The Real Skinny on Cellulite

        Like many other woman,Susan Sebnick, 45 a teacher,hated the way her hips and bottom looked in the mirror:the cellulite and the layer of fat underneath gave her a bumpy,out-of-proportion look. Desperate to look better, she paid $200 for an anti cellulite cream she tossed out several weeks later. “ I went on every 'lose your cellulite' diet and exercise program in ever woman's magazine.” Sebnick says. “I just couldn't stick with them.”

         Many woman have had similar experiences, and are now asking if anything is effective against this unsightly condition. The first step is to understand what cellulite is—and what woman are up against.

       The “orange peel skin” called cellulite is the result of fiber bands that anchor skin to underlying muscle. In men, the tiny connective tissues form a crisscross, trellis-like pattern, resulting in a smooth skin surface. But in woman's cellulite-prone areas, the bands anchoring skin to muscle are attached vertically, forming mattress like pockets.

      Especially among women genetically prone to be bottom heavy, when these pockets fill up with fat, the characteristic punch-like marks become noticeable. “I've seen women of all ages with cellulite,” says Dr.Gerald Pitman, a Manhattan plastic surgeon and spokesman for the American Society of Plastic and Re constructive Surgeons. “Some have it at 16, some at 60.

       ”Worse, recent studies have confirmed what women always suspected---it's harder to lose weight from cellulite-prone areas. “Women's lower body fat is less metabolically active,” says weight-loss physician Michael Steel man, president of the American Society of Bariatric Physicians.

      “This appears to be because there are more alpha2 receptors on fat cells in the thigh area than are present in fat cells elsewhere. These receptors can be likened to 'off' switches that keep a cell's fat deposit from being burned up as energy.” adds Steelman.

So what works in the war on cellulite? What doesn't?

Skin creams

            Last year alone, overall sales of anti-cellulite creams approached $100 million. Many of the thigh creams on the market now contain ingredients like caffeine, which speeds up the body's metabolism when ingested, but whose effectiveness when slathered on the skin is unknown. Alpha hydroxy acids supposedly spur ex foliation of dead skin cells and stimulate production of the skin's own collagen (a protein found in connective tissue),thus making it more elastic. Their effectiveness in countering cellulite is unproved. Another sometime ingredient is collagen itself. But the FDA says there's no convincing evidence that the collagen in cosmetics actually penetrates the skin.

          The latest trendy ingredient is aminophylline, an asthma drug that, it is believed, might flip a switch in the cell, telling it to start burning fat.

         Two scientists, Drs. Frank L. Greenway and George A. Bray of the Pennington Biomedical Research Center at Louisiana State University, found that the substance could cause a small amount of shrinkage in cellulite-clad "saddlebag" thighs.

       In one study 18 overweight women were placed on a diet and encouraged to begin a walking program. Five used an aminophylline solution in a cream base on one thigh and a placebo cream on the other, five days a week for four weeks. The other women tried creams containing different drugs. The women using the aminophyllinebased cream lost about half an inch more on the treated thigh.

          Steelrnan, the weight-loss physician, also got good results over a 12-week period with arninophylline cream on overweight women who dieted and exercised. They also lost about a half inch more than the control group.

             "Women who used the cream felt it evened out the 'hail damage' cellulite appearance," says Steelman, who thinks that the creams may somehow relax the connector bands rather than stimulate fat loss. He isn't sure the cream will work long term, however.

            Nor does it seem to work alone. Dr. Leroy Young of the Washington University School of Medicine me in St. Louis tested aminophylline on women who were instructed not to modify diet or exercise in any way. It had no effect whatever.

        Dr. Iohn E. Bailey of the U5 Food and Drug Administration advises caution. He worries that an asthmatic might use aminophylline cream, become sensitized to the drug and then have an allergic reaction to aminophylline the next time she takes it to relieve asthma. Asthma sufferers should discuss arninophylline creams with a doctor before using them.

Verdict: Thigh creams haven't produced lasting results. However, 

an aminophylline cream, in conjunction with diet and exercise, might be beneficial.

