Two press ads for The Slimline Clinic:
a. The first ad stated "Become slimmer in time for summer, with rapid Inch-Loss therapy at The Slimline Clinic! You will achieve the size & shape you desire after treatment with the latest, painless Ultrasonic Liposuction technology. Inches lost from Stomach, Back, Hips, Legs & Arms, Average permanent inch-loss is 15 after a 12 session course".
b. The second ad stated "Get the perfect beach body with Non-Surgical Ultrasonic Liposuction from The Slimline Clinic. The Slimline Clinic's Non-Surgical Ultrasonic Liposuction therapy has already helped thousands of men & women achieve the bodies they always wanted. It is fast, effective and 100% pain free ... Drop a dress size in 6 weeks, Lose up to 2 inches per session, Permanent inch loss, Sessions consist of a full consultation before an ultrasonic massage given privately by a qualified and experienced consultant, followed by a complimentary 10 minute session on our vibration plate to maximise inch loss. For fastest results treatments should be conducted twice weekly".
A testimonial stated "’This Inch loss programme worked for me. It can work for you, too!’ Leslie, 29, lost 16 inches in just 6 sessions! ‘The best thing was I didn't need a strict diet. Although, losing all those inches has encouraged me to live a healthier lifestyle - I'd never go back to my old body shape’". Further text stated "The Slimline Clinic makes losing weight easy, especially from stubborn fatty areas like your belly, hips, arms and legs".
The complainant, who had purchased a 12-session course, challenged whether the efficacy claims could be substantiated.
The Slimline Clinic said all their machines had a CE approval which demonstrated that they met regulatory requirements and that, if regulators required clinical trials, they were carried out prior to CE approval. They also said it was the responsibility of the manufacturer to provide such evidence but that, while the manufacturer made performance claims, the claims in their marketing communications were based on their own experience and data.
They said the treatment was based on ultrasound waves that, at specific frequencies, caused the fat in cells to liquify and drain from the body through its waste systems. They said, while fat was removed from the body permanently, if a client reverted to a diet and exercise regime where their energy expenditure was less than their energy intake then over time, fat would build up again. They also said the treatment removed fat without the need to diet or exercise. They said they established whether the client was fit and healthy enough to have the treatments before arranging a consultation to discuss diet and exercise and identify the location of the inch loss. They directed us towards a video on their website which they said showed the process their clients went through when they attended the clinic.
They said the claims "Become slimmer in time for summer", "You will achieve the size and shape you desire", "Get the perfect beach body" and "The Slimline Clinic has already helped thousands of men and women achieve the bodies they always wanted" were subjective claims that were based on feedback from their customers. They also said the claims that their treatment was "fast and effective" and resulted in "permanent inch loss" were factual and that the claims "2 inches per session" and "average permanent inch loss is 15 inches" could be substantiated by a study they conducted titled "Reduction of Subcutaneous Adipose Tissue Using a Novel Low Frequency Ultrasound - Cavitation Technology Device". They submitted a copy of the study which they said showed that, based on a single measurement around the waist of 24 subjects, a mean average of 3.58 inches were lost after 12 sessions and reduced body fat in the top, middle and bottom areas. They also submitted a table which they said summarised five clinical studies that were carried out by surgeons or medical companies and demonstrated that the average centimetre loss per treatment was between 1.7 and 3.2 per treatment for each patient. They submitted several articles about ultrasound treatments, one of which referred to a study for an ultrasound, non-invasive fat reduction and body contouring system and said the results were similar to their own study.
They said, because slimming was a whole body process and they did not offer a whole body treatment, they were not a weight-loss or slimming company and the weight control and slimming rules did not apply to them. They said their treatment was more like body contouring and removed fat from a specific area in order to change the shape to what the client wanted.
The ASA considered inch loss claims constituted slimming claims and that readers would understand that any claimed inch loss would be a result of weight reduction achieved by loss of body fat. Ad (a) stated "Average permanent inch-loss is 15 after a 12 session course" and "Inches lost from Stomach, Back, Hips, Legs & Arms" and ad (b) stated "Lose up to 2 inches per session", "The Slimline Clinic makes losing weight easy, especially from stubborn fatty areas like your belly, hips, arms and legs" and included a testimonial that stated "’This inch loss programme worked for me. It can work for you too.’ Leslie. 39, lost 16 inches in just 6 sessions". Because the CAP Code stated that it was unacceptable to claim that people could lose a precise amount of weight within a stated period, or that weight or fat could be lost from specific parts of the body except through invasive procedures, we concluded these claims were in breach of the Code.
