If you're part of the 15 percent of women who have no experience with cellulite, then you are indeed blessed. For many of us, especially the ones who are veterans of the weight wars, however, we know it intimately. If you look in the mirror at all, there's no missing those fat deposits under the skin that make it look like orange peel, usually on our hips, buttocks, and thighs. It's most common in those of us of the feminine persuasion. It comes about because there are strands of fiber like collagen tissue that connect your skin with the underlying tissues and thus create compartments for our fat cells. When the fat cells get bigger, the compartments bulge out and produce the dimpling effect. The more fat in those fat cells, the more bulging and you can guess the rest.

But there also seems to be a genetic component that helps determine whether a person will display cellulite or not. Some thin women exhibit marked cellulite in certain areas and some women who are medically classified as *morbidly obese* don't display any at all. People who have thicker skin seem to have less of it, too. In addition, hormonal and other changes that occur during pregnancy and aging can lead to weakening of the collagen fibers and the thinning of the skin, both of which can lead to more cellulite.

There is no well-defined adverse medical effect of cellulite, other than cosmetic, so The Journal of the American Medical Association (JAMA) stated that *there is no medical condition known or described as cellulite in this country* almost 20 years ago. So there's no *cure* for this unsightly phenomenon, but there certainly seem to be a lot of products and procedures on the market with the professed goal of combating it.

Notwithstanding all these considerations, the conventional wisdom is that weight gain is directly associated with the appearance of cellulite on our bodies. If that's true, then losing weight should help get rid of it.

In the August 2006 edition of the journal of the American Society of Plastic and Reconstructive Surgeons, Dr. Sam Speron, from Chicago, described a study on 29 women who were enrolled in medically supervised weight loss programs. The programs varied from low fat meals to liquid diets to prescription drugs to surgery. The average weight loss for these patients was 30.5 pounds, but ranged from 2.3 to 102 pounds.

At the end of the study, seventeen of these patients had an improved appearance in the cellulite affected areas, but nine actually looked worse. The cellulite didn't totally disappear in anybody. The dimples got shallower in the patients who looked better.

So what made the difference? According to Dr. Speron, the patients who lost larger amounts of weight, especially fat in the thigh area, had the greatest improvement in their cellulite. These were also the patients who had the highest starting body mass index (BMI; a measure of weight to height) and the worst cellulite to begin with. The ones whose cellulite got worse started at a lower BMI, lost less weight, and did not decrease their percentage of thigh fat. Another important factor related to appearance was skin elasticity. If the skin didn't tighten up after the weight loss, the cellulite looked worse.

So what's a body to do? Seems a major key here is to reduce the percentage of fat in the thighs or wherever the cellulite is appearing. Anybody got any good ideas on how to do that? Seems the experts all say there's no way to get rid of subcutaneous fat in just one area. You can build the underlying muscles by doing exercises that emphasize using those muscles, but that doesn't reduce the fat over them unless we lose fat all over. So it's back to the sound diet and every day exercise routine. What price health and beauty?