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Episode 99: Uncovering the Causes of Cellulite and How to Manage it with Dr. Azza Halim

Brief summary of show:

In this episode, we dive into the topic of cellulite. We start by explaining what cellulite is and what causes it. We then discuss various remedies for cellulite, including a healthy lifestyle and topical treatments.

Our guest, Dr. Halim, shares her insights on the importance of drinking filtered water for reducing the appearance of cellulite. Finally, we talk about what to do if traditional remedies are no longer working, including medical procedures that may be available.

Dr. Halim is a leading, board-certified anesthesiologist and physician with a focus in aesthetic medicine, anti-aging treatments and regenerative medicine. She has a diverse background in medicine and wears many hats, making her a foremost source on a variety of topics within the wellness and beauty space.

She is a national medical director for hospital, surgical and aesthetic practice startups, runs her own medical consulting company and is a national educator and KOL for various companies, having spoken at conferences such as A4M, Boston BioLife, and Empire Medical Training and Kimera Labs.

Join us for a comprehensive look at cellulite and the steps you can take to address it.

Listen in as we talk about:

  • [2:30] What cellulite is

  • [4:30] What causes cellulite

  • [6:15] How to remedy cellulite

  • [14:50] What type of filtered water Dr. Halim recommends

  • [21:20] Procedures to take if traditional remedies no longer work

Notes from Natalie:

Connect with Dr. Halim

Connect with Me

View Transcript for this Episode

[00:00:00] Natalie: Uncovering the causes of cellulite and how to manage it with a healthy lifestyle, that's what's ahead on the podcast today.


[00:00:09] Natalie: Hi everyone, it's Natalie. Raise your hand if you're frustrated by cellulite. I hear you and I see you today.

[00:00:17] I have a very special guest, Dr. Aza Halim, a board certified anesthesiologist and aesthetic medicine physician. Dr. Halim has devoted her career to helping people, and today she's gonna share with us her expertise on getting. Of cellulite. You know, cellulite is a common problem. Know that it's common for many people and it can be hard to get rid of.

[00:00:39] But with the right treatment plan and holistic approach, it's definitely achievable. Dr. Helene completed her medical training at Northwestern University in Chicago. She's an expert in laser treatments, skincare supplements, and nutrition, and she has a. Background in various areas such as facial rejuvenation, integrative and [00:01:00] functional medicine, nutrition and hyperbaric medicine.

[00:01:03] Her goal is to create a comprehensive and lasting rejuvenation plan for her patients. I love it that she takes this approach and it treats the whole person, not just the cellulite or another problem. So sit back, relax, or go on a walk. Get ready to learn the latest techniques and tips on how to get rid of cellulite plus so much more on your health with Dr. Aza Halim.

[00:01:27] Dr. Halem, thank you for joining me and we have a lot to talk about. These are topics we women, um, think about and discuss.

[00:01:36] Dr. Halim: Thank you so much, Nelly, for having me, and uh, yes, cellulite is definitely a topic that is always something coming up, especially with all my patients and clients. It doesn't matter which location or what city or state I'm in, it's one of

[00:01:49] Natalie: those just stubborn women.

[00:01:52] Things where It doesn't matter if you're old or young or big or small or even thin. We deal with, tell

[00:01:58] us, let's start with the [00:02:00] basics. What is cell.

[00:02:01] Dr. Halim: That's a great question, and you're absolutely right. So cellulite, there's a definition of it, and many people call it orange peel skin. And what that is, is that that's the reason.

[00:02:10] It doesn't have anything to do with how heavy or skinny or slim or trim or how much we weigh because what it is really is. The fibrous connective tissue that we have creates a tethering band. So it actually causes the fat cells to protrude and bulge. And this is the reason you get that lumpiness and they call it orange peel skin.

[00:02:28] Uh, one of the things that I do often see, and I tell my patients too, because when people say, well, I've had it since I was 16, or I had it when I started. Seeing it at the age of my twenties. How is that possible? It is possible because don't forget, when we go through puberty, we go through hormonal changes.

[00:02:44] And of course with the hormonal changes and especially with women, we are higher in estrogen than in men. This is the reason, uh, cellulite is not common in men, but can be seen in men, but in different areas. Estrogen is a hormone that is stores. But it also helps our collagen. [00:03:00] This is the reason too, as we age, we lose estrogen, we lose collagen, the skin becomes thinner.

