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Innovative Technologies Preference for Slimming Treatment

Authors:

Abstract

Slimming centres are one of the popular places to reshape one’s body figure in Malaysia. Technology innovations are being used by the slimming centres to provide slimming treatments. This research looks at the preferred treatments that are commonly offered by slimming centres in Malaysia. Primary data were collected through a survey questionnaire. The unit of analysis were those consumers who had experienced consuming treatment in slimming centres. The data were collected based on a multiple response questionnaire and analysed using Statistical Package for the Social Sciences (SPSS). It was found that the majority of consumers had experience of consuming more than one treatment in slimming centres since the majority of slimming centres offer slimming treatments in the form of a package. Those slimming centres that offer more treatments within a package might appear more attractive to consumers. This research highlights the most common treatments that are normally experienced by the consumers.
1
International Journal of Business and Management 1 (2): 01-06, 2017
e-ISSN 2590-3721
© RMP Publications, 2017
DOI: 10.26666/rmp.ijbm.2017.2.1
Innovative Technologies Preference for Slimming Treatment
Hasliza Hassan
1
, Abu Bakar Sade
2
and Muhammad Sabbir Rahman
3
1
Faculty of Management, Multimedia University, Cyberjaya, Selangor, Malaysia,
2
Faculty of Business and Information Science, UCSI University, Kuala Lumpur, Malaysia,
3
Department of Marketing and International Business, North South University, Dhaka,
Bangladesh
Abstract: Slimming centres are one of the popular places to reshape one’s body figure in Malaysia.
Technology innovations are being used by the slimming centres to provide slimming treatments. This
research looks at the preferred treatments that are commonly offered by slimming centres in Malaysia.
Primary data were collected through a survey questionnaire. The unit of analysis were those consumers who
had experienced consuming treatment in slimming centres. The data were collected based on a multiple
response questionnaire and analysed using Statistical Package for the Social Sciences (SPSS). It was found
that the majority of consumers had experience of consuming more than one treatment in slimming centres
since the majority of slimming centres offer slimming treatments in the form of a package. Those slimming
centres that offer more treatments within a package might appear more attractive to consumers. This
research highlights the most common treatments that are normally experienced by the consumers.
Key words: Bodyweight, Malaysia, Obesity, Overweight, Slimming, Technology
INTRODUCTION
As a well-developing country, Malaysia has been
encouraging women’s empowerment in daily socio-
economic lifestyle. There is a continuous increase in
the percentage of women in the workforce and who
are earning a stable income for living. Nowadays,
with more purchasing power, women can spend
more money on their daily food. In line with the
continuous improvement in the education system in
Malaysia, more women are working in the corporate
sector as professionals. Due to a sedentary lifestyle,
especially by those women who are working in an
office environment, there is a continuous increase in
the percentage of overweight and obesity. This trend
has become more prevalent, with Malaysia being
acknowledged to have the fattest population in
Southeast Asia. Overall, the percentage of
overweight and obese women is higher than the
percentage of men with 48.6% and 43.8%,
respectively [1]. Due to the modern lifestyle with
better income, dining at restaurants has become a
culture in Malaysia. Although women are supposed
to consume fewer calories than men, 2,000 kcal and
2,500 kcal per day [2], respectively, no restaurants
in Malaysia customize the portion of food based on
gender. Instead, the majority of restaurants
encourage consumers to purchase more food in
bigger portions. Consequently, the behaviour of
excessive eating in the daily meals has somehow
made the whole nation fatter than before.
The media, especially women’s magazines, have a
strong influence in directing people’s perception of
the image of a perfect women’s figure [3]. The
majority of editors publish features on women’s
issues concerning fitness and health, and picture
slim women to encourage women to lose weight,
wear small size clothes and have small waistlines
[4]. The availability of such media content in a
highly overweight and obese population, especially
among women, has opened an opportunity for
slimming centres to grab the potential market. Due
to the influence of modern media, being oversized
can erode self-confidence and discourage someone
from moving forward, especially for those who are
working in the corporate sector. In addition, research
findings have shown that those who are overweight
or obese not only consider themselves as ugly and
are ashamed of their body figure, but also feel that
they are less effective in work performance [5].
Hasliza/ International Journal of Business and Management, 1(2) 2017, Pages: 01-06
2
The Malaysian healthcare system is ranked third in
the world after France and Uruguay [6], which has
made Malaysia a hot spot for medical tourism within
the last five years. The most well-known medical
treatments are cosmetic surgery, dental and
dermatology. This is mainly due to the cost-
effectiveness and excellent quality standard that can
be provided [7]. The momentum from medical
tourism has spilled over to slimming treatment. In
addition to support from tourists, the slimming
centre industry has been growing in the Malaysian
market due to the continuous growth in the
percentage of overweight and obesity in the
population. Slimming centres provide slimming
treatments through the use of technology
innovations with assistance from the therapist to
reduce the amount of fat underneath the skin. The
effectiveness of the treatment is very much
dependent on the capability of the available
technology. Some treatments require consistent and
continuous sessions while others can show
immediate results. Normally, the investment in the
slimming treatment will determine the speed and the
extent of the results that can be obtained from the
treatment. The common treatments that are normally
provided by slimming centres are deep tissue
massage, electric pads, sauna, hot blanket,
liposuction and laser lipo. Findings have shown that
the majority of consumers who have experience of
consuming the slimming treatment programmes
provided by slimming centres are satisfied with the
results to lose weight. However, the effectiveness of
these results also depends on one’s daily diet; as
without continuous control of one’s diet, there is a
high chance of regaining the weight six to eight
months after the slimming treatment [5].
LITERATURE REVIEW
One of the ways to reduce body weight is through
deep tissue massage [8]. Deep tissue massage is a
technique that reaches deep layers of the muscle and
fascia, which is the connective tissue surrounding
the muscle, through firm pressure and slow strokes
[9]. Deep tissue massage can assist in the relief of
stress, overcome muscle pain, ease movement for
those who have injured their tissue, and reduce the
heart rate and blood pressure [10]. The most suitable
way to massage is by manual lymphatic drainage
massage, self-massage over the abdominal area, and
vigorous massage for cellulite prone areas [8],
especially the thighs and buttocks [11]. Massaging
is able to reduce cellulite and make the skin firm and
supple after losing weight. However, an improper
massage technique might lead to injury [12]. Since
not everyone can employ the proper technique to
massage, it would be a good initiative to have an
advanced massaging technology machine in a
slimming centre. Normally, the therapist in the
slimming centre will assist the massaging by using
innovative technology or a machine. Hence, it is
highly expected that the result will be more intense
compared to a manual hand massage. Due to the
effectiveness of massaging to reduce body weight,
there are many innovative tools on the market that
can be easily used at home. However, the result is
not exactly the same as following the treatment by a
professional therapist from a slimming centre.
Electric pads, also known as electrotherapy, are a
tool that uses electrical muscle stimulation (EMS)
[13]. EMS is also known as neuromuscular electrical
stimulation or electromyostimulation [14]. This
slimming machine is used to reduce cellulite,
puffiness, and toxins in the body to lose weight and
inches. The electric pads are placed over specific
body areas. Normally, approximately 16 to 25
electric pads are placed on the body areas. The
muscles will contract due to electrical impulses that
are set through the machine programme, which
usually lasts between 45 and 60 minutes. The
effectiveness of the electric pads is dependent on
how deep the stimulation is within the muscles [13].
The electric pad treatment is combined with diet,
massage and galvanic treatments to reshape specific
body areas [15; 16]. Due to the continuous evolution
of technology, some slimming centres use electric
pads to reshape the facial figure, which is known as
facial faradic [17].
With the continuous improvement of technology,
traditional sauna has been transformed to became
infrared sauna and is commonly available in most
slimming centres. Unlike traditional sauna’s that
warm up the air with heat and humidity, infrared
saunas use light to create the heat [18]. Infrared
saunas can assist one in reducing weight within a
short period of time. However, this treatment does
not change the percentage of fat, muscle strength or
overall fitness [19]. The infrared from saunas can
penetrate up to 7.5 cm under the skin to push away
the sweat of the body. Infrared saunas are able to
burn 400 to 600 calories within 30 minutes, and a
person of average fitness can sweat a pound during
one treatment. In addition to reducing weight,
infrared saunas are able to improve health through
the detoxifying effect, and improve the immune
system, skin health and elasticity. This treatment can
also reduce cellulite, heart problems, hypertension,
and muscle and joint pain [20]. This treatment is an
alternative for physical exercise [21] and is effective
in reducing body weight [22].
A hot blanket is an alternative treatment to saunas in
which the whole body is heated directly. Since hot
blankets can provide direct heat to the body, this
treatment is more effective than a conventional
sauna and allows the consumers to breathe more
easily. This treatment usually takes approximately
Hasliza/ International Journal of Business and Management, 1(2) 2017, Pages: 01-06
3
30 minutes, and the infrared can penetrate the skin
to about 2 cm to 7 cm. In addition to burning fat, hot
blankets can also assist in increasing the
metabolism, and enhancing the immune system,
absorption of nutrients and blood circulation [23].
Further findings indicate that the hot blanket
treatment can also enhance cardiovascular health,
relieve stress, control cellulite, and enhance the
appearance of the skin [24].
Liposuction is the easiest way to remove substantial
amounts of fat in the body [25; 26]. Consumers are
given a general anaesthetic in advance and the
technique to suction the fat depends on the
accumulation of fat underneath the skin [27]. Due to
the complexity of the treatment, only a qualified and
trained surgeon should be allowed to handle this
treatment [28]. Although this treatment is effective,
the treatment leaves an obvious scar. In addition to
the obvious cosmetic effects, liposuction can change
the body composition, as well as the hormonal
balance and psychology of the consumers [25].
Findings have proven that liposuction treatment can
minimize cardiovascular risks [29]. Nevertheless,
consumers still need to control their daily diet after
the treatment to maintain their body figure
appearance. Without proper control of the diet, the
result of liposuction will not be sustainable in the
long term [30].
Laser Lipo is an alternative to traditional liposuction
[31] and breaks up fat using a laser without any
harsh suction. Similar to the traditional liposuction,
this treatment is more suitable for reducing the size
of specific parts of the body, such as the hips, waist,
and thighs. However, unlike other treatments, as this
treatment is unable to enhance the metabolism, it is
not suitable for people who are obese or pregnant.
The treatment usually takes between 20 and 40
minutes. Consumers who do not drink sufficient
water might feel tired, woozy or sick after the
treatment [32]. Only a qualified therapist in a
slimming centre can offer this treatment to avoid the
consumer’s skin from being burned by the laser [33].
Modern women who are willing to spend on their
body figure appearance might perceive laser lipo as
a better option than other treatments since it can
provide immediate results without extreme pain or
scarring of their skin.
METHODOLOGY
A cross-sectional study was conducted to discover
what kind of technology treatment is normally
preferred by those who have experience in
consuming slimming centre treatments. Due to this,
the unit of analysis for this research is those people
who have experience as well as those who are
currently experiencing treatment from slimming
centres within three main states Kuala Lumpur,
Selangor and Negeri Sembilan in Malaysia. The
questionnaire was set in a multiple response survey
format where the respondents were given the option
to choose more than one treatment in the slimming
centre. The respondents were given a brief
explanation about the research and questionnaire in
advance to ensure they could clearly understand the
purpose of the research and the questionnaire. None
of the respondents were forced to participate to
ensure the precision of the outcome. A token of
appreciation was given to those who were willing to
participate in the research survey. Overall, 308 data
were used for descriptive analysis by means of
Statistical Package for the Social Sciences (SPSS).
Since this research only focuses on six treatments,
the data used for analysis should be considered as
sufficient with the formula of 50 + 8k = N where 50
+ 8(6) = 98 [34].
RESULTS ANALYSES AND DISCUSSION
All of the respondents for this research are women
because the majority of consumers in the slimming
centres are women. Although the data collection
targeted women above the age of 20, the majority of
the respondents are aged between 35 and 39 years
(29.2%) followed by between 30 and 34 years
(25.3%). An average number of respondents are
between the ages of 25 and 29 years old (12.7%),
above 45 years old (12%), and between 40 and 44
years old (11%). Only a minor percentage of
respondents are between the ages of 20 and 24 years
old (6.8%). In line with this, the majority of the
respondents have an individual monthly income in
the range of RM 5,001 to RM 7,500, while the
average household income is in the range of
RM10,001 to RM 15,000. The majority of the
respondents are career women working as
government servants, private sector employees,
entrepreneurs, and charity organization employees.
Only ten of the respondents are housewives, and
eight of the respondents are students. In general, the
majority of the slimming centre consumers are
career women above 25 years old of age and have a
stable individual and monthly household income.
The main reason for this is probably because it
requires high investment to consume the slimming
treatments offered at slimming centres.
For each of the innovative technology treatments,
the respondents were requested to confirm whether
they had or had not experienced consuming any of
the six specified treatments in slimming centres
deep tissue massage, electric pads, sauna, hot
blanket, liposuction or laser lipo. To further
determine how often the consumers had consumed
the specific treatment, the experience was further
categorized into rarely, sometimes, frequently and
Hasliza/ International Journal of Business and Management, 1(2) 2017, Pages: 01-06
4
always. The summary of the findings is shown in
Table 1. The total combined percentage of
respondents who had experienced and never had
experienced consuming each innovative slimming
technology is not exactly 100% because some data
are missing. Missing data is unavoidable because the
data were collected manually through a survey
questionnaire. Nevertheless, the number of missing
data is minimal, between 1% and 3.3%, for each
treatment. This percentage is acceptable for
quantitative statistical analysis, which is normally in
the range of 15% to 20% [35]. Accordingly, the
available data collection was used for the following
descriptive analysis since the missing data would not
affect the overall research analysis.
Slimming centres provide a variety of treatments for
consumers to choose and experience. Based on the
findings, this research found that the majority of
respondents have experienced consuming saunas.
This is represented by 80.2% of the total respondents
(247 respondents). Also, a high number of
respondents have experienced consuming a hot
blanket, which is represented by 75.0% (231
respondents) and electric pads, which is represented
by 73.4% (226 respondents). Among the
respondents, 70.1% (216 respondents) have
experienced consuming deep tissue massage, while
only 65.6% (202 respondents) have experienced
using laser lipo. Only 55.5% of the respondents (171
respondents) have experienced using liposuction.
Overall, the percentage of respondents who have
experienced consuming treatments in slimming
centres is within the range of 55.5% to 80.2%. The
most common treatments that are provided and
consumed in the slimming centre are sauna and hot
blanket. The technology that uses heat to burn fat
seems to be highly acceptable by society since the
majority might perceive that burning fat requires
them to use heat to sweat. Electric pads and deep
tissue massage seem to be moderately accepted.
These two treatments use vibration technology to
burn fat. Although vibration technology does not fit
the common expectation of society to burn fat
through heat and sweat, this research found that a lot
of consumers have experienced consuming these
types of treatment. The number of respondents who
have experienced consuming laser lipo is low
because laser treatment is normally more costly than
other common treatments. Nevertheless, this is a
more advanced technology than liposuction where
the consumers can see the results almost
immediately after the treatment without any harsh
suction pain or scarring after the treatment.
The number of respondents who have experienced
using liposuction is much lower than other
treatments because not all slimming centres are able
to provide this treatment. In addition, normally, all
the treatments in slimming centres are provided by
therapists, whereas only qualified and trained
surgeons can provide liposuction services to the
consumers. Hence, not all slimming centres offer
this treatment and the cost for liposuction is
normally far higher than other treatments.
Nevertheless, liposuction treatment is able to
provide immediate results. Although the percentage
of respondents who have experienced consuming
liposuction treatment is the lowest, more than half of
the total number of respondents have consumed this
service. This shows that there is still a high potential
market for liposuction treatment since there are
consumers who do not mind spending extra for such
treatment.
No specific treatment appears to be preferred by
consumers since the majority have consumed more
than one treatment in the slimming centres. One of
the main reasons why the majority of the
respondents have experienced consuming a variety
of treatments offered by slimming centres is because
most slimming centres normally offer their services
as a package in which the consumer will experience
more than one treatment per package within a course
of treatment. The treatments might also be in
rotation depending on the number of treatments
taken within a package. Hence, it would be more
worthwhile to provide a wider variety of treatments
within one package as an attraction for the
consumers since different treatments might have a
different impact on reshaping the body figure and
expose the consumers to more treatment experiences
in the slimming centre. In addition, providing a
variety of treatments within a package gives an
impression to the consumers that their investment is
worth more since different treatments use different
technology. The more slimming treatments a
slimming centre is able to provide also acts as an
indicator of its reliability and capability
Hasliza/ International Journal of Business and Management, 1(2) 2017, Pages: 01-06
5
Table 1: Treatment Experience in Slimming Centre
Treatment /
Experience
Never
Rarely
Frequently
Always
Total
Deep tissue
massage
89
28.9%
216
70.1%
305
99%
40
13.0%
49
15.9%
38
12.3%
Electric pads
77
25.0%
226
73.4%
303
98.4%
56
18.2%
76
24.7%
18
5.8%
Sauna
58
18.8%
247
80.2%
305
99%
27
8.8%
69
22.4%
77
25.0%
Hot blanket
67
21.8%
231
75.0%
298
96.7%
37
12.0%
79
25.6%
42
13.6%
Liposuction
130
42.2%
171
55.5%
301
97.7%
41
13.3%
47
15.3%
30
9.7%
Laser Lipo
98
31.8%
202
65.6%
300
97.3%
42
13.6%
50
16.2%
34
11.0%
CONCLUSION
Although Malaysia is already ranked high globally
for its healthcare services, the demand for more
advanced slimming treatment technologies seems to
be lagging. Due to the modern lifestyle and increase
in the rate of overweight and obesity in Malaysia,
there is a high possibility that the market opportunity
for slimming centres will grow over the next few
years. The target market for slimming centres is
more streamlined to those career women with a
stable income who need to spend time to rest, but, at
the same time, prefer to be personally treated to
reduce their body weight and reshape their body
figure. In line with this, slimming centres provide
the ideal venue for consumers to pamper themselves
in a relaxing spa environment and obtain the desired
body figure without too much hassle, because almost
every treatment uses slimming technology
innovations with assistance from a therapist. In line
with the increasing number of women in the
workforce, there is a high chance for the
sustainability of slimming centres in the market. The
availability of slimming centres is somehow
empowering women to develop their socio-
economic stability.
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... Despite what has just been said, the exact and exhaustive mechanism of action of the IR rays and their direct or indirect biological effects are still poorly understood. The biological IR responses have instead been much more documented, and they generally include: enhancement of peripheral blood circulation, promotion of vasodilatation, blood flow, capillary dilatation and blood perfusion [6,34], reduction of blood pressure [35], reduction of oedema [36], enhancement of metabolism [6], recruitment, activation and proliferation of fibroblasts and increase the collagen synthesis, disposition and regeneration [26,37], improvement of wound healing and enhancement of endothelial repair [6,26,27], the increase of fat burning and the reduction of fat deposits, so help in losing weight and in inhibiting obesity [5,6,14,38,39], reduction of intravascular lipids deposition and risk of arteriosclerosis [40], the control of cellulite [38,[41][42][43], aid in photorejuvenation (reduction of pigmented lesions, fine lines and wrinkles) and photoprotection against UV-induced damage [44,45], stimulation of different types of neural cells and nerves with sedative and analgesic effects [46,47], alleviating fatigue and pain and improving muscle recovery and relaxation in athletes and shown positive effects on general disorders of the locomotor system [47][48][49][50][51][52], show an anti-inflammatory effect [1,6], increase relaxation, reduce insomnia, alleviate depression and improve sleep quality [6,53,54], control of hair loss of the scalp and regrowth of vellus [55,56]. ...
... Despite what has just been said, the exact and exhaustive mechanism of action of the IR rays and their direct or indirect biological effects are still poorly understood. The biological IR responses have instead been much more documented, and they generally include: enhancement of peripheral blood circulation, promotion of vasodilatation, blood flow, capillary dilatation and blood perfusion [6,34], reduction of blood pressure [35], reduction of oedema [36], enhancement of metabolism [6], recruitment, activation and proliferation of fibroblasts and increase the collagen synthesis, disposition and regeneration [26,37], improvement of wound healing and enhancement of endothelial repair [6,26,27], the increase of fat burning and the reduction of fat deposits, so help in losing weight and in inhibiting obesity [5,6,14,38,39], reduction of intravascular lipids deposition and risk of arteriosclerosis [40], the control of cellulite [38,[41][42][43], aid in photorejuvenation (reduction of pigmented lesions, fine lines and wrinkles) and photoprotection against UV-induced damage [44,45], stimulation of different types of neural cells and nerves with sedative and analgesic effects [46,47], alleviating fatigue and pain and improving muscle recovery and relaxation in athletes and shown positive effects on general disorders of the locomotor system [47][48][49][50][51][52], show an anti-inflammatory effect [1,6], increase relaxation, reduce insomnia, alleviate depression and improve sleep quality [6,53,54], control of hair loss of the scalp and regrowth of vellus [55,56]. ...
... It also differs from IR emitting materials for clothing because the type of discharge and the materials used are different. In addition, warm air allows heat to penetrate a few millimeters into the skin, while IR heat can penetrate into the skin from about 2 cm to 7 cm [38] and the depth of penetration depends on their wavelength, i.e. it decreases with the increasing of wavelength [8]. ...
