What is Lipedema?
Lipedema is a chronic medical condition characterized by a symmetric buildup of adipose tissue (fat) in the legs and arms. A common but under recognized disorder, lipedema may cause pain, swelling, and easy bruising. It may be accompanied by an unusual texture within the fat that can feel like rice, peas, or walnuts beneath the surface of the skin. The intensity of pain may range from none to severe, and its frequency may be constant, come and go, or only occur when the fat is pushed on. Limited public awareness of lipedema, coupled with few research-backed treatments, can lead to exacerbation of symptoms as well as physical and emotional distress. Common symptoms include fatigue, muscle pain, or easy bruising.
Who Gets Lipedema?
Lipedema occurs almost exclusively in females, with rare reports of development in men. Although believed to be prevalent, the exact incidence is not known.
What Causes Lipedema?
The causes of lipedema are not well understood. It is reported to start or worsen during puberty and other periods of hormonal changes, such as pregnancy and menopause. Research is underway to determine the biological role of hormones, genetics, inflammation, and metabolism in the condition’s development.
Is It Obesity?
No. Obese fat occurs throughout the body. In lipedema, the fat occurs in the limbs, sparing the hands and feet. People with early-stage lipedema typically do not have diabetes, high cholesterol, or high blood pressure.
Is it Lymphedema?
No. The swelling in lymphedema often affects only one side of the body, and includes the hands and feet. Furthermore, lymphedema can be diagnosed with imaging or genetic tests.
The Lipedema Foundation maintains a resources page – lipedema.org/resources – where you will find everything from self-care videos to ICD Codes.
Lipedema is not rare, but a proper diagnosis is rarely made
Despite initial medical reports from more than 75 years ago, there are no definitive diagnostic tests for lipedema. It is often misdiagnosed as obesity, lymphedema, Dercum’s disease, or chronic venous insufficiency. Underlying lipedema may also be present in patients with these conditions. Currently the only way to diagnose lipedema is to have a trained physician perform a physical examination with a review of the patient’s medical history. However, few physicians are comfortable diagnosing and treating lipedema because of the lack of diagnostic tests and research-backed treatments. Therapists may be confident in distinguishing lipedema from lymphedema. Surgeons who perform liposuction are able to remove fat but may not provide broad or long-term care.
Quality of Life
Alongside the physical pain symptoms, lipedema can impact an individual’s mental health and quality of life, leading to lack of energy, feelings of hopelessness, low self-esteem, or eating disorders. Affected individuals are encouraged to speak with their healthcare provider about their mental health. Support groups where patients can share their experiences may also be found through social media. To find these groups, go to Facebook and search lipedema or lipoedema.
What to Do About Lipedema
Dealing with lipedema can be a lonely and confusing journey. Typically, individuals with lipedema are encouraged to:
Improve Lymphatic Flow
Help Your Body Deal with Lipedema
Get Emotional Support
Although fat caused by lipedema cannot be lost by just reducing calories and exercising, providers who treat lipedