Estrogen also makes fat whereas testosterone breaks down fat. So a women's body is basically—and I hate to say it—genetically designed to be a place for cellulite to develop. Men have one layer of fat throughout their entire body and a one-to-one alpha- and beta-receptor ratio.
Today we're seeing younger women developing cellulite—women in their teenage years are getting cellulite. How do you explain that? Too much estrogen makes fat cells larger, so…younger women who are overweight might have a condition called estrogen dominance, which means they are making too much estrogen and/or are eating foods [such as soy or using containers that leak bisphenol-A] that have estrogen-mimicking ingredients.
Why do some women have more cellulite than others?
I've spent a lot of time traveling in developing countries and photographing local women. When I photograph these women [who don't have much, or any, cellulite], you see the kind of work they're doing and the kind of food they're eating. They're eating all organic foods, they're constantly moving from the time they get up. These women are washing clothes in the river. Getting water [in an industrialized country] means getting up and going to the fridge or faucet. For women in developing countries, they're walking to the river and coming back carrying a heavy container. So the physical activity levels in industrialized nations have also decreased.
Many women wear regular underwear with elastic across the buttocks. When you see panty lines, it's cutting off circulation—just think what it's doing to your body. Look, take a tourniquet, put it around your leg and see what happens. And a lot of women wear underwear under panty hose. The panty hose force the lymphatic drainage back into the body. It's like turning the hose on and clamping it so every thing gets backed up.
Cellulite didn't become a problem until the 1970s and 1980s when the diet and activity and underwear started changing. Back in the '20s, women wore longer skirts and the underwear was loose, almost like pajamas. Cellulite is always underneath where the elastics go, and if you draw an invisible line where the cellulite is, you will see where the panty lines are. I tell people the most important preventive thing you can do, if you can't afford treatment, is change your [style of] underwear: Wear a thong.
Does diet play a big role in the amount of cellulite people get?
Diet does play a role, because look, women in Asia, what do they have for breakfast? Noodles—it's a high-calorie meal, but when they go to work they burn those calories. In contrast, we eat these calories, then go to work and sit at a desk. Think of those [fat-producing] alpha receptors just waiting to rock and roll.
So, it all goes together. That's why women struggle to lose weight below the waist. From the waist up, for every four receptors that break down fat, there are five that make it, so it's almost a one-to-one ratio. From the trunk up, there's just one layer of fat, except for the triceps arm area.
It's really a whole biochemistry. People tell you: Don't eat fat, don't eat sugar. It's really more than that. It's hormone balance—you need to eat healthy, you need activity.