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Infrared devices and technologies are used for weight loss, cellulite treatment, body remodeling, beauty treatments, and wellness. Infrared (IR) is a type of electromagnetic radiation that has the ability to stimulate living tissues resulting in numerous biological responses. Exposure to IR is perceived as heat and their mechanism of action is related to the absorption of energy by photoacceptor molecules. Adverse reactions have also been documented. The studies, research papers and reviews of the last thirty years have been collected and examined and this review describes in more detail the main devices that use infrared: infrared thermal blankets, far-infrared thermal blanket, infrared lipo laser paddles, infrared lamps, far-infrared lamps, infrared saunas, far-infrared saunas, and infrared caps. IR thermal blanket improves blood circulation and the metabolism of the whole body, accelerate the detoxification, trigger the consumption of calories and fat burning. It is an alternative treatment to saunas but more effective. IR lipo laser paddles are a non-invasive alternative to traditional liposuction that helps to remove fat accumulated in specific areas of the body. IR lamps increase the absorption of cosmetic products, improve local blood circulation and relieve muscle and joint pain. IR saunas have a relaxing effect and the same effects of the thermal blanket and the IR lamps. IR caps can stimulate hair follicles and hair regrowth. Despite numerous studies, the precise mechanisms of action of the infrared need more research as well as the molecular targets that are directly or indirectly involved by their thermal effects and their non-thermal effects.
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The images in advertisements have the power to shape one’s perception, specifically the way one looks at the world. While the images of women portrayed in most advertisements in the American and European context are often seen as a creation of artificiality that establishes an impossible standard of physical perfection for most women, the question of whether such a state of affairs exists in the Asian context and the underlying reasons for such a state remains in ambiguity. This paper seeks to shed some light in this dark area of the scholarship and contribute its findings to the body of knowledge as it aims to provide an in-depth investigation on how women are portrayed in Malay advertisements and the implications that may be perceived by its viewers, with a concentration on the area of artificiality. Several distinguished famous advertisements featuring women found in Malay magazines that are distributed worldwide were analyzed using a qualitative thematic analysis. The findings of the study indicates that women in Malay advertisements were being portrayed: (i) in an ideal yet artificial state of perfect facial beauty, (ii) passive and as a precious belonging to men, (iii) young with the characteristics of intelligence, cheer and beauty, (iv) being absolutely slim in all conditions, and (v) having high confidence even in their worst periods of the month. The rationales in the elucidation of the observed phenomenon and the subsequent theoretical and managerial implications were also presented in the paper. Keywords: Advertising, Artificiality, Malay, Portrayal, Women
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Background Liposuction can remove a substantial amount of body fat. We investigated the effects of liposuction of large volumes of fat on anthropometrics, body composition (BIA), metabolic hormones, and psychological measures in overweight/obese women. To our knowledge, this is the first study to examine both physiological and psychological changes following liposuction of large volumes of fat in humans. Method Nine premenopausal healthy overweight/obese women (age = 35.9 ± 7.1 SD, weight = 84.4 kg ± 13.6, BMI = 29.9 kg/m² ± 2.9) underwent liposuction, removing 3.92 kg ± 1.04 SD of fat. Following an overnight fast, height, weight, waist, and hip circumferences were measured at baseline (one week pre-surgery) and post-surgery (wk 1,4,12). Blood samples were drawn for fasting concentrations of glucose, insulin, leptin, and ghrelin. The Body Shape Questionnaire (BSQ), Body Dysmorphic Disorder (BDD) Examination Self-Report (BDDE-SR), and Zung Self-Rating Depression Scale (ZDS) were administered. Results Body weight, BMI, waist circumference, and body fat consistently decreased over time (p < .05). Glucose did not change significantly, but insulin decreased from wk 1 to wk 12 (p < .05). Leptin decreased from baseline to wk 1 (p = .01); ghrelin increased but not significantly. Changes in body fat and waist circumference (baseline to wk 1) correlated positively with changes in insulin during that period, and correlated inversely with changes in ghrelin (p < .05). BSQ scores decreased significantly over time (p = .004), but scores for BDDE-SR (p = .10) and ZDS (p = .24) did not change significantly. Conclusion Liposuction led to significant decreases in body weight and fat, waist circumference, and leptin levels. Changes in body fat and waist circumference correlated with concurrent changes in the adipose-related hormones, insulin and ghrelin (baseline to wk 1), and body shape perception improved. Thus, besides the obvious cosmetic effects, liposuction led to several positive body composition, hormonal, and psychological changes.
