Which nonsurgical procedures actually work? Business is booming in the fight against fat.

• Position: Fat Reduction

THE FAT fight is a booming business. Overall cosmetic surgeries in the U.S. have seen a consistent nine percent increase throughout the recession and are projected to reach a record of more than $15,000,000,000 by the end of the year. Liposuction is the fourth most common procedure, with more than 200,000 performed in 2011 alone.

Also on the rise is a dizzying array of nonsurgical fat reduction procedures that promise to shrink waistlines, eliminate love handles, and destroy fat. Most do none of the above and many are not even designed to affect fat cells--but they sell.

Mary Engle, director of the Federal Trade Commission's Division of Advertising Practices, maintains her agency lacks the resources to crack down on ads with exaggerated claims. "Often it doesn't rise to the level of fraud. There are so many problematic ads out there and we really have to pick and choose what we focus on."

This leaves the public to sort through a myriad of elective products and procedures that sound remarkably similar--everything from chemical injectibles, lasers, and radio-frequency heating to rubber suits and pills.

"It's such a crowded marketplace that we've confused patients and converted our industry into a circus with barkers and pitchmen selling a lot of junk. Doctors know better, but consumers have a hard time sorting out science from science fiction," confirms Bill Johnson, director of Innovations Medical, Dallas, Texas. He separates the procedures into three categories: those that do not work; those that are effective for skin treatment only; and those that reduce fat effectively.

"In the first category, nothing is [Food and Drug Administration]-approved or effective, and we can group all the chemical injectibles, wraps, and rubber suits under the heading of junk medicine." For example, mesotherapy claims chemical mixes injected or inserted under the skin can reduce fat, but little medical science supports the concept. Rubber suits are touted for weight loss, not fat reduction. Herbal and contour body wraps are advertised for safe and reliable weight loss, but again, no medical science indicates they produce results. Yet, these procedures generate millions in sales every year.

"In the second category, we have a lot of skin treatments that smooth out and tighten the skin, but do little or nothing to reduce fat," explains Johnson. "Some of them do help improve the waistline, thighs, or arms, but they do not affect fat cells."

Several of the more...