or less covered your doubts on whether you are a suitable candidate for Aqualyx treatment.

How about weight loss then?

In recent times, there has been a lot of buzz around weight loss injection drugs such as Saxenda and Ozempic. Saxenda contains Liraglutide, whereas Ozempic contains Semaglutide, which are both Glucagon-like peptide 1 receptor agonist (GLP-1 RA). Ozempic is originally used to treat people with Type 2 Diabetes mellitus. They are not insulin injection. They mimic glucagon hormone in our body, and both glucagon and insulin are equally important to manage the body’s blood glucose level.

They work by suppressing the hunger centre in your brain responsible for appetite. They also give you feeling of fullness as stomach emptying is delayed, meaning that the food you consumed remains in the stomach for longer period of time before it is digested. This causes people to eat less and lose weight over time.

Although it sounds tempting to people who are eager to lose weight, they do cause side effects like nausea, vomiting and diarrhoea. A more serious risk linked to these GLP-1 drugs is hypoglycaemia (low blood sugar level), but higher risk if you are also taking other blood sugar lowering drugs like sulfonylureas or insulin.

Though not proven in human, lab studies have linked these drugs with thyroid tumours in rats. Hence, these drugs are not recommended if you have family history of medullary thyroid cancer or multiple endocrine neoplasia. They are also not recommended if you have had pancreatitis.

Question is, if you rely solely on the drug to lose weight and continue an inactive lifestyle and unhealthy diet, what happens when you stop taking the drug?

There is a high likelihood that you will gain the weight back. It is not sustainable to take these drugs for the rest of your life, nor is it necessarily desirable, given the potential for side effects. Adopting healthy lifestyle can be challenging because it means changing your habits and behaviours, but it is ultimately more sustainable and without side effects.