What Is Cellulite? How Is It Different From Regular Fat?

Dr. Oz describes cellulite as marshmallowy fat cells that swell together and bulge up underneath the skin, creating that unsightly dimpling effect.  With this understanding of cellulite, the obvious treatment option is to decrease the size of the fat cells.

But is cellulite really that simple?

First Things First: Cellulite is Not Plain Fat

Some cellulite pundits like to claim that cellulite is “plain ol’ ordinary fat.”  Doctors have even published journal articles stating that “so-called cellulite” does not exist, despite the fact that they can see it with their own eyes.  If cellulite does not exist, then why do we even have a word for it?  Why is the term so readily and universally accepted?  Are we all delusional?  Cellulite must be different from fat somehow, or else we would just call it fat. 

Of course, the difference between fat and cellulite is obvious. Cellulite is the dimpled appearance of fat underneath the skin. No dimples?  Then it’s plain old ordinary fat.  Got dimples? (Or rimples, or cottage cheese… ?)  You’ve got cellulite.

But cellulite differs from normal fat in other ways, too. In our interview with world-renowned lymphatic specialist Dr. Bruno Chikly, he points out that fat is something that will dissolve during an extreme fast.  Cellulite will not.  This explains the studies showing that women often see an increase in cellulite when they lose weight.  It also explains why liposuction is notoriously bad at treating cellulite. It’s because, I repeat, cellulite is not plain fat.

Fat: It’s Not What You Think*

Like most people, I always thought fat cells are the body’s way of storing reserves of energy for later use.  When you eat more calories than you burn, your body automatically stores the excess as fat.  Since most of us tend to eat more rather than burn more on a daily basis, the fat accumulates in certain predisposed areas, depending mostly on our individual genetic makeup.  Then it just sits there, a perpetual benchwarmer, growing ever more dejected as it waits for its big chance to get back in the game.

But in the last fifteen years or so, scientists are discovering that fat is much more complicated (and clever) than we tend to believe.  Fat is not a passive repository but an active organ that performs a variety of essential functions, functions we are just beginning to understand. Endocrinologists recently discovered that fat is the largest endocrine organ in the body.  Like the pituitary gland and the thyroid gland, fat is responsible for sending and receiving certain key hormones. These hormones work to relay important messages between the fat and other organs, including the brain.

The Anatomy of Cellulite, Part I

Cellulite is located in the hypodermis, the layer of cells directly under the dermis.  The hypodermis is also known as subcutaneous fat.  Its main purpose is to attach the skin to the muscle and bone beneath through a network of connective tissue.  It also provides cushioning, insulation, and temperature regulation.

Furthermore, subcutaneous fat is now known to be particularly instrumental in the production of hormones that regulate appetite, blood pressure, and reproductive functions.1 As you can see, fat is a lot more complicated than a spare fuel tank.

The material connecting the subcutaneous fat cells to the skin is composed of fibrous bands called septa.  Cellulite forms when septa break down and are no longer able to smoothly connect the subcutaneous fat to the skin. Instead, the fat cells push directly on the dermis resulting in all kinds of, shall we say, “creative” patterns.

The next natural question to ask is, what causes septa to break down?  What causes cellulite?