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Background: In 2010, overweight and obesity were estimated to cause 3·4 million deaths, 3·9% of years of life lost, and 3·8% of disability-adjusted life-years (DALYs) worldwide. The rise in obesity has led to widespread calls for regular monitoring of changes in overweight and obesity prevalence in all populations. Comparable, up-to-date information about levels and trends is essential to quantify population health effects and to prompt decision makers to prioritise action. We estimate the global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013. Methods: We systematically identified surveys, reports, and published studies (n=1769) that included data for height and weight, both through physical measurements and self-reports. We used mixed effects linear regression to correct for bias in self-reports. We obtained data for prevalence of obesity and overweight by age, sex, country, and year (n=19,244) with a spatiotemporal Gaussian process regression model to estimate prevalence with 95% uncertainty intervals (UIs). Findings: Worldwide, the proportion of adults with a body-mass index (BMI) of 25 kg/m(2) or greater increased between 1980 and 2013 from 28·8% (95% UI 28·4-29·3) to 36·9% (36·3-37·4) in men, and from 29·8% (29·3-30·2) to 38·0% (37·5-38·5) in women. Prevalence has increased substantially in children and adolescents in developed countries; 23·8% (22·9-24·7) of boys and 22·6% (21·7-23·6) of girls were overweight or obese in 2013. The prevalence of overweight and obesity has also increased in children and adolescents in developing countries, from 8·1% (7·7-8·6) to 12·9% (12·3-13·5) in 2013 for boys and from 8·4% (8·1-8·8) to 13·4% (13·0-13·9) in girls. In adults, estimated prevalence of obesity exceeded 50% in men in Tonga and in women in Kuwait, Kiribati, Federated States of Micronesia, Libya, Qatar, Tonga, and Samoa. Since 2006, the increase in adult obesity in developed countries has slowed down. Interpretation: Because of the established health risks and substantial increases in prevalence, obesity has become a major global health challenge. Not only is obesity increasing, but no national success stories have been reported in the past 33 years. Urgent global action and leadership is needed to help countries to more effectively intervene. Funding: Bill & Melinda Gates Foundation.
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A 2-step approach for obtaining internal consistency reliability estimates with item-level missing data is outlined. In the 1st step, a covariance matrix and mean vector are obtained using the expectation maximization (EM) algorithm. In the 2nd step, reliability analyses are carried out in the usual fashion using the EM covariance matrix as input. A Monte Carlo simulation examined the impact of 6 variables (scale length, response categories, item correlations, sample size, missing data, and missing data technique) on 3 different outcomes: estimation bias, mean errors, and confidence interval coverage. The 2-step approach using EM consistently yielded the most accurate reliability estimates and produced coverage rates close to the advertised 95% rate. An easy method of implementing the procedure is outlined.
Chapter
Liposuction is one of the most commonly performed aesthetic procedures worldwide and has caught the imagination of surgeons, patients and manufacturers alike during its brief history. The latter are now increasingly marketing direct to patients; however, liposuction is not a panacea for obesity and patients may not always fully appreciate this. On the other hand, eminently satisfactory outcomes are achievable with careful patient selection when undertaken by appropriately trained surgeons using optimally selected technologies. With such a range of techniques, technologies and recent advances, this chapter briefly reviews some of the pertinent scientific evidence.
Chapter
Liposuction is a very popular procedure that can remove substantial amounts of subcutaneous fat. This chapter presents the impact of surgical removal of subcutaneous adipose tissue on body weight. Current data does not support a long-term weight reduction following liposuction. The removal of body fat reduces the weight in the short term but also seems to trigger feedback mechanisms, which cause body fat and weight regain in the long term. This process follows fat redistribution, which occurs predominantly in non-aspirated fat depots. Additional clinical studies, with adequate follow-up period, are needed to determine the long-term effects of liposuction in body weight and composition.
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Liposuction surgery has generally been divided into volume liposuction and liposculpture [1]. In the former, large volumes of fat are aspirated in order to substantially improve the shape and contour of the body. This is a form of surgery directed towards the control of aesthetics and health in general and it can even be used in cases of true obesity. In liposculpture, small fat deposits are aspirated with the sole purpose of giving the body a better shape. This surgery is basically practiced for aesthetic reasons. However, a new technique has been developed in which large volumes of fat are aspirated and body contour is improved at the same time. Attention is paid to detail, especially in the flanks, back, waist, and hips [1]. The word sculpture come from the Latin sculpere, meaning to carve or scratch. It is a variant of scalpere, from which the English word scalpel is derived. Its past participle, sculptus, and the noun sculptura are other variants from which the word sculpture gets its origin [2]. The traditional volume liposuction implies performing large aspirations from specific sites of the body [3]. The authors' goal is to perform liposuction surgery for the whole body. In other words, the surgery is performed in different parts of the body at the same time. This is a combination of volume liposuction and liposculpture called volume liposculpture [1] (Table 63.1). Because of cultural, social, and ethnic reasons, most of the patients operated on are overweight. (Table presented).
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A severely obese 28 year old woman (body mass index (BMI) 37.9) with type 2 diabetes, controlled hypertension, and sleep apnoea is seeking your advice about weight loss. She has lost 6 kg over the past year by reducing portion sizes, but her weight has recently plateaued. She does not want to consider bariatric surgery and asks instead about drug treatments. Current treatment for obesity consists primarily of health behaviour modification (diet, exercise, and behavioural therapy) for all patients and bariatric surgery for a minority of selected severely obese people.1 Because health behaviour modification is unsuccessful in many patients, and the availability of bariatric surgery is limited, additional adjunctive, effective, and safe obesity treatments are needed. To date, antiobesity drugs have not adequately filled this therapeutic void. The serotonergic agents fenfluramine and dexfenfluramine were withdrawn in 1997 because of associations with cardiac valvulopathy and pulmonary hypertension.2 After the withdrawals of rimonabant ( Acomplia ) in 2009 for depression and suicidal ideation, and sibutramine ( Meridia, Reductil ) in 2010 because of increased cardiovascular risk, orlistat became the only agent available for long term weight management. In 2012, two new oral agents—phentermine and extended release (ER) topiramate ( Qsymia ) and lorcaserin ( Belviq )—were approved by the US Food and Drug Administration as adjuvants to health behaviour modification in patients with a BMI of greater than 30 or greater than 27 if they also had an obesity related comorbidity, such as hypertension, dyslipidaemia, or type 2 diabetes. As discussed elsewhere, the European Medicines Agency did not approve either agent, citing toxicity concerns and a lack of morbidity and mortality data.3 Here, we provide a clinically focused summary to guide GPs in the use of these drugs. ### Orlistat This inhibitor of gastric and pancreatic lipase prevents intestinal fat metabolism and absorption.4 Prescription orlistat ( Xenical ) has been …
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Numerous rules-of-thumb have been suggested for determining the minimum number of subjects required to conduct multiple regression analyses. These rules-of-thumb are evaluated by comparing their results against those based on power analyses for tests of hypotheses of multiple and partial correlations. The results did not support the use of rules-of-thumb that simply specify some constant (e.g., 100 subjects) as the minimum number of subjects or a minimum ratio of number of subjects (N) to number of predictors (m). Some support was obtained for a rule-of-thumb that N ≥ 50 + 8 m for the multiple correlation and N ≥104 + m for the partial correlation. However, the rule-of-thumb for the multiple correlation yields values too large for N when m ≥ 7, and both rules-of-thumb assume all studies have a medium-size relationship between criterion and predictors. Accordingly, a slightly more complex rule-of thumb is introduced that estimates minimum sample size as function of effect size as well as the number of predictors. It is argued that researchers should use methods to determine sample size that incorporate effect size.
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Due to recent trends in liposuction, anatomic consideration of the body’s fatty layers is essential. Based on this knowledge, a circumferential approach to achieving maximal aesthetic results is highlighted. In the upper arm, aspiration of fat from only the posterolateral region can result in skin flaccidity and disharmony of the overall balance of the upper arm contour. Different suction techniques were applied depending on the degree of fat accumulation. If necessary, the operation area was extended around the axillary and scapular regions to overcome the limitations of the traditional method and to achieve optimal effects. To maximize skin contracture and redraping, the authors developed three-dimensional circumferential liposuction (3D-CL) based on two concepts: circumferential aspiration of the upper arm, to which was applied different fluid infiltration and liposuction techniques in three anatomic compartments (anteromedial, anterolateral, and posterolateral), and extension of liposuction to the periaxillar and parascarpular areas. A total of 57 female patients underwent liposuction of their excess arm fat using this technique. The authors achieved their aesthetic goals of a straightened inferior brachial border and a more slender body contour. Complications occurred for five patients including irregularity, incision-site scar, and transient pigmentation. Through 3D-CL, the limitations of traditional upper arm liposuction were overcome, and a slender arm contour with a straightened inferior brachial border was produced. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors at http:// www. springer. com/ 00266.