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CELLULITE CROSS SECTION: As fat pushes up on the connective layer (shown here in gray), it creates the bumpy surface on the skin we know (and love) as cellulite.
ISTOCKPHOTO/JGROUP

Editor's Note: This story is part of an In-Depth Report on the science of beauty. Read more about the series here.

Cottage cheese, orange peel, hail damage. By any other name, cellulite may still throw the perfectly sane into a tizzy as winter pants and coats are doffed for more revealing spring and summer styles.

This cultural anxiety has meant big bucks for some beauty product–makers and medical practitioners alike. A barrage of products and procedures promise to seek out and destroy the lumpy fat on thighs, bottoms, arms and tummies, but a miracle cellulite assassin has still yet to be uncovered.

It might stand to reason that in our fat-phobic culture, where even famous backsides (à la Jennifer Lopez and Kim Kardashian) are critiqued, such distinct jelly deposits are so loathed. And cellulite doesn't only afflict the full-figured. It's also a scourge of the skinny, not to mention girls as young as teenagers. Despite the vast amounts of time and money that have gone into trying to find ways to dissolve these nuisance nodules—from lasers to caffeine creams—researchers and doctors are still scratching their heads.

So can anything—other than a serious overhaul of cultural beauty standards—really conquer these less-than-darling dimples? We spoke with osteopathic physician Lionel Bissoon to help us get to the bottom (so to speak) of some of the cellulite hoopla. Bissoon runs a clinic for mesotherapy (injections of homeopathic extracts, vitamins and/or medicine designed to reduce the appearance of cellulite) in New York City, and is the author of the book The Cellulite Cure published in 2006.

[An edited transcript of the interview follows.]


What exactly is cellulite?
It's a condition that affects 90 percent of women and 10 percent of men, mostly in industrial nations. As women start approaching menopause, estrogen starts decreasing. From 25 to 35 is when you start seeing the appearance of cellulite. Estrogen has an impact on the blood vessels. When estrogen starts to decrease, you lose receptors in blood vessels and thighs, so you have decreased circulation. With decreased circulation you get less oxygen and nutrition to that area, and with that we see a decrease in collagen production…. [Also, at this time] fat cells start becoming larger, [they] begin protruding through the collagen [and become the bumpy fat known as cellulite].

Women tend to get cellulite around knees, saddlebags and buttocks, because they have three layers of fat in these areas [instead of just one]. Women also have three levels of fat in the stomach and in the triceps areas.

Does cellulite serve a purpose?
I don't think it has an evolutionary purpose. I think as people have evolved in an industrial society, we've become lazier. Our jobs are sitting at a desk, answering the phone. We don't go to the gardens and pick our food—we drive to the store and park in the spot closest to the building. So we've become more sedentary as a culture.

The bulk of the articles on cellulite in the scientific literature started in about the late '70s, but you [could] say women didn't expose their legs [much before then]. What I try to do is find old picture books, women in the 1950s or 1960s…. When you find these pictures, women had perfect legs. And back in the '40s and '50s they didn't have the computer programs to retouch those photos.

Why do women get cellulite more than men?
The [structure of] collagen, the main protein of connective tissue, in women has the appearance of a picket fence, whereas in men it looks more liked a cross-linked fence. So you can see the cross-linked structure is much stronger [and will hold fat in better].

Another reason women get cellulite has to do with the [two kinds of] adrenergic receptors. When stimulated, alpha receptors will cause fat cells to produce fat [as well as triggering constriction of blood vessels and release of sugar into the bloostream] when beta receptors are stimulated, they break down fat [as well as increasing heart rate and relaxing blood vessels]. In women, for every one beta receptor in the thigh, there are nine alpha receptors.