Cold therapy for overweight and obesity
Evidence review
Overview
Almost all patient studies in obesity used whole-body or partial-body cryotherapy chambers (about -166 to -202 F for 2-3 minutes), not cold-water immersion; one laboratory crossover used a water-perfused cooling suit. In a 12-month lifestyle obesity program, adding 28 cryotherapy sessions did not increase weight loss (11.9% vs 11.5% at 5 months), although fasting glucose and LDL cholesterol fell more. In a randomized study of 65 overweight to obese adults, adding 10 sessions to interval training improved blood glucose but blunted some training-related changes. Small uncontrolled studies from a few research groups report reductions in inflammatory markers, leptin and body fat, increased resting energy expenditure, and better spinal and shoulder range of motion during rehabilitation; a 2022 scoping review judged the evidence insufficient for definitive conclusions. In a randomized crossover of 14 young men with obesity, 5 hours in a 60.8 F water-perfused suit lowered fasting glucose and improved glucose tolerance compared with a thermoneutral suit, an acute laboratory effect.
Key findings
- Controlled trial, n=19, 12-month lifestyle program +/- 28 cryotherapy sessions (-166 F): weight loss 11.9% vs 11.5% at 5 months and 9.9% vs 8.0% at 12 months (p>=0.54); fasting glucose -0.41 mmol/L (p=0.026) and LDL -0.44 mmol/L (p=0.034) more with cryotherapy at 5 months (Karppinen 2025).
- Randomized, n=65, BMI ~30: interval training + 10 cryotherapy sessions improved blood glucose (p=0.03), while FGF21, adiponectin, visfatin and beta-cell function improved only with training alone (Kozłowska-Flis 2021).
- Non-randomized, n=42, BMI ~38-43: 10 sessions (-166 F, 2 min) during 4-week rehabilitation improved spinal and shoulder range of motion (e.g. shoulder extension p<0.001, d=0.51); controls unchanged (Cerfoglio 2025).
- 10 sessions (-166 F) in obese men: TNF-alpha fell 4.3-fold and IL-6 by 19% in lower-fitness men (Ziemann 2013); hsCRP and hepcidin fell (Dulian 2015).
- 5 daily partial-body sessions (-202 F, 150 s): resting energy expenditure rose 5.5% in obese women (1,610 to 1,698 kcal/day) (De Nardi 2021).
- Scoping review (8 studies): data limited and insufficient for definitive conclusions; larger high-quality trials needed (Fontana 2022).
- Randomized crossover, 14 young men with obesity: 5 h in a 60.8 F water-perfused suit lowered fasting glucose, improved glucose tolerance and beta-cell response, and raised triglycerides vs a 77 F suit (Chamorro 2025).
Every study we reviewed
1 found no effect · 5 mixed results · 7 found benefit
Each study was checked on PubMed. The colored edge shows the direction of the result. The research library lists 34 studies on obesity, across all heat and cold therapies, including case reports and older work not graded here.
Effects of Whole-Body Cryotherapy Combined With Conventional Obesity Management Versus Obesity Management Alone: A Clinical Trial.
Karppinen JE et al. Obesity (Silver Spring). 2025. PubMed 40903800 · DOI · Free full text
- Who
- Adults with obesity in a 12-month lifestyle obesity management program
- What
- Whole-body cryotherapy chamber, -166 F (-110 C), 3-4 min, about twice weekly for the first 5 months (28 sessions) added to the program vs program alone
- Protocol
- -166 (chamber air) °F · 3-4 min · 2/wk · about 21
- Measured
- Weight loss at 5 and 12 months; BAT glucose uptake; energy expenditure; clinical parameters
- Result
- Weight loss 11.9% vs 11.5% at 5 months and 9.9% vs 8.0% at 12 months (p>=0.54); no difference in BAT glucose uptake or energy expenditure; greater reductions in fasting glucose (0.41 mmol/L, p=0.026) and LDL cholesterol (0.44 mmol/L, p=0.034) at 5 months with cryotherapy.