[00:03:05] So that allows for those spat cells as well as the bulging to protrude through those tethering connective tissue bands. Hmm. Whereas when you have thicker skin, Just like men do. And also the way their connective tissue lays our connective tissue is more vertical. Men is more diagonal, so they get more of a crisscross, so it actually helps hold down the fat cells from bulging and men tend to have, um, thicker and stronger skin, more collagen because of testosterone.

[00:03:31] right? Not that I'm saying women should jump on testosterone to prevent this, okay? Don't get me wrong, , uh, but these are all factors that go into play with Skylight. This is the reason that no matter when people say, well, I've tried every diet and I've tried this, I've tried that. , there's so many factors that go into it, and one of the things that I tell everybody, yes, it's called lumpiness.

[00:03:52] It's dimpling, it's um, orange peel skin. It all has to do with how our connective tissue lays and also our fat cells [00:04:00] protrude.

[00:04:00] Okay, so now does it have to do with genetics? There is a genetic role and component. Yes. Does it have to do with. Diet is, can be contributory. Because if you tend to eat a lot of carbs and sugars and fat, obviously that's going to add to the amount of fat cells you have.

[00:04:17] So the more fat cells you have, the thinner the skin, the more protrusion, the more bulging, the more you're going to likely see more cellulite. So that just kind of makes sense, and I try to explain that in a very basic fashion. Does it mean that if you have zero fat, you're gonna see no, uh, highlight? No, that's not true.

[00:04:34] Okay. Because as I mentioned, certain factors include what, besides the fat cells and fat content is going to be your connective tissue. Mm-hmm. , it's going to be your elasticity, right? The collagen in your skin. As you get older, the elasticity decreases. Collagen decreases because it all goes in in hand with our hormone levels on our estrogen decline.

[00:04:54] Okay? That's why when people say, well, if I exercise, it goes away. [00:05:00] When you exercise your. , when you tone, you're tightening the skin. Hmm. It gives you that nice, smooth appearance. It's not that you got rid of all the cellulite that's underneath because you do have your connective tissue. You do have muscle.

[00:05:15] You do have fat cells, and you do have skin. So those are the different layers. This is the reason that I tell women too, because of our estrogen, we tend to see it more on hips, thighs, and buttocks. Men, if they get cellulite, it's gonna be more around the abdominal area if they gain and lose weight there, and that's where men will also see their stretch marks as well, if they do tend to gain And weight and graphic.

[00:05:38] Yeah, that's the other thing too. Fat diets. Rapid weight loss is also not good because don't forget, it does affect your elasticity as well. Yeah.

[00:05:47] Natalie: Well, let's, okay, so let's talk about remedies here. First of all, we know being healthy is going to help. So what you eat, of course, what we put in our bodies is gonna help how we look, but what are some things, and then we'll [00:06:00] get to last resort, things you can do and, uh, some of the, the, the procedure that, you have, that I know others don't, but let's talk about basics first.

[00:06:09] So getting healthy, what would that look like to you in Reduceing Cellulite since that's our

[00:06:15] Dr. Halim: main. So one of the things that I try to encourage all my patients, because obviously I'm not going to tell people to become vegetarian if that's not their lifestyle, right? Mm-hmm. , and I find that when you try to enforce upon people things that they're not going to buy into, it doesn't last.

[00:06:31] They're not gonna be compliant, correct? It doesn't last. It doesn't work. This is how people go on these fad diets. Yeah. They try this, they try that, they get tired of it, and they come back and they say, I just gave up. I just couldn't handle it anymore. Yeah, yeah, exactly. So my approach always, because I also do, uh, functional medicine, so my approach is beauty and wellness from the inside out.

[00:06:51] So I start with, before doing aesthetic treatments is counseling my patients and also doing consultation for their actual, um, nutrition. how and [00:07:00] what their diet consists of, what their exercise routine is, because we tend to also see cellulite more rampant in sedentary lifestyle. Mm-hmm. , because of the fact that your muscle tone is not toned.

[00:07:10] Right. Your skin is more lax and people tend to also fluctuate in their weight, which is why it's going to increase to the appearance of the cellulite. Now when you eat a healthy diet that consists of proper hydration because hydration's important for our elasticity. People take that for granted. I think I eat all too often when I tell, ask my patients, do you drink enough water?

[00:07:32] Well, no, probably not, but like what does that have to do with anything? That's exactly the response I get and I'm like, well, hydration's important cuz it's important for all of our cells. Your skin is the largest organ of your. So your skin needs nourishment and it needs hydration. Your skin is that top layer.

[00:07:49] So for you to minimize that appearance of cellulite, you need proper hydration, right?

