Anatomy and Physiology- Fat in the body

Adipose tissue is also called fatty or subcutaneous tissue and there are different types of fat cells within this tissue.

Adipose cells store fat. Fat cells are made of areolar connective tissue and are found located in the subcutaneous layer of the skin and around vital organs.

Women tend to have a thicker layer of fat than men, giving them a softer outline. After menopause, women tend to put on weight in the male pattern, on the waist and abdomen rather than hips and thighs. Different types of fatty tissue are found in different areas of the body and respond differently to electrical and mechanical treatment, massage, exercise, and diet. The therapist needs to recognise the range of fatty tissue and select the appropriate electrical and mechanical treatments.

Functions of fat include-

  • Fat provides the body with insulation from the cold.
  • Provides protection for internal organs by acting as shock absorbers.
  • Its main function is to be a reserve of lipids which can be burned to meet the energy needs of the body. Fat cells will fill with triglycerides and if this stored energy is not used and calories still exceed demand the cell will expand to a maximum of 4 times its natural size. The more exercise a person does, the more the energy the body needs. This energy will come from the fat cells and the fat cells will decrease in size.
  • A healthy adult who has healthy body fat has 25-30 billion individual fat cells. An overweight adult has 75 billion individual fat cells, with severe obesity this number can be as high as 250-300 billion!

There are three types of fat found within the body-

  • Soft fat- This has a jelly-like feel and is soft, fluid and easy to manipulate and mobilise. It is most common in women following pregnancy around the abdomen. Moves easily over underlying tissues. Will be warm to the touch. Responds to diet, exercise and massage, electrical and mechanical treatments. Often found on the chin/neck area, top of hips, back of arms, abdomen, and inner thigh area.
  • Hard fat- This has a compact feel and is solid and firm to touch. It is difficult to manipulate and mobilize therefore difficult to disperse. Will be firm to touch, can be mistaken for muscle. Commonly found on lower arms, lower legs, and sides of the thighs
  • Cellulite- The skin has a soft lumpy, pitted, uneven appearance; the skin may seem tightly stretched. When the muscle is contracted, or the skin squeezed the appearance is increased. In some cases, tiny nodules can be felt like grains or rice under the fingertips. It has the appearance of being dimpled with an orange peel type texture. Cellulite is cool to the touch due to trapped toxins, fluid and poor circulation. Causes of cellulite are linked to the hormonal imbalance or natural hormonal levels (oestrogen and progesterone), poor diet, poor circulation, hereditary, lack of exercise, water retention and toxins. Found typically on the thighs and buttocks. Cellulite is generally thought to be engorged fat cells trapped in the matrix. When massaging over cellulite, care is needed as the fluid trapped in the tissues presses down on the sensory nerve endings making pressure painful. Responds well to a combination of electrotherapy body treatments that drain the fluid to the nearest lymph nodes and helps to break down the fatty cells

Cellulite occurs when the fat deposits increase causing the cells to swell. The compartments in the skin that hold the fat cells become distended under pressure, restricting the tissue drainage in the surrounding area. Collagen fibres become wrapped around the fat cells causing further changes in the skin tissue. Where the fat cell compartments become extended the supporting tissue strands become tight, causing the skin to pull at the point where they are attached to the skin. This causes the skin to become dimpled. The blood capillaries become leaky allowing further fluid to collect so that there is excess fluid and impurities in the tissues.

Cellulite is mainly caused by

  • Slowing down of elimination
  • Accumulation of tissue fluid
  • Change in the formation of the connective tissue in the subcutaneous layers

In some cases, cellulite can be very sensitive to touch due to pressure from tissue fluid on the nerve endings. It can occur on thin people and has a variety of contributing factors. The main ones are:

  • Poor diet high in refined foods and caffeine
  • Sluggish digestion (constipation) or poor eating habits
  • Lack of activity
  • Poor circulation
  • Fluid retention
  • Some medication can contribute to cellulite

Trapped or compact fat

  • Often found on people who have been very active and then stopped
  • Fat cells form in between the muscle fibres
  • Hard to disperse


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