- Limitations
- Small; allocation method not stated in abstract; secondary outcomes not adjusted for multiplicity.
Short and long-term effects of high-intensity interval training applied alone or with whole-body cryostimulation on glucose homeostasis and myokine levels in overweight to obese subjects.
Kozłowska-Flis M et al. Front Biosci (Landmark Ed). 2021. PubMed 34856759 · DOI · Free full text
- Who
- Overweight to obese adults (BMI about 30)
- What
- High-intensity interval training (6 units) alone vs training plus 10 whole-body cryotherapy sessions, -166 F (-110 C), 3 min
- Protocol
- -166 (chamber air) °F · 3 min
- Measured
- Incretins, myokines, adipokines, glucose, HOMA-B
- Result
- Training alone increased FGF21 (p=0.03) and adiponectin (p=0.05) relative to training plus cryotherapy, lowered visfatin and improved HOMA-B (p=0.02); training plus cryotherapy improved blood glucose (p=0.03). Changes lasted about 4 weeks.
- Limitations
- Short intervention; surrogate outcomes; unequal group sizes; no cryotherapy-only arm.
Effects of whole-body cryostimulation on spinal and shoulder range of motion in individuals with obesity.
Cerfoglio S et al. Front Rehabil Sci. 2025. PubMed 40772266 · DOI · Free full text
- Who
- Adults with obesity in inpatient rehabilitation (BMI 38-43)
- What
- Whole-body cryostimulation, -166 F (-110 C), 2 min, 10 sessions added to a 4-week multidisciplinary rehabilitation program vs rehabilitation alone
- Protocol
- -166 (chamber air) °F · 2 min · 4 wk
- Measured
- Spinal and shoulder range of motion and task duration (motion capture)
- Result
- Cryostimulation group improved range of motion and task duration in all movements except anterior flexion (e.g. shoulder extension p<0.001, d=0.51; spinal rotation p=0.029, d=0.42); controls showed no significant change.
- Limitations
- Non-randomized; control group had higher BMI; musculoskeletal surrogate rather than weight outcome.
Whole-Body Cryostimulation in Post-COVID Rehabilitation for Patients with Obesity: A Multidisciplinary Feasibility Study.
Fontana JM et al. Biomedicines. 2023. PubMed 38002092 · DOI · Free full text
- Who
- Inpatients with obesity and post-COVID symptoms
- What
- Whole-body cryostimulation within a 4-week multidisciplinary rehabilitation program (exercise, diet, psychological support)
- Protocol
- 4 wk
- Measured
- Feasibility; weight, waist, lipids, inflammation, physical performance, pain, well-being
- Result
- All participants attended all sessions; weight, waist circumference, BMI, lipid and inflammatory profiles, physical performance, pain and psychological well-being improved significantly.
- Limitations
- Uncontrolled; cryostimulation cannot be separated from the rest of the program; magnitudes not given in abstract.
Different Changes in Adipokines, Lipid Profile, and TNF-Alpha Levels between 10 and 20 Whole Body Cryostimulation Sessions in Individuals with I and II Degrees of Obesity.
Pilch W et al. Biomedicines. 2022. PubMed 35203477 · DOI · Free full text
- Who
- Inactive men with class I (n=9) or class II (n=9) obesity and normal-weight controls (n=9)
- What
- Whole-body cryostimulation, -184 F (-120 C), 3 min, once daily 5 days/week, 20 sessions
- Protocol
- -184 (chamber air) °F · 3 min · 5/wk · 4 wk
- Measured
- Body composition, adiponectin, leptin, TNF-alpha, lipid profile
- Result
- Twenty sessions produced significant changes in body composition; leptin and TNF-alpha fell between sessions 10 and 20; no significant change in lipid profile.
- Limitations
- Small; no untreated control; magnitudes not given in abstract.
Blood pro-oxidant/antioxidant balance in young men with class II obesity after 20 sessions of whole body cryostimulation: a preliminary study.
