Dear Carrie: Cellulite

Hi again, everyone. Thanks for the comments and emails in response to my last post on menopause and hot flashes. I’m working on getting through your questions and hope to do several posts throughout the summer that speak specifically to issues that matter to women. Now that summer is here for most of the country, it seems like a good time to share a frequent reader issue this time of year.

Dear Carrie,

I’m 35 and have been Primal for almost two years now. I’ve always been fairly thin, but going Primal in my eating and exercise has helped me get in better shape and build muscle. Unfortunately, I’m still plagued with some cellulite on the backs of thighs and hips. (Can I mention that I hate swimsuit season?) Why is cellulite so stubborn? Every “miracle cure” I’ve ever tried did next to nothing. Tell it to me straight – will this ever go away? Is there anything I can do? Thanks to you and Mark for everything you do with the Primal community.


Janet, you’re in good company – including in the Primal community. Cellulite is as stubborn as it is common. As you say, all kinds of products and procedures promise the moon but rarely deliver. The actual physiology of cellulite makes it hard to actually eliminate. Nonetheless, there are some Primal style approaches for both minimizing the look and addressing the causes of it.

As Mark likes to say, let’s first break it down. Cellulite describes the sometimes pitted appearance of fat deposits in the body. It’s most often seen on the thighs and derrière, but it can show up the hips, stomach, and upper arms as well. In milder cases, the tell-tale texture only shows up if you pinch the area or if the area is compressed (like when you bend down or cross your legs). In other cases, it’s visible regardless of your posture.

It’s probably of little surprise to say that women are more prone to it. (Aren’t we lucky, ladies?). Estimates vary but suggest that at least 80% of women have cellulite to some degree. (As I said, you’re in good company at least.) Women – even lean, healthy women – naturally have more body fat than men. Furthermore, our fat cells arrange themselves in more bulge-prone vertical columns as opposed to the more restrictive, reinforced net-like design men have.

The infamous pattern of cellulite forms from a simultaneous push and pull on fat cells in these columns. As our individual fat cells grow, they push outward through these columns. The “pull” comes from the fibrous connective bands that run between these columns to link the skin and muscle. The result of this “at odds” process is a bubbling effect – the bumpiness many of us see.

While the connective cords are flexible when we’re young, they tend to stiffen with age. The more fat you have to contain in these areas, the more strain there is on the connective tissue. Nonetheless, the thinnest, most athletic woman can have cellulite. On the flip side, there are women who carry a fair amount of extra weight and still have the smoothest thighs imaginable. Many experts believe there’s a genetic component to cellulite propensity, and some research has targeted genetically based factors.

Beyond the basic physiology of cellulite, different experts point to varying “contributing” factors. Hormonal changes, like the midlife decrease in estrogen, can contribute to a loss of elasticity in the fat restraining connective bands. During each pregnancy and for some months postpartum, our ligaments and other connective tissue are loosened by a natural release of Relaxin, which helps allow for the expanding uterus and aids in labor. Skin also expands and can remain slack post-pregnancy, which can contribute to the appearance of cellulite. If you’ve done a lot of crash or yo-yo dieting in your life, the back and forth changes can further slacken the connective cords. The hormonal effects of stress can influence fat production. Finally, a lack of activity and perhaps toxin buildup can impair the circulation and lymphatic drainage in cellulite-prone areas.

So, we have the million dollar question: can cellulite actually be “cured”? I know too many women who have tried too many methods and treatments to promise a miracle remedy. But I believe most women can see a decrease in the appearance of cellulite – and simultaneously improve the underlying physiological processes like circulation and lymphatic drainage that help prevent cellulite – through various lifestyle behaviors.

Although fat itself isn’t the cause of cellulite, reducing your overall body fat can take pressure off of the connective bands. Exercise is your best bet, and I’d recommend mixing it up. Use interval training to lose body fat and vigorous resistance training to build up and tone your muscles in areas where you have cellulite. The added muscle mass will help fill in where skin is loose from fat loss.

Yoga and Tai Chi both use whole body movement to enhance lymphatic drainage and detoxification. Dr. Howard Murad, author of The Cellulite Solution, says circulation and drainage – of both water and toxins – are key to fixing the actual physiological conditions behind cellulite. The more frequent movement, the better. Although there’s not much on record about our hunter-gatherer foremothers and the appearance of their thighs, some observations suggest the regular activity and clean diets of hunter gatherer groups meant cellulite was unheard of – at least in one Peruvian group.

You can enhance the health of your connective tissue and skin’s collagen through regular exercise, whole body movement like yoga and Tai Chi, avoiding sugar, and by incorporating relevant nutrients into your diet like EFAs (especially omega-3s), clean saturated fats, and glucosamine. (Sounds suspiciously Primal, doesn’t it?) Consider it a good excuse to make some healthy homemade broth on a regular basis. I’d recommend checking out the Cellulite Investigation website for more Primally-compatible tips.

Some women I know with cellulite look to Traditional Chinese Medicine, which treats cellulite as a deficiency in Qi/Chi. I know a few women who have had luck with acupuncture, which does genuinely improve circulation to the targeted channels and locations, can improve lymphatic flow, and purportedly nurtures the connective tissue. The effects on cellulite weren’t dramatic, but there was a discernible difference over the course of a few weeks. Moreover, the improvement appeared to be long-term, but these women were also doing yoga and other exercise as a regular routine.

Cellulite focused massage can temporarily improve the appearance of cellulite. A good massage can enhance drainage in the area, but the majority of its effect is probably mild swelling (like some of those cellulite creams induce). It might be a good option if you’re getting ready for a beach vacation, but don’t expect long-lasting results. Some friends have had luck with collagen-boosting creams like Retin-A and Renova.

As for myself, I know I’m lucky when I say it hasn’t been an issue I’ve had to deal with much. After having the kids, I did notice some changes in my thighs. When I bumped up my exercise routine and delved more into yoga practice, I noticed those changes gradually disappear. Some years later I adopted a more Primal Blueprint eating strategy and added extra weight training to my routine. Having rounded the corner into menopause, I believe these choices and my regular yoga practice have probably helped in this regard.

Finally, there’s the issue of perspective. Cellulite in and of itself isn’t unhealthy. If you’re lean, strong, and fit, these are far more important factors – for both the impact of your health and your physical appearance. Who’s with me on that one?

Thanks for reading, and share your own comments or suggestions on the cellulite issue. Enjoy summer, everyone!

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