Anti-Cellulite “Diets”

                   UNFORTUNATELY, there's no such thing, "There's only a diet to lose weight ' says Sheah Rarback, spokes person for the American Dietetic Association and assistant professor at a Miami medical school, "and you can't target where it will come off."

Close examination of "lose that cellulite" diets show they're merely low-fat regimens,much like other low-fat diets that make no cellulite claims.

Verdict: A low-fat, reduced calorie diet will help you slowly shed pounds and possibly 

lose fat in celluliteprone areas—but not necessarily.

Herbs and Pills

        “THE MAJORITY OF THEM do nothing,” says Bailey. Some of the substances are diuretics Water loss may cause a temporary illusion of a slimmer body, but you'll soon drink yourself back to where you started.

       One pill touted for weight and/or cellulite loss probably does speed up metabolism. Sometimes marketed as Ephedra or "Ma Huang," it's usually a combination of ephedra, an herb, and caffeine. But a few people have died after taking over-the-counter drugs containing ephedra, and hundreds of others have been treated for liver failure, high blood pressure or other perilous maladies.

       The good news is that the new generation of diet pills, including the oft-prescribed combination of phentermine (lonamin) and fenfluramine (Pondimin) are helping many people. The latest diet drug is dexfenfluramine, sold under the name Redux. Overall weight loss can also mean a decrease in cellulite—or at least the area may look better, since the fat layer underneath the rippled skin may be diminished.

Verdict: There are no miracle pills to get rid of cellulite. Many products on the market are scams 

(your wallet will get slimmer, but your thighs will stay the same), and some may be dangerous.

Liposuction

       THE PLAS1IC SURGEON who performs this procedure takes a wand-like instrument and, after making a small incision, literally vacuums up fat in the troublesome area. Dimpled skin remains after the fat underneath is removed, but most women report the surgery greatly improves the contours of cellulite-clad hips, thighs and buttocks. The best news about liposuction is that the fat cells suctioned out are gone forever. Even if a patient gains weight, it's less likely to be in that area.

         On the downside, liposuction isn't for everybody. The best candidates are healthy women of fairly normal weight who have pockets of fat in specific areas. And it can be very expensive. Most women tend to have two or three areas done, thus boosting the final cost. (Anesthesia and hospital charges are extra.)

Verdict: Liposuction is expensive, and dimpled skin remains, but the fat is gone.

Massages, Wraps, Hoses, Etc.

         MANY MACHINES and cellulitereducing devices loofah mitts and inflatable wraps, for instance are meant to act like massage. Some fancy spas have even squirted their clients with high-pressure hoses. According to doctors, these treatments don't work. "At best, massage can induce a small, temporary fluid loss or compress fatty tissues," says Steelman. Fit looks better, but it won't last." Massage doesn't break up fatty tissues, as is sometimes claimed. if it did, the little chunks coasting through your veins could cause a stroke.

Verdict Save your money.

Exercise

    SPOT EXERCISE ALONE----endless leg lifts, for example won't affect cellulite. But eventually cellulite on overweight women will yield to a constant exercise program, especially when paired with a low-fat diet, says David Brennan, an exercise physiologist. “The trick is finding a regimen you like so you can stay with it.”

       Start with aerobics aimed at strengthening the heart, which also has the effect of banishing flab. Walking 30 minutes a day, there times a week aerobics classes, running or cycling. Light weight-training or toning exercises are also important. “I used to have cellulite,” says Jooyce Vedral, author of Definition and other exercise books. “Without toned muscles underneath, the indented skin I is just hanging there. Light weight-training makes all the difference.” In fact, many studies indicate that strength-training programs actually change the body's metabolism so that fat is used up even in stubborn, cellulite-prone areas.

        Jidi Misssett, founder of an exercise program, says that people in the worst shape at the start of a program see the results of their efforts sooner than those who have less weight to lose or who are in better condition. “If you're already pretty trim, it may take six months to see improvement in cellulite-laden areas.” says Missett.

Verdict: For most people, exercise in conjunction with a healthful diet works.