Abstract
Purpose. This is the first comparative study aimed to find out the effect of moderate continuous aerobic exercise versus the widely popular body reshaping intervention, cryolipolysis, on cortisol (stress hormone), aerobic capacity (VO2max), 6-minute walking test (6MWT) in central-obesity (CO) patients.
Methods. Sixty CO patients (30 men and 30 women) were recruited from El Zawia El Hamra One Day Surgery Egyptian Hospital with a body mass index (BMI) ranged from 35–39.9 kg/m2 to be randomly assigned to the aerobic continuous moderate-intensity exercise group (thirty patients who received 30 minutes of treadmill walking, 3 sessions per week) and cryolipolysis group (thirty patients received on-abdomen one session for 60 minutes weekly). Both groups were ordered to reduce their daily diets to 1500–1800 Kcal/day (the diet was revised by a diet specialist every 14 days to consider the inclusion of fat (20–25%), carbohydrate (high complex, 50–60%), and protein components (25–30%). Anthropometry (weight, BMI, and waist circumference), plasma cortisol, VO2max, and 6MWD were assessed before and after 12-week cryolipolysis and exercise.
Results. A significantly improved difference was extracted using paired tests either within-exercise or with-cryolipolysis groups regarding the patients’ weight, BMI, cortisol, VO2max, and 6MWT. In favor of the exercise group, the post-treatment comparison between exercise and cryolipolysis groups showed a more marked significant statistical difference (p < 0.05) regarding the patients’ weight, BMI, VO2max, and 6MWD. In favor of the cryolipolysis group, post-treatment waist circumference showed a more marked significant decrease when compared to its post-treatment level of the exercise group. Regarding post cortisol levels between exercise and cryolipolysis groups, a non-significant difference was reported.
Conclusion: After the addition of aerobic exercise or cryolipolysis to a 12-week supervised DR plan, both therapeutic interventions can improve central fat deposition, weight, cortisol, VO2max, and 6MWT in CO patients.

Keywords
aerobic exercise, cryolipolysis, cortisol, aerobic capacity, six minute walk test, central obesity