I exercise and eat a balanced diet: why do I still have cellulite?

In a nutshell:

• Simply eating a balanced diet isn’t enough to make cellulite disappear completely.

• Exercising regularly isn’t enough on its own to make cellulite disappear completely either.

• As cellulite is multifactorial, structural and physiological, it requires a holistic approach. 

Your hormones play a key role in your cellulite

Oestrogen triggers a cascade of simultaneous biological processes that determine the appearance and development of cellulite in women.

Researchers agree on the close link between oestrogen and cellulite. This explains why cellulite affects women more, as oestrogen is a female sex hormone. In particular, it promotes gynoid fat distribution (thighs, hips, buttocks), water retention and the structure of connective tissue (with fibrous septa oriented almost vertically, resulting in a more visible dimpled appearance, unlike in men) (1).

Consequently, periods of significant oestrogenic fluctuations (puberty, pregnancy, hormonal contraception) are often accompanied by a worsening of the ‘orange peel’ appearance. Even over the course of a single menstrual cycle, you may notice a noticeable difference in the irregularities of your skin’s surface.

Did you know? A 2018 study also suggests that certain endocrine disruptors with oestrogen-mimicking effects could disrupt fat storage and water retention by ‘disrupting’ the hormonal system (2). Although plausible in light of recent scientific discourse on endocrine disruptors, this theory remains hypothetical.

There are certain anatomical factors that may contribute to this

As well as lifestyle factors, genetics can predispose some women to more visible cellulite.

Even amongst women, we’re not all equal when it comes to cellulite. Genetics carry more weight than a balanced diet and an exercise routine. So no, there isn’t a single gene specifically responsible for cellulite; but there is indeed a combination of several genetic variants that provides the perfect breeding ground for cellulite to thrive. Your genes determine, for example, the structure of your tissues. And unfortunately, inheriting fragile connective tissue means you’re predisposed to developing dimpled skin. This may involve fibrous septa that are too rigid, which consequently cause fat to ‘protrude’ all the more noticeably. Your genes may also be responsible for a lack of venous tone and a tendency towards water retention. All these factors play a key role in the development of dimpled skin (3).

Did you know? Genetics can also determine how sensitive your tissues are to fluctuations in oestrogen levels (4) and, furthermore, your fat metabolism.

Ageing skin is more prone to developing dimples

Skin ageing and the onset of the menopause bring about profound changes that accentuate the appearance of cellulite, particularly a decline in collagen.

Skin ageing also has a significant impact on the appearance of ‘orange peel’ skin. Despite all your efforts to maintain a healthy lifestyle, cellulite may seem to get worse simply because your skin is ageing. Over time, it loses some of its biomechanical properties. Collagen synthesis decreases in both quality and quantity. The result: the skin is less elastic, but also thinner. The bulging of fat cells against the skin’s surface is therefore much more pronounced in ageing skin. Even without gaining weight, you may therefore develop more of these small dimples typical of cellulite.

Did you know? Cellulite that appears during the menopause has several distinctive features. It results from a combination of collagen loss, skin laxity, stiffening of the fibrous septa, a reduction in muscle mass and a change in fat distribution (5). Most of these changes stem directly from the decline in circulating oestrogen levels.

Exercise: cardio vs. strength training – do you really have to choose?

No, and it seems more beneficial to combine the two. Cardio helps reduce the protrusion of fat lobules, whilst strength training helps smooth out irregularities on the skin’s surface.

In the popular imagination, exercising is one of the best ways to lose fat. This is true, except that current scientific understanding does not regard cellulite as a ‘simple’ excess of fat. Rather, it is a phenomenon that is both structural and hormonal (5). This is why losing fat can help to (moderately) reduce the appearance of orange peel skin, but without making it disappear completely. High-intensity workouts are effective for ‘burning’ fat and stimulating blood circulation. However, they have no impact on the structure of your connective tissue – which nevertheless plays a key role in the depth of the dimpling.

Worse still: overly strenuous cardio workouts that focus solely on weight loss can lead to a loss of muscle tone, which, paradoxically, can ‘deepen’ your dimples and make your cellulite even more noticeable. In fact, researchers recommend combining cardio with strength training. Adopting this combination regularly over several months could be the key to achieving more significant improvements in the ‘orange peel’ appearance of cellulite.

Diet: is cutting down on salt and ultra-processed foods enough?

No, arbitrarily restrictive diets cannot make cellulite disappear and may sometimes cause other imbalances.

The misconception that cellulite is solely linked to excess fat fuels the myth surrounding low-carb and ketogenic diets, detox, gluten-free or sugar-free diets. In reality, overly restrictive diets do not constitute a balanced diet. They may even indirectly contribute to cellulite by accelerating muscle loss and promoting the yo-yo effect. All these relatively arbitrary restrictions also carry a risk of nutritional deficiencies.

Furthermore, there is little scientific evidence to support the adoption of an anti-cellulite diet. Salt, for example, is sometimes banned on the pretext that it promotes water retention. Any resulting swelling, however, is temporary and has no effect on the structural mechanics of cellulite (orange peel skin). Ultra-processed foods, meanwhile, are suspected of stiffening the fibrous septa through the production of AGEs (advanced glycation end-products). Researchers have also highlighted a link between ultra-processed foods and dysfunction of adipose tissue (6). Nevertheless, this is not a direct cause of cellulite; rather, it is an aggravating factor. Reducing your intake is beneficial, but it merely serves to ‘limit the damage’.

