Zeltiq Aesthetics (ZLTQ)

Saul (or anyone else who reads this board), have you looked into this company? This was a MF recommendation a while ago. I bought shares last August and I’m up about 40%. Now considering taking another bite, but I would love to get some other analysis and opinions about the company. My initial purchase was motivated almost entirely by the MF recommendation and the medical technology that ZLTQ has developed. Non-invasive fat removal without diet or exercise. I can’t help but to believe that there’s an enormous market for this product/service. They estimate they have achieved 9% penetration of North American market and 5% of international markets.

Saul has repeated many times that he’s not fond of story stocks, wants to see real earnings, so this alone might disqualify ZLTQ from his portfolio, but it’s not like they’ve got a drug in trials, they’ve got actual products, real sales revenue, international reach, and growing base of procedures completed utilizing their products. 50% of their revenue was derived from consumables in 2014 (for those of you who love the razor and blade model, as I do), consumables are expected to grow to 70%. Consumables revenues are growing faster than devices. They have a product pipeline, it is not a one-trick pony, but it is true that all their ponies ride in the same ring (but they are exploring other treatments).

In 2014 Zeltiq was recognized as the fastest growing medical device company by Deloitte.

Here’s an interesting investor presentation: http://files.shareholder.com/downloads/AMDA-HFC01/3889889528…

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Non-invasive fat removal without diet or exercise.

People worry about global warming. Worry about personal fat instead which has become an American epidemic and is becoming a global one.

I lost 35 pounds over the past five years or so and I’m weighing about the same as I did as a young adult. It was not a diet as much as a change in eating lifestyle. Eisenhower warned about the military-industrial complex. I warn you about the food-industrial complex. A lot of packaged goods are full of bad stuff like sugar and chemicals many of which are there not for your good but to preserve the packaged goods, to extend their shelf life and so on. Switch from packaged goods to fresh food with as little processing as possible. The other change is to reduce animal products and increase fresh fruit and leafy, colorful vegetables. If possible, switch to virgin olive oil. Stop eating sugar altogether, that’s the hard one.

And exercise is good. Go for a walk any time you can.

The Bachelor’s Cuisine
Since my dad had a hotel I was the guy who usually brought the food for our long distance sailboat races. Over time, I became the ship’s cook. Cooking is a creative art and I took a fancy to it. Now I want to share some of my culinary inventions. Simple but tasty.

http://softwaretimes.com/recipes.php

Denny Schlesinger

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Well done on the lifestyle change!
ZLTQ is an interesting MF Pick and one that I felt compelled to buy into. IMHO the American public will look to any quick fix for obesity. ZLTQ provides the most advanced, non-surgical option at this time. I took a small bite at the original recommendation, and while I am happy with the performance to date, I have yet to figure out whether or not it is worth taking a larger bite based on fundamentals and future prospects (other than my cynical view of why this will be such a popular procedure).
Best,
Rob

I looked at ZLTAQ but then went on the internet and looked for whether customers were happy or not happy with the results. It was a very mixed bag.
As with any cosmetic procedure it is hard to separate out results. How much was in operator skill? How much in patient selection? How many of the patients had blamed all their life problems on fat thighs, got them fixed but found out nothing in their life was any better after the procedure?
Also just because something is "non invasive"doesn’t mean it is better., or actually even non invasive because obviously the cold is invading tissues.

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I also looked at ZLTQ today. I read the recommendation and all the posts on the board. I read the last earnings report. I looked at the investor presentation. It all looked very tempting, but I couldn’t convince myself that this was right for me. It’s something intangible. It clearly works for some people, to some extent, and they are good at convincing doctors to buy the machine, so I presume it will do pretty well, but it just has a little feeling of hucksterism that makes me uncomfortable.

Saul

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Yeh I looked into this a few years ago when it started hitting Singapore. Many Spas have bought into it. Asians will try any crackpot idea that is promoted for aesthetic purposes from flashing lights to energy waves. When I read about the user experience on the web I decided it has very little genuine impact if any, that another new get thin quick scheme would come about and displace them and they might be exposed to litigation. Had I invested I would be 4x by now.
rrrr
Ant

Denny,
Thanks for your reply. In fact, I said nothing in my post about my personal situation, but now that you’ve brought it up, I’m quite a bit overweight and considering becoming a ZLTQ end customer as well as an investor.

Just for drill, I never experienced any weight problems until I turned 50. Prior to that I would eat what I wanted, as much as I wanted, whenever I wanted and would in some miraculous manner always maintain a weight appropriate for my smallish 5’6" frame.

After 50, I found that my weight would go up if I was careless about my diet. In that I had spent my entire life being small, I thought I would try and get as big as I could just to see what it would be like to have a large body and wear bib overalls and so forth. I managed to gain about 20 pounds and peaked at 165, somewhat pudgy, but not really big by any definition. I simply could not get any bigger.