Pilch W et al. Redox Rep. 2021. PubMed 33560197 · DOI · Free full text
- Who
- Young men with class II obesity (BMI >35, n=14) and non-obese men (n=10)
- What
- Whole-body cryostimulation, 20 sessions
- Measured
- Total oxidant and antioxidant status, antioxidant enzymes
- Result
- Total oxidant status was higher at baseline in obese men and fell significantly after the series; total antioxidant status unchanged; authors judged 20 sessions insufficient for class II obesity.
- Limitations
- Small; no untreated control; oxidative-stress surrogate only.
The effect of whole-body cryostimulation on body composition and leukocyte expression of HSPA1A, HSPB1, and CRP in obese men.
Pilch W et al. Cryobiology. 2020. PubMed 32289283 · DOI · Free full text
- Who
- Obese men (BMI 36.2, n=12) and normal-weight men (n=9)
- What
- Whole-body cryostimulation, -184 F (-120 C), 2-3 min, 20 sessions
- Protocol
- -184 (chamber air) °F · 2-3 min
- Measured
- Body mass, fat mass, CRP, leukocyte HSP gene expression
- Result
- Body mass, fat mass and body fat percentage decreased significantly in both groups; CRP was higher in obese men at baseline and after 10 sessions but not after 20.
- Limitations
- Small; no untreated control; magnitudes not given in abstract.
Body Composition, Lipid Profile, Adipokine Concentration, and Antioxidant Capacity Changes during Interventions to Treat Overweight with Exercise Programme and Whole-Body Cryostimulation.
Lubkowska A et al. Oxid Med Cell Longev. 2015. PubMed 26171117 · DOI · Free full text
- Who
- Adults with obesity (BMI 30.4)
- What
- Six-month moderate aerobic exercise program with two series of whole-body cryostimulation (20 sessions each)
- Protocol
- 26 wk
- Measured
- Body composition, adipokines, lipid profile, antioxidant enzymes
- Result
- Body mass, fat and lean mass and adiponectin, leptin and resistin did not change; LDL cholesterol and triglycerides decreased significantly and HDL rose slightly.
- Limitations
- Uncontrolled; exercise and cryostimulation combined.
The whole body cryostimulation modifies irisin concentration and reduces inflammation in middle aged, obese men.
Dulian K et al. Cryobiology. 2015. PubMed 26475491 · DOI
- Who
- Middle-aged men with obesity (BMI >30), physically active and inactive
- What
- Whole-body cryostimulation, -166 F (-110 C), 3 min, once daily, 10 sessions
- Protocol
- -166 (chamber air) °F · 3 min · daily/wk
- Measured
- Irisin, hsCRP, hepcidin
- Result
- Irisin rose in inactive men (338.8 to 407.6 ng/mL) but not in active men (371.5 to 343.3 ng/mL); hsCRP and hepcidin fell.
- Limitations
- Uncontrolled; very small; biomarker outcomes only.
Whole-body cryostimulation as an effective method of reducing low-grade inflammation in obese men.
Ziemann E et al. J Physiol Sci. 2013. PubMed 23744123 · DOI · Free full text
- Who
- Men with obesity (BMI >30), higher vs lower cardiorespiratory fitness
- What
- Whole-body cryostimulation, -166 F (-110 C), 10 sessions
- Protocol
- -166 (chamber air) °F
- Measured
- Inflammatory cytokines and adipokines
- Result
- In lower-fitness men IL-6 fell 19%, resistin 6.8% and visfatin 7.4%, and TNF-alpha fell 4.3-fold; IL-10 rose in both groups; adiponectin and leptin unchanged.
- Limitations
- Uncontrolled; very small; biomarker outcomes only.
Partial-Body Cryostimulation Increases Resting Energy Expenditure in Lean and Obese Women.