In a nutshell: reducing the appearance of cellulite is about much more than just targeting every bit of excess fat.

Given that science describes it as a multifactorial phenomenon (genetics, hormones, ageing, tissue, circulation), the most sensible approach would be to aim for a balanced body composition. Rather than obsessing over ‘burning’ calories, it would therefore be far more beneficial to improve the quality of one’s supporting tissues (particularly through strength training) (7) and to maintaining a stable weight (without resorting to excessive cardio or becoming obsessed with a sculpted physique) (8).

It also seems worthwhile to look after the quality of connective tissue and its collagen levels. This approach relies in particular on a healthy lifestyle (regular physical activity, restorative sleep, giving up smoking, sun protection and a balanced, protein-rich diet) and on protective measures. One should therefore avoid anything suspected of causing the collagen fibres and fibrous septa to stiffen, particularly chronic excesses that contribute to oxidative stress, glycation and inflammation.

Everything therefore suggests that cellulite requires a holistic approach to be properly managed. This holistic perspective is precisely what functional medicine, which is holistic by nature, addresses. Our expert’s insight below illustrates just how cellulite, far from fitting the simplistic models sometimes attributed to it, is based on multiple and complex interactions.

A word from the functional medicine doctor

"I see many cases in my practice (lipoedema), yet cellulite is multifactorial. It is often linked to a metabolic problem: either it reflects low-grade inflammation (too many pro-inflammatory fats versus omega-3s), or it results from poor lymphatic circulation linked to thyroid dysfunction, or it stems from insulin resistance: breakfasts that are too sugary, snacks that are too sugary… There is also a link with cortisol: if pregnenolone, a precursor to many hormones, is mobilised to produce cortisol in response to stress, other hormonal pathways are less effectively supported (such as that of testosterone), which can contribute to cellulite. Finally, a lack of physical activity also plays an important role."

Dr Yoni Assouly, functional medicine doctor and author

A word from the nutritionist

"What role do blood sugar levels and insulin play in the development or persistence of cellulite? Insulin is a hormone that stimulates the storage of lipids in fat cells and inhibits the breakdown of fat (lipolysis). Chronic hyperinsulinaemia therefore promotes the hypertrophy of fat cells, the accumulation of subcutaneous fat and the structural changes in adipose tissue characteristic of cellulite. Repeated blood glucose spikes and insulin resistance are also associated with increased oxidative stress and low-grade chronic inflammation. Indeed, the inflammatory component of cellulite is now well established. Added to this are effects on microcirculation and water retention, which can accentuate the ‘orange peel’ appearance. Several hypotheses* link alterations associated with metabolic syndrome (characterised in particular by insulin resistance, abdominal obesity, dyslipidaemia, etc.) to the signs of cellulite. These two conditions share common mechanisms, such as inflammation, hormonal imbalances and disturbances in the functioning of adipose tissue." 

Reference: Adamidis N, Papalexis P, Adamidis S. Exploring the Link Between Metabolic Syndrome and Cellulite. Cureus. 29 June 2024;16(6):e63464. doi: 10.7759/cureus.63464.

Lila Bouber, PhD in Nutrition and Scientific Consultant

It may be helpful to incorporate skincare treatments into your daily routine that improve skin quality, along with massages that target lymphatic and blood circulation.

Whilst we cannot claim to cover all the causes of cellulite, certain natural skincare treatments can help smooth out the dimpled appearance of your skin. Active ingredients that support the activity of fibroblasts—which are involved in collagen synthesis—as well as caffeine, antioxidants and moisturising formulas are particularly recommended to help improve the appearance of the skin. We advise combining these with regular physical activity and a balanced diet to target several aspects of cellulite and optimise your results.

Wooden lymphatic drainage brush. Use just before showering, on dry skin, gently brushing towards the heart and from the bottom upwards for 5 to 10 minutes. Its exfoliating action stimulates microcirculation, which plays a role in cellulite (orange peel skin), for a toning and firming effect. Beech wood handle and sisal bristles derived from agave fibre.

Organic concentrated body treatment for a sculpted figure. Apply by massaging into the areas affected by cellulite, such as the tummy, thighs, bottom or hips. Its fresh, creamy texture melts quickly into the skin, leaving it feeling velvety soft, without any greasy or sticky residue. Certified organic formula, made in France. Do not use on children, or on pregnant or breastfeeding women. Do not use on irritated or broken skin, or on mucous membranes.

Cellulite (orange peel skin) is generally harmless. However, it can sometimes be a sign of significant underlying imbalances, particularly vascular, lymphatic, dermatological or endocrine ones. If you have any doubts, we encourage you to consult a healthcare professional.

When trying to improve the appearance of cellulite, staying hydrated is often one of the first steps to take as part of your daily routine. Properly hydrated skin and tissues promote better fluid circulation and can sometimes reduce the sensation of swelling or water retention, which can accentuate the dimpled appearance of the skin. Be wary, however, of a common misconception: tea and coffee are no substitute for water. Although they contribute to your overall fluid intake, their caffeine content can also have a diuretic effect in some people, especially when consumed in large quantities.

Hélène Betoux is a French beauty journalist specialising in web media. Every day she writes tips, advice, and guides to help consumers choose the right beauty products. With a strong interest in natural, organic, and clean cosmetics, she analyses and shares trends and innovations in the sector.