Now, about 15 years later I’m having a hard time getting much below 190. My wife is Chinese which is to say that I eat a LOT of vegetables and not much meat. My plate is about 50% vegetables for both lunch and dinner. We also keep the rice and noodles to relatively small portions, often none at all, sometimes we split a steamed bun. We cook at home using fresh, raw ingredients the vast majority of the time (in the US we shop primarily at Whole Foods, in China we shop primarily at farmer’s markets). We only use olive oil (rather than the Chinese staple, peanut oil). We rarely use sugar, never drink pop, etc. We use a small amount of soy sauce, but infrequently add salt. Both in American and Chinese supermarkets I am constantly amazed by the vast array of packaged, canned and frozen products we never buy. Also, we walk an hour or more almost every day.

Yet, my weight remains stubbornly higher than it should be. Can you see why the Zeltiq offering might be of interest to me? Quite possibly my situation is not unique.

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A lot of packaged goods are full of bad stuff like sugar and chemicals many of which are there not for your good but to preserve the packaged goods, to extend their shelf life and so on. Switch from packaged goods to fresh food with as little processing as possible. The other change is to reduce animal products and increase fresh fruit and leafy, colorful vegetables. If possible, switch to virgin olive oil. Stop eating sugar altogether, that’s the hard one. And exercise is good. Go for a walk any time you can.

Denny, I love it! You’ve been spying on my family!
Saul

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Thanks Saul and others for prompt, thoughtful and thought-provoking replies to my original post. Saul, if memory serves, I think you posted at one time that you were an MD prior to retirement, so I gave your post extra consideration.

Someone else posted that Asians will try anything for aesthetic reasons, I spend a lot of time in China (I’m here now as I write this). My sense is that Asians (the Chinese anyway) will try anything for a variety of reasons. A couple of years ago my wife and I were on a bus tour of Zhangjiajie (fabulous scenery). The bus stopped at a foot massage clinic (for those who are not familiar with tours in China, your guide will take you to a number of commercial enterprises as part of the “tour”, I assume they either get paid to put the business on the route or at least get a commission on sales). Anyway, we all got a free foot soak and massage, which was the come on for selling us the potion used in the soak. There was a presentation which I did not understand, but the gist of it was that there were a host of proven medical benefits to be derived from the foot bath. I burst into laughter (the only one in the room laughing) when I discovered that the primary ingredient was literally snake oil.

I tried to explain to my wife what this term meant, but I don’t think she really grasped it. Also, my laughter did not discourage several people on the tour who purchased a bottle of the stuff.

Anyway, for those interested I’ve decided against any further investment in ZLTQ. Saul said it smacks of hucksterism - well, I think not quite, but upon further research I found that to be a candidate for this treatment you have to wanting to trim a little paunch here, or an extra inch there, but it would not help you if you were seriously overweight. So, the imagined customer base suddenly shrunk from the huge numbers of overweight folks to the truly vain who strive to look perfect. Further, I found customer reviews of the procedure to be mixed - with maybe a few more positives than negatives, but few folks seemed really enthusiastic about the results. I did not get the impression that this procedure left anyone with a “WOW!” response. Just, “Well yeah, helped me trim an inch and a half”, or some other tepid response.

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brittlerock, I hope you realize my “rant” was not aimed at you in any way. Mass obesity is an unfortunate consequence of affluence, we can afford to eat too much, something cavemen and hunters and gatherers could not do. An extra layer of fat was a wonderful store of energy for the next famine or winter but we no longer have famines, the supermarkets are fully stocked 24/7/365. So we have to learn restraint. But as a buddy of mine used to say, “The only thing I can’t resist is temptation.”

I apologize to anyone who felt offended by my rant. Sorry.

Denny Schlesinger

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Mass OBESITY is an unfortunate consequence of affluence, we can afford to eat too much, something cavemen and hunters and gatherers could not do. An extra layer of fat was a wonderful store of energy for the next famine or winter but we no longer have famines, the supermarkets are fully stocked 24/7/365.

Not too long ago, being fat was a sign of wealth and success as it signaled you could afford plenty of food when it was scarce…now, unfortunately with all the fast food chains, dollar menu value meals, and cheap high calorie, high fat, high sodium food in abundance the reverse is true.

Sweetadeline

Not too long ago, being fat was a sign of wealth and success
Very true and it still is amongst Chinese men to a degree. Japanese and Korean men see it as unsuccessful and have resisted the obesity epidemic more than Chinese. For Chinese, Korean and Japanese women though there is no such connotation, being pretty is a #1 pre-occupation. To this end everything has an aesthetic focus. Spas have been so successful here partly because they have medicalised their offering - to the degree that it is termed a “treatment”. This is the Zeltiq target market here. It is doubly successful as Asians would rather add something into the equation than drop something out. They would rather have their bubble tea, fairy cakes, KFC and aesthetic treatments than forego lifestyle preferences.