Ad (a) also stated "You will achieve the size & shape you desire after treatment", "Become slimmer in time for summer, with rapid Inch-Loss therapy at The Slimline Clinic" and ad (b) also stated "Drop a dress size in 6 weeks", "Permanent inch loss", "[Non-surgical Ultrasonic Liposuction] can allow you to reach your ideal size in as few as 12 sessions", "The frequency of the sound wave targets fat cells, causing them to turn into a liquefied state", "... we allow the body to naturally filter the liquid fat" and "Our treatments ... get to work on your unwanted fat cells". These were objective slimming claims that either directly or indirectly implied that the therapy offered by The Slimline Clinic could result in the reduction of fat and therefore needed to be substantiated by robust documentary evidence.
The Slimline Clinic said they conducted a study that evaluated the efficacy of low frequency ultrasound in reducing unwanted local adipose tissue by measuring the abdominal circumference of 24 female patients aged 30 to 76 years before each of 12 treatments they received. The treatments were performed with a low frequency sound cavitation device and smooth movement of the applicator over the treatment area was applied. Each subject also received a lymph drainage therapy. After 72 hours circumference was measured. A results table indicated that the average loss of each subject after 12 treatments was 3.583 inches and the conclusion stated that low-frequency ultrasound was a safe, effective and non-invasive method of local fat reduction. However, the study was conducted by the Company Director of The Slimline Clinic, rather than a third party and the results were based on circumference measurements, rather than loss of body fat. Furthermore, there was no evidence that demonstrated that any measurement reduction was a result of the therapy, rather than other factors during the 72 hours after treatment and before final measurements were taken. The study was therefore insufficient in supporting any slimming claims, including those that related to inch loss. The table submitted indicated that, in addition to The Slimline Clinic's study, five clinical studies had been conducted. It stated various authors, number of treatments and subjects and loss of inches. However, full details of each study had not been included.
The video was presented by one of the consultants at The Slimline Clinic who explained how the process worked. She was shown turning on a machine which stated, "Radio Frequency System Cavitation Cellulite System" before using a large probe to massage the client's abdominal area. She stated "The treatment is completely painless and all you will feel is a warm sensation as the fat begins to liquidise beneath your body. We use an ultrasound machine similar to the machines used to do baby scans in hospitals ... The ultra sight sound waves pass through the fat layer causing the fat cells to vibrate against each other. As the fat cells vibrate the cells warm up and turn into liquid. Once the fat is in a liquid state it drains through the lymph nodes and exits the body via the lymphatic system over the next 72 hours." She also stated, "We will expect you to lose one to one and a half inches of area such as your tummy, after each session. Some clients may even lose three or four inches in total between sessions ... in as little as four weeks you can drop a dress size." While the video explained how the process worked, because we had not received any trials to support the claims made by the consultant, it did not constitute substantiation for the marketing claims.
Because we had not received robust trials to support the efficacy claims in ads (a) and (b), we concluded that they had not been substantiated and were in breach of the Code.
Ads (a) and (b) breached CAP Code (Edition 12) rules 3.1 3.1 Marketing communications must not materially mislead or be likely to do so. (Misleading advertising), 3.7 3.7 Before distributing or submitting a marketing communication for publication, marketers must hold documentary evidence to prove claims that consumers are likely to regard as objective and that are capable of objective substantiation. The ASA may regard claims as misleading in the absence of adequate substantiation. (Substantiation), 13.1 13.1 A weight-reduction regime in which the intake of energy is lower than its output is the most common self-treatment for achieving weight reduction. Any claim made for the effectiveness or action of a weight-reduction method or product must be backed, if applicable, by rigorous trials on people; testimonials that are not supported by trials do not constitute substantiation. 13.4 13.4 Before they make claims for a weight-reduction aid or regimen, marketers must show that weight-reduction is achieved by loss of body fat. Combining a diet with an unproven weight-reduction method does not justify making weight-reduction claims for that method. and 13.9 13.9 Marketing communications must not contain claims that people can lose precise amounts of weight within a stated period or, except for marketing communications for surgical clinics, establishments and the like that comply with rule 12.3, that weight or fat can be lost from specific parts of the body. (Weight control and slimming).
The ads must not appear again in their current form. We told The Slimline Clinic not to claim that people could achieve a precise inch loss within a stated period, or that weight or fat could be lost from specific parts of the body. We also told them not to make inch loss or other slimming claims unless they held rigorous trials to demonstrate that any such loss was achieved by the loss of body fat caused by the therapy.