SKIN LINE · CONCERNS

Adipose tissue

Why it occurs and what we can do about it

Adipose tissue is a natural and essential part of the human body. It is not simply ‘excess fat’, as is often perceived in an aesthetic context, but active biological tissue that performs important functions. It stores energy, helps regulate body temperature, protects certain organs from mechanical impact and produces biologically active substances that influence metabolism.

The problem arises when the amount of adipose tissue becomes excessive or when it accumulates disproportionately in certain areas of the body. This can alter the body’s silhouette and contours and may be associated with an increased risk of various metabolic and cardiovascular diseases.

It is important to distinguish between total body fat and localised fat deposits. A person may have a normal body weight but have more pronounced fat deposits in a specific area. At the same time, reducing adipose tissue is not merely an aesthetic issue – the approach must take into account an individual’s health status, dietary habits, physical activity and the specific characteristics of their body.

What is adipose tissue?

Adipose tissue is a type of connective tissue, consisting mainly of adipocytes – fat cells – which store energy in the form of triglycerides. It is distributed throughout various parts of the body and serves different functions depending on its location.

Subcutaneous adipose tissue is located immediately beneath the skin and forms a significant part of the body’s visible contours. It acts as an energy reserve, a thermal insulator and provides mechanical protection.

There is also visceral adipose tissue, which is situated around the internal organs in the abdominal cavity. It is metabolically more active, and excessive amounts are associated with a higher risk of insulin resistance, type 2 diabetes, cardiovascular disease and other metabolic disorders.

The amount and distribution of adipose tissue are influenced by numerous factors and do not depend solely on body weight.

Types of adipose tissue

Several types of adipose tissue are distinguished in the human body, each with different functions.

White adipose tissue – the main type of adipose tissue in adults. It stores energy and has an important endocrine function, secreting substances called adipokines, which are involved in the regulation of appetite, inflammation and metabolism.

Brown adipose tissue – contains more mitochondria and specialises in heat production. In adults, its quantity is relatively small, but it continues to play a role in thermoregulation and energy metabolism.

Beige adipose tissue – consists of fat cells with properties that, under certain conditions, can resemble those of brown adipose tissue. This type of adipose tissue is the subject of scientific research due to its potential role in energy balance.

In terms of distribution, a distinction is also made between subcutaneous and visceral adipose tissue. It is precisely the location of fat deposits that is significant not only for physical appearance but also for metabolic health.

Causes and risk factors for the accumulation of adipose tissue

The accumulation of adipose tissue occurs when the body stores more energy than it expends over the long term. However, this process is far more complex than the simple rule of ‘eating more than we burn’.

Genetic factors can influence appetite, energy expenditure and the way the body distributes fat stores. Hormonal changes can also alter body composition and the areas where fat accumulates.

Factors that may contribute include:

a prolonged calorie surplus;
low physical activity;
insufficient sleep;
chronic stress;
certain medications;
some endocrine disorders;
genetic predisposition;
age-related changes.

In women, the distribution of adipose tissue may change around the time of the menopause, when the hormonal profile shifts. In men, a tendency towards an increase in abdominal adipose tissue may also be observed as they get older.

It is important to note that we cannot reliably choose from which specific area the body will burn fat through exercise. So-called ‘spot reduction’ is not a physiologically realistic approach. When losing weight, the body mobilises fat stores according to its individual biology.

Is adipose tissue a disease?

Adipose tissue itself is not a disease. It is a normal part of the body and is necessary for its functioning.

A problem may arise when there is an excessive amount of body fat. Obesity is defined as a chronic condition and is associated with an increased risk of a number of health complications. These include high blood pressure, type 2 diabetes, abnormal lipid profiles, sleep apnoea, fatty liver disease and cardiovascular disease.

There are also cases of localised fat deposits, which are not necessarily linked to being overweight. These may be part of a person’s normal anatomy or may persist even after overall weight loss.

Therefore, assessment should not be based solely on weight in kilograms. Waist circumference, body composition and general health are also important factors.

When should you see a doctor?

It is advisable to consult a doctor when the increase in body fat is significant, occurs rapidly or is accompanied by other changes in the body.

Be aware of the following:

rapid and unexplained weight gain;
significant changes in appetite;
persistent tiredness;
menstrual cycle irregularities;
other signs of hormonal imbalance;
swelling or fluid retention;
a sudden change in the distribution of body fat;
painful or unusual localised fatty lumps.

Not every soft lump under the skin is simply fatty tissue. For example, a lipoma is a benign tumour of fatty tissue and is different in nature from a normal localised build-up of subcutaneous fat.

A medical examination is required in the case of painful, firm, rapidly growing or fixed lumps.

Daily care for adipose tissue accumulation

Maintaining a healthy body composition requires consistency, rather than short-term restrictions. Your diet should provide sufficient protein, fibre, vitamins and minerals, whilst taking into account your individual energy requirements.

Regular physical activity also plays an important role. A combination of aerobic exercise and strength training can help control body weight and preserve muscle mass during weight loss.

Sleep is often underestimated. Chronic sleep deprivation can affect the mechanisms that regulate hunger, satiety and energy balance.

If you wish to reduce body fat, it is wiser to adopt a sustainable approach rather than following crash diets with a large calorie deficit. Significant fluctuations in weight can be difficult to maintain and may have an adverse effect on body composition.

Home remedies for tackling the problem and home care products

No cream, oil or home massage can reliably destroy subcutaneous fat cells. Cosmetic products can improve the condition and hydration of the skin, but they cannot replace methods for actually reducing fat tissue.

Home care should focus on factors that can be controlled – diet, exercise, sleep and overall lifestyle. If a reduction in body fat is required, a personalised diet plan drawn up by a qualified specialist may be more beneficial than restrictive diets.

It is important to approach products advertised as ‘fat-melting’ or ‘fat-cell-destroying’ simply by applying them to the skin with a critical eye. Such claims often go beyond the actually proven effects of cosmetic ingredients.

Modern solutions for tackling localised fat deposits

When the problem is primarily localised fat deposits, modern aesthetic medicine offers various options. These are not a substitute for a healthy diet and exercise, but are targeted at specific areas that may prove more resistant to general weight loss.

Among the non-surgical approaches is cryolipolysis, in which fat cells are subjected to controlled cooling. The procedure is designed for localised subcutaneous fat deposits and is not a method for treating obesity.

Another approach involves various radiofrequency technologies, which use controlled energy to affect the tissues. Depending on the specific technology and parameters, the procedure can have an effect on adipose tissue whilst simultaneously promoting skin tightening.

There are also injection methods for localised fat deposits, which utilise substances with a lipolytic effect. These have specific indications and must be carried out by a qualified medical professional.

In cases of more significant fat deposits, liposuction may be considered. This is a surgical procedure in which subcutaneous fat tissue is removed from selected areas using a cannula. It is not a method for general weight loss and requires careful assessment of the indications and risks.

The choice of procedure must be tailored to the individual. Factors such as the amount of fat tissue, the quality of the skin, the anatomy of the area and the expected outcome are all important.

Adipose tissue is a natural part of the body and should not be viewed solely as an aesthetic flaw. When it comes to localised deposits, modern aesthetic methods can help to contour specific areas, but the best results are achieved with carefully selected patients and realistic expectations. In cases of significant or unexplained increases in adipose tissue, the first step is always to assess the patient’s general state of health.