RENEE MONTAGNE, host:

Now on Your Health, and the skinny on fat-dissolving injections. They're being offered in some medical day spas and plastic surgery clinics all across the country. If the thought of getting shots to shed inches in your tummy or hip sounds too good to be true, it might be.

NPR's Allison Aubrey reports on why some plastic surgeons are urging consumers to hold off.

ALLISON AUBREY: When 48-year-old Gabrielle Stoye decided it was time to get rid of the extra inches around her waistline, she bought a bunch of exercise gadgets and videos.

Ms. GABRIELLE STOYE: See all the tapes: "Tae Bo," "The Firm," "Body Flex." I just - I have just about everything, you can see.

AUBREY: When her love handles didn't shrink, she first considered liposuction, but was turned off by the idea of surgery. What she opted for instead is called lipo-dissolve, a procedure that involves a series of injections of a soybean derivative and an emulsifier right into the fatty tissue.

Ms. STOYE: And there was a little bit of discomfort and tenderness for a few days. But when the swelling started to go down, I was able to tell almost immediately that I was going to have size reduction.

AUBREY: Over the course of several months and several rounds of injections, Stoye says she lost five inches. She also acknowledges that at about the same time, she switched to a diet of raw fruit and vegetables that may also account for some of the loss.

Ms. STOYE: My stomach is gone. It's flat. So here it is.

AUBREY: Cosmetic surgeon Roger Friedman, who performs the procedure, admits not everyone who gets the procedure is satisfied. About 12 percent of 17,000 patients who tried it were disappointed, according to one survey. As Friedman administers a round of injections into patient Sonia Hanson's love handles, he says he thinks the procedure has a good track record.

Dr. ROGER FRIEDMAN (Cosmetic Surgeon): So the popping you're hearing is the pneumatic gun. And again, Sonia's probably be getting probably about 60 or 70 per side.

AUBREY: Sonia says the sensation is similar to a bee sting.

Dr. FRIEDMAN: What she's going to see first is she's going to see swelling. She may also have a little of bit of itching, also not uncommon. People get what's referred to as a histamine release.

AUBREY: The liquid that's injected into patients is marketed as a natural compound. But here is where the story gets interesting. The Food and Drug Administration considers the compound a drug, and has never approved it for this use. What's more, there's never been any rigorous studies to show it works. The best evidence comes from a survey of doctors already using the technique, but authors of the survey had financial ties to the company marketing lipo-dissolve. Critics say a bigger concern is safety.

Dr. JOEL SCHLESSINGER (Dermatologist; President, American Society of Cosmetic Dermatology and Aesthetic Surgery): The stuff may work, but the concern is what does it do while it is reducing that fat?

AUBREY: Joel Schlessinger is a dermatologist in Omaha and president of the American Society of Cosmetic Dermatology and Aesthetic Surgery. He says with these injections, it's unclear how exactly the body breaks down fats and clears the compound. There are no good safety studies. The backers of lipo-dissolve say the compound exits through the urine. But Schlessinger points out it's not that simple. First, it would be absorbed in the blood.

Dr. SCHLESSINGER: Through the blood, it would either be cleared through the liver or through the kidneys.

AUBREY: Where it could potentially do damage. Schlessinger has written to the FDA, asking the agency to investigate. And officials there are looking into it. In a written response to NPR's questions on the matter yesterday, the FDA emphasized that any drug must be approved by the FDA in order to be marketed in the United States.

Ms. CINDY PEARSON (Executive Director, National Women's Health Network): I think the FDA is saying, in so many words, that this is unlawful marketing and it should stop.

AUBREY: Cindy Pearson is the executive director of the National Women's Health Network, a nonprofit consumer advocacy group. She said the FDA should use its authority to halt the businesses until the marketers of lipo-dissolve take steps to gain FDA approval.

Ms. PEARSON: Until that happens, doctors should stop themselves and no longer use this.

AUBREY: Surgeon Roger Friedman, whose center worked on Gabrielle Stoye, says he's upfront with his patients that the process is not FDA approved. And his interpretation of the law is that he's not really marketing a drug. He says his group is selling a procedure that uses a natural compound. But he does agree research is needed.

Dr. FRIEDMAN: Currently, actually as we speak, we're working to actually study this. And we're going to do this as a multi-center study.

AUBREY: They'll have to start with the basics. For example, injecting the real compound into volunteers', say, left thighs and shooting a placebo into their right thighs.

Dr. FRIEDMAN: And then you then compare the results, not telling the doctor or the patient which is which.

AUBREY: That will help get at whether the procedure is effective. To check safety, researchers could look to see whether liver enzymes are elevated after the injections. Even before those studies are done and even before the FDA weighs in, it's clear many people seem willing to pay a few thousand dollars to try lipo-dissolve, even if it is unproven.

Allison Aubrey, NPR News, Washington.

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