Asia is catching up with the West very very quickly and probably will overtaking it. I can see obesity climbing by the month in Singapore. (It has doubled in the last 7 years). It doesn’t help that nutritional information/awareness is woefully inadequate here (even if human anatomical understanding is much stronger than in the West), convenience and sedentary living ingrained and snacking culture prolific. Asia is making all of the mistakes the West did and more so. Zeltiq or any provider of either the promise of or the reality of effortless weight loss should be onto a winner here.

Ant

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Denny,
No offense taken - I only posted a reply in order to demonstrate that it’s possible to do all (or mostly) the right things and still have a stubborn problem with weight. It is enormously frustrating. I’m sure I am not the only one who fits in this category.

Being overweight is not an aesthetic issue with me, I’m too old for that and I’ve never been particularly vain anyway, but it is a health concern. I have some of the common medical conditions associated with being overweight which I am sure would be ameliorated if not entirely eliminated with weight loss.

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Ant,
Too true, though my experience and observations are with respect to the Chinese rather than Asians generally. In the past eight years that I have regularly spent time in China I can attest to a visible change in the physique of the average young Chinese male. To a lesser extent this also applies to the females.

In a nutshell, I observe an increasing proportion of young men who are heavy - I wouldn’t go so far as to use the term “fat”, but more men who are visibly bigger in the waist line are evident than when I first visited China about eight years ago.

I speculate (I have no quantifiable evidence) that American influence and business plays a large role in this. My impression is that the Chinese do not envy America, in fact they admire much of what the see of America (and Europe) via movies, TV, the internet, magazines and other print media. To a large extent they want to emulate the American/Western life-style. They most certainly have adopted (and adapted) a lot of Western fashion.

People in the West generally walk or ride bicycles for recreation or exercise, but not for commuting and running errands. We use cars for those activities. There has been a veritable explosion of motorized vehicles in China. Electric and gas powered motorcycles clog the streets and sidewalks (that’s right, no problem with driving you motorcycle on the sidewalk, and it’s the appropriate place to park your motorcycle). But cars are also everywhere, many, maybe the majority, are expensive European cars. Net result is people here get a whole lot less physical activity than they did just a few years ago.

The other culprit is Yum Brands, McDonalds, Starbucks and a few other American restaurant chains. High calorie, low nutrition KFC outlets are extremely popular. McDonalds are also everywhere, and suffer a drop off in business only after a food quality scare which occurs with some regularity (McDonalds always quickly deflects the problem onto some Chinese supplier rather than their business practices of always driving for lowest possible input costs, a business imperative, food quality, not so much). With the exception of the potato, not a vegetable to be sold in these stores (OK, maybe a bit of lettuce, onion and tomato on the more expensive burgers). Anything that came out of the water, has been subsequently dipped in batter and deep fried. Also, be sure to throw Coke and other high sugar drinks into the mix. The Chinese diet is becoming westernized in the worst possible way.

Undeniably, the Chinese are gaining weight.

This coupled with an obsession for beauty and fashion should be great for a business like Zeltiq Aesthetics. It’s Western. It’s high tech (another western penchant with high adoption in China), it holds the promise of making you more beautiful, a rapidly expanding middle-class with more disposable income - what could go wrong? And I note that ZLTQ is up more than 8.5% as of Monday’s close, just after I made a decision to not expand my position.

One thing that has not changed in China is the perception of value. Apple’s iPhone is the most desired phone because it offers high functionality and ownership cachet. It is considered a good value even at a premium price. Zeltiq’s cool-sculpting at an average treatment cost of $1,500 (US) - I’m not so sure. Dissatisfaction expressed on Weibo (Chinese Twitter-like platform) could kill this business in China very quickly. I’m not confident that the Chinese (and possibly other Asians) will perceive value with this procedure. If they find it over-priced, or simply fails to deliver as advertised, it’s dead on (or shortly after) arrival.

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http://finance.yahoo.com/news/coolsculpting-r-procedure-name…

I imagine this article had something to do with the jump in the 8.5+% stock price, although it appears to have been published the day after the stock jumped - I suppose it may have been leaked, not exactly insider trading, but not exactly public either.

The world of investing is filled with ambiguities.

Anyway, I talked to my wife about my decision to not increase my investment in ZLTQ (I did not sell either). My conclusion is as long as I have a logical, rational explanation for my actions, I’m going to be happy with the outcome. I can take responsibility for my decisions, the market will do whatever it does in spite of them.