Cottage cheese. Orange peel. Dimples. There are just a few of the nicknames given to cellulite, the fat that accumulates underneath the skin. The lumpy, bumpy appearance of cellulite is due to the structure of the connective tissue (collagen) that lies right under the surface of the skin. When the underlying fat deposits begin to push against the layers of connective tissue, it gives a dimpled appearance to the skin. Cellulite is usually found on the thighs, buttocks, stomach and arms, and can occur in people who are thin as well as those who are overweight. Both men and women can get cellulite, but it is more common in women due to hormonal changes.

What Causes Cellulite?

Overweight, normal weight and underweight people can all develop cellulite, although body composition can affect both the presence and appearance of cellulite. People with a higher body-fat percentage and less lean muscle mass are more likely to have cellulite.

Other factors for developing cellulite include:

• Hormones (estrogen) - As women age, the production of estrogen declines. This hormone is responsible to keeping blood vessels flowing smoothly. Less estrogen means poorer circulation and a decrease in new collagen production.
• Smoking - Smoking reduces blood vessel flow and weakens and disrupts collagen formation, allowing for connective tissue to become stretched.
• Lack of physical activity - People who are sedentary are more likely to have less lean muscle mass and more body fat. As weight and body fat increases, it pushes against the fat underneath the skin, giving it a puckered appearance.
• Dehydration – While dehydration doesn’t directly cause cellulite, it can cause other changes that can increase the production of fat. People usually feel hungry before they feel thirsty and the increase in calorie intake over time can lead to weight gain. Also, dehydration affects the circulatory system’s ability to break down fat and eliminate it as waste.
• Thickness and color of skin - Cellulite is more evident on people who have thin skin and/or lighter skin tones. 

How to Get Rid of Cellulite

Most people who are plagued by cellulite will do anything to get rid of it—the quicker the better. Countless products like creams and wraps promise to reduce cellulite, but results are temporary and generally due to pulling water out of the body to give it a less puffy appearance.

Liposuction is a surgical procedure that removes deep, visceral fat, not subcutaneous fat (cellulite) and can actually make the appearance of cellulite more pronounced. In 2012, the Food and Drug Administration (FDA) approved a laser treatment for cellulite, which is an invasive procedure that melts the fat and connective tissues and stimulates collagen production. It has minimal down time, but is rather costly (several thousand dollars per session). A non-invasive device called CoolSculpting was recently approved by the FDA. It works by freezing fat cells, which the body then naturally eliminates. It is also an expensive procedure and some doctors question the ability of the body’s liver to handle a larger influx of fat to process and eliminate.

Diet and Exercise

Although most people would prefer a quick-fix solution to cellulite, it appears that good old-fashioned diet and exercise is the only proven method to safely and permanently reduce and prevent cellulite.

Diet

A well-balanced, plant-based diet will decrease inflammation in the body and promote weight loss. Focusing on fruit, vegetables, whole grains, healthy fats and lean proteins, while also staying well-hydrated with water and green and herbal teas, will help to nourish the body and prevent new fat cells from being formed, provided calorie intake does not exceed calorie output. Steer clear of fast food, processed and refined food products, as well as high-sugar foods and beverages. Choose organic and seasonal foods when possible, and make sure to carry a water bottle around as a reminder to stay hydrated.

Exercise

Regular exercise is key to losing body fat and reducing the appearance of cellulite. A combination of aerobic exercise and strength training has been shown to yield the best results. A study at South Shore YMCA in Quincy, Mass., found adults who did three 30-minute aerobic workouts per week for eight weeks lost 4 pounds, but gained no muscle. When participants instead performed 15 minutes each of aerobic exercise and strength training, they lost 10 pounds of fat and added two pounds of muscle and improved overall body composition. Aerobic exercise, such as walking, running, biking and exercising on an elliptical trainer, performed at a heart rate above 60 percent maximum heart rate will burn more calories and use more body fat as a fuel source. Both sustained heart-rate training and high-intensity interval training (HIIT) have shown adaptations in the body to burn a greater percentage of stored fat. Strength training helps creates new muscle tissue, which will in turn increase metabolic rate. Whether the mode of strength training is with weights or body weight, both will firm and tone muscles and will tighten the skin, making cellulite less noticeable.

The Bottom Line

Cellulite may not be pretty, but it isn’t harmful to your health. Although there are some factors beyond control (age, hormones, genetics), lifestyle changes (hydrate, proper diet, regular exercise, not smoking) that will reduce body fat and increase metabolism can help reduce the appearance and help prevent the formation of cellulite.