[00:07:53] Natalie: So it's proper hydration. I hear this all the time. How much I, I will be the first to admit I have to force [00:08:00] myself and I still don't get enough water. So what's proper?

[00:08:02] Dr. Halim: How? How many ounces are you drinking a

[00:08:04] Natalie: day? Okay, so I have one of those ridiculous.

[00:08:07] Bottles that tells you what time of day you need, right? Everyone does that, and 32, I carried around with me and I'm lucky to get through that 32

[00:08:15] Dr. Halim: in a day. Okay, so your goal should be 64

[00:08:18] Natalie: ounce. I know, and that's two of those great bigs. I mean, right. It's like I'm drinking and going to the bathroom all day long and I'm busy, so I know If

[00:08:28] Dr. Halim: you can make it to 32, I'm willing to accept that.

[00:08:32] Okay, but 64 is the goal, but minimum should be 32. Shouldn't be less than that. Cause I hear patients all the time, they tell me, oh, well I had two of those small bottles and each bottle's eight ounces and eight ounces comes two is only 16. How do you flush out the toxins in your system?

[00:08:47] Natalie: Okay, everybody listening, make it Google.

[00:08:50] Get one of those big ones. Okay. I'm gonna tell you a funny story because I have two uh daughters, 22 and 18, and I bought my mother-in-law one of these big [00:09:00] bottles with the time it says by 8:00 AM by 10:00 AM I think people probably know what I'm talking about. They're great cuz it's a reminder, right? I bought her one for Christmas and I thought I was being really great for my mother-in-law too.

[00:09:11] A case for it that has a strap so she can carry it around. Right. And my daughters thought that was like the silliest thing ever. Well, so I didn't give it to my mother-in-law and I kept it and I love it. So tip from me is buy one of the big ones and then I can carry it like a purse. It doesn't, I, it's with me and, but the best way to drink and I have been drinking more water when I have it with.

[00:09:35] You know, if I take it to my son's basketball game, I'm sipping on it the whole time. If I leave it the car, I'm not, so you have to take it with you, even if it looks ridiculous. Like my daughters say ,

[00:09:45] Dr. Halim: they should be getting on that bandwagon at,

[00:09:49] Natalie: I think it's gonna be the new thing that you have, like a purse.

[00:09:52] You carry your great big water bottle with you, .

[00:09:56] Dr. Halim: And it's funny that you say that because even in my offices you'll [00:10:00] see that everybody has that similar bottle. But if you walk by, you'll see how people, it's just, it's just sitting there and I'm thinking it's either not carrying

[00:10:08] Natalie: it with them. You need to take them all the straps.

[00:10:10] I'm in a link, uh, a link to this where I got this cuz it's really, it looks funny, but it's so smart because I can't put that big bottle in my backpack or in my. Right. That's a little strap like a purse. .

[00:10:23] Dr. Halim: No, and that, that's a great thing because I always tell people, do whatever it takes to give you that reminder, or for you to remember to carry it with you, cuz it's not gonna help that you fill it up in the morning and it sits in on your table.

[00:10:35] It's not gonna walk with you. You need to make sure to somehow, and I know now there's apps on the phones that give you those water hydration reminders. Yeah, it's like an alarm. And some people do have them and I've seen them ring and then people just ignore them. They just turn 'em off. . I have

[00:10:51] Natalie: an app like that that reminds me to stand up when I'm working and I'm like, oh, stop telling me to stand up.

[00:10:55] You know what I mean? , I'm like, the apps only work for a little bit. It is a good reminder, [00:11:00] but, okay, so tip number one, drink more water, 60 ounces. But if I can get through the 32, at least that, that's better. All right. I think that's really important. And I know our, I know our skin is an organ, so we have to feed it and, okay.

[00:11:13] Good.

[00:11:14] Dr. Halim: What. Lots of healthy greens, vegetables, and fruits. And also, I always recommend and suggest for people to eat organic just because of the fact that too. Don't forget when we don't eat organic, we are exposing ourselves to a lot of the pesticides, a lot of the chemicals. And that's an issue in itself.

[00:11:31] And I'm sure everybody has seen and read about all of the issues that are arising with all the pesto. Pesticide and contaminants. Obviously, we can't eliminate all pesticides and toxins are an environment, unfortunately, because we just live in that kind of an environment where there's pesticides, there's chemicals, there's everything.

[00:11:48] And you also have to wonder sometimes too, about. , even the organic farms, how far are they apart from another farm that shares the same soil table where the pesticides were seeping into [00:12:00] that? But you're trying to minimize the exposure by at least, even if it's a little bit in the soil, it's also, it's not being sprayed on top of it.