De Nardi M et al. Int J Environ Res Public Health. 2021. PubMed 33919703 · DOI · Free full text
- Who
- Middle-aged women with obesity (BMI 31, n=15) and lean women (n=16)
- What
- Partial-body cryostimulation (head outside the chamber), -202 F (-130 C), 150 s, daily for 5 days
- Protocol
- -202 (chamber air) °F · 2.5 min · 5/wk · 1 wk
- Measured
- Resting energy expenditure (indirect calorimetry), respiratory quotient
- Result
- Pre-session resting energy expenditure rose from day 1 to day 5 by 5.5% in obese women (1,610 to 1,698 kcal/day) and 8.2% in lean women; effect of session and time p=0.02, independent of group (p=0.09).
- Limitations
- Uncontrolled; 5 days; energy-expenditure surrogate only.
Whole-body cryostimulation in obesity. A scoping review.
Fontana JM et al. J Therm Biol. 2022. PubMed 35636880 · DOI · Free full text
- Who
- 8 studies of whole-body cryostimulation in patients with obesity
- What
- Whole-body cryostimulation
- Measured
- Weight, inflammation, oxidative stress, abdominal obesity
- Result
- Limited data suggest anti-inflammatory and antioxidant effects and possible reductions in abdominal obesity and body mass, but the data fail to reach definitive conclusions; larger high-quality studies needed.
- Limitations
- Scoping review of small, mostly uncontrolled studies.
Acute Cold Exposure Improves Glucose Tolerance and Induces Beta-Cell Secretion Response Linked to Lipid Utilization in Young Male with Obesity.
Chamorro R et al. Exp Clin Endocrinol Diabetes. 2025. PubMed 41125105 · DOI
- Who
- Young men with obesity (age 26.4, BMI 31.9) without other chronic disease (Germany)
- What
- Acute cold exposure with a water-perfused suit at 60.8 F (16 C), shivering avoided, 5 h in total vs the same suit at thermoneutral 77 F (25 C), randomized order
- Protocol
- 60.8 °F · 300 min
- Measured
- Glucose tolerance, beta-cell secretion and insulin sensitivity (Botnia clamp), lipids, hormones
- Result
- Compared with thermoneutrality, cold exposure raised plasma noradrenaline, lowered fasting glucose and improved glucose tolerance with a greater beta-cell response, and raised plasma triglycerides (figures not given in the abstract).
- Limitations
- Single 5-h laboratory session with a cooling suit, not cold-water immersion; 14 men; mechanistic, short-term outcomes.
Protocols used in the studies
Whole-body cryotherapy chambers at -166 F (-110 C) to -184 F (-120 C) for 2-4 min per session, usually 10-20 daily weekday sessions, or 28 sessions twice weekly over 5 months in the longest trial; partial-body cryostimulation at -202 F (-130 C) for 150 s daily for 5 days. Most studies combined cryotherapy with exercise, diet or rehabilitation. One acute laboratory study used a water-perfused suit at 60.8 F (16 C) for 5 hours. No trial of cold-water immersion in obesity was found.
What is still unknown
Whether whole-body cryotherapy adds clinically meaningful weight, glucose or lipid benefit to standard obesity care in adequately sized randomized trials; whether cold-water immersion has any effect in obesity (no trial found); durability after sessions stop; interaction with exercise training adaptations.
Safety
Cautions for cold therapy in this condition
- A single 3-min whole-body cryostimulation session lowered mean skin temperature by 12.9 C (23.2 F) in 21 patients with severe obesity without reaching dangerous levels; sex and age affected the response (PMID 41930507).
- Hematological changes after 10-20 sessions in men with obesity stayed within reference ranges (PMID 33886608).
- Adding cryotherapy to interval training blunted some training-related metabolic changes (FGF21, adiponectin, beta-cell function) (PMID 34856759).
- Cold exposure raises blood pressure acutely; obesity often coexists with hypertension and coronary disease. See the cold general safety entry for whole-body cryotherapy contraindications.
For clinicians
Suggested rationale
Whole-body cryotherapy did not increase weight loss when added to a lifestyle obesity program (Karppinen 2025), and the remaining evidence is small, largely uncontrolled studies with inflammatory, metabolic and range-of-motion surrogate outcomes (Fontana 2022 review). Current evidence does not support cold exposure as an obesity treatment; it has been studied only as an adjunct to rehabilitation.
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