[00:12:06] And also, if you can't get organic, then try to get at least some of those, they have those, um, fruit washes at Whole Foods. , yeah. That tend to, uh, uses like the Citron lemon and uh, orange peel. Yeah. To actually cleanse off a lot of that residue from the pesticide. Yeah. Um, I tend to actually wash my fruits and vegetables with that as well.

[00:12:26] That's great. In order to rinse it off and, uh, also to try to use. Filtered water as best as possible rather than drinking tap water. I know a lot of people think that there's nothing wrong with tap water, but you'll see more and more literature and studies coming out about tap water, the contaminants, the chlorine, everything that's in it, which is being absorbed into your body and your system.


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[00:14:22] Dr. Halim: What

[00:14:22] Natalie: do you do for filtered water? I have a, water delivery that comes in the big jugs, and that's what we do. We do an alkaline water, but I'm always curious what experts do because there are so many options when you're just trying to drink good

[00:14:35] Dr. Halim: water. . So Kagan is very well known for their alkaline water.

[00:14:40] That's a system. But I also have in my personal, uh, home reverse osmosis. Mm-hmm. , which reverse osmosis is probably one of the best, uh, waters to drink, to shower with, bathe and do everything with. Now, obviously, I always will fill everything up before I leave my house to go to work. Mm-hmm. or so forth. And then also same thing, if you have the [00:15:00] Kagan.

[00:15:01] um, there's those systems which Alka will give you that alkaline water. Yeah. But you also don't wanna be too alkaline either, right. You don't wanna go to either extremes. So this is the reason, like I tell people, you know, everything in moderation, even your fruits and vegetables. Yeah. I'm not telling everybody to go on a complete vegetarian or vegan diet, right?

[00:15:16] Not everyone can handle that. But when you're eating raw vegetables, there's pros and cons to that as well. The raw vegetables are great for your body and your metabolism and to increase in speed up your, um, the metabolism, but certain vegetable. , you need to actually steam them or actually wilt them a little bit because your body is not made to digest them.

[00:15:36] And this is where people get a lot of flatulence or they get abdominal bloating. Mm-hmm. . And also the other thing you have to take into consideration is how does it affect your thyroid? Right. I know we're getting into a few other things from the wellness standpoint, but even spin it. Spinach has a lot of oxalates.

[00:15:52] When you actually steam your spinach rather and eating it raw, you're less likely to absorb the oxalates. Now, why? You may ask, well, what do I [00:16:00] care about that? Well, you should because as you get older, the oxalates can actually diminish your calcium in your bones, and this is where we tend to see the uptick on osteopenia and osteoporosis.

[00:16:14] besides the fact that when people live on antacids or protein, proton pump inhibitors, right? Proton pump inhibitors with your PPIs to completely shut off stomach acid, right? That contributes to osteopenia and osteoporosis because it also absorbs all the calcium outta your bone, so you're leaching that calcium out of your bone.

[00:16:31] So those are things that

[00:16:32] Natalie: you're saying eat the spinach, raw, or cement. Steam. Okay, good. Because I don't love raw spinach. I'll eat it every once in a while in a salad, but I love taking a package of spinach and just throwing it in the sauce pan. And I mean, you'll get a whole package of spinach and, you know, it'll whit down and you're like, and I, I, I, I have low iron, so spinach, I just, I crave with a little salt on it.

[00:16:58] It's so good.

[00:16:59] Dr. Halim: It [00:17:00] is. And it's very healthy for you, but if you steam it, then you don't worry. because every good thing does come to an end if you overdo it, right? Yeah. Yeah. Because if you eat too much raw spinach now you're also affecting your bone density, right? Yeah. Which you don't wanna do. So everything in

[00:17:14] Natalie: moderation, but do it.

[00:17:16] Okay. Yeah. So I'm, I'm hearing you say the fruits and vegetables. I try to make that my first, and I always tell my kids, like, make that first, you know, you can't just sit down and have a steak, like make your, make your fruit. What? Sometimes they will, and my husband too, like just, you know, make your fruits and vegetables first and then add.

[00:17:33] Your protein and then the carbs make that like a little special thing. ?

[00:17:37] Dr. Halim: Well, the, the carbs also, once again, that depends on what the carbs that you're eating. Because this is the thing I tell people, do not deprive yourself of carbs because when you deprive your body of a particular food group, you're going to crave that food group.

[00:17:50] That's right. And that. And if you crave that food group, that's how you binge. Right? So now you get into that vicious cycle. Yeah. It becomes a big thing. Yeah, exactly. So I [00:18:00] tell people I don't have an issue with people eating a small baked potato or some baked sweet potatoes. What the issue is when we start doing deep frying, when we add unhealthy fats to the food, right?

[00:18:11] Oh, when the, when

[00:18:12] Natalie: the whole meal is based on that. I mean, my son would eat macaroni and cheese and you know, just carbs all. if I let him, but when that's the base of our meal, like pasta or whatever, it's, it's, it's hard. So start with the fruits and vegetables, right? Add a protein and then a little carb is okay.

[00:18:31] And good.

[00:18:32] Dr. Halim: And even for myself, um, I tend to do, even if I, I'm not a big pasta person by nature, but like I do have to add some carbs because like I said, if you eat just pure protein or in just pure vegetables, like some people think that that's great and you're very lean and trim and that's fine, but your body's.

[00:18:47] Fills going to be depleted of certain other nourishment. Yeah. So sometimes I'll throw in some of those pasta that are made out of like either lentils or cashier co flour or something. Yes, definitely cauliflower. Yeah. And actually you can mask their [00:19:00] taste. Cause some will say, oh, I dunno how that's gonna taste.

[00:19:02] Depends on how you cook. It depends what you add to it. Let

[00:19:06] Natalie: me tell you, I made stir fry the other night with cauliflower rice. My kids didn't even know, and they don't, I don't think they listened, so it's okay, but , it was great. Some vegetables, a fried egg, like mix it all up. They thought they were having regular fried rice.

[00:19:21] Oh, I hope they'll be so

[00:19:23] Dr. Halim: mad at me. . But you know what I, I did that with my nephews as well as they were growing up, and as long as they like it, then there's no reason to complain, right? No, and it's good. Yeah, it's healthy for you. And then even when it comes to the healthy fact, So we know olive oil is healthy for you.

[00:19:38] Mm-hmm. , we know that instead of using butter to cook wood, you can use gh, right? Mm-hmm. . So GE is also healthier and that's been the whole big thing. You don't wanna do deep frying. I know everyone now is big on the air fryer kick, which is fine because it gives you very good food taste without all the excess oil.

[00:19:55] Yeah. So you wanna minimize that as well. And basically, cuz all that's going to [00:20:00] contribute along with if you already predispose genetic. , right? Mm-hmm. , if it runs in your family or if you originally have thin skin, like some people just naturally have good, strong, thicker skin and they're going to age slower anyways, whereas other people are just unfortunately have thinner skin.

[00:20:16] That's just their genetic, that's their heritage. So

[00:20:19] Natalie: we're eating better, we're drinking more water. Um, but the cellulite's not going away either genetically or whatever. Now, I mean, if that's exercise, okay, so add in exercise. So we're drinking lots, water, we're eating better. It starts to show a little bit exercise, a normal part of your life, good for your heart, everything else is, well, it's gonna reduce some of that.

[00:20:40] But then for those people who are like, I'm doing all of these things, and I still don't feel comfortable in the way my thighs look or whatever.

[00:20:49] What steps do you take and what procedures can help with

[00:20:53] Dr. Halim: this? So one of the first things I do after I assess and make sure that they are following proper nutrition, proper [00:21:00] exercise.

[00:21:00] Natalie: Yeah. I love it that you do all of that first, by the way. Thank you. Mm-hmm. .

[00:21:03] Dr. Halim: Oh, oh, absolutely. One of my big thing in aesthetics that I've always been a big, uh, fan of is I always tell patients, okay, let's go through whether I'm doing nonsurgical hair restoration, whether I'm doing cellulite treatments, whether I'm doing cosmetic treatments, whatever it is, body contour.

[00:21:16] My big first thing is also regimen, because I tell everyone what is the point for me to laser resurface your skin? If you're not having proper hydration, you're not taking good skin care of your skin. Exercise, diet, and skincare, right? Yeah. Right. Um, and then you go get exposed to the sun and you're not wearing sunblock, then that defeats the purpose.

[00:21:35] Yep. Yeah. So when it comes even to soil, number one, if you're one of those sun bathers and sun lovers and you're out there all the time on the beach and you're exposing your entire body, don't forget that. That's also damaging your collagen elasticity. So you're going to actually show more actual, uh, rippling.

[00:21:52] Oh, okay. So that's another thing I tell people. Sunblock is important to prevent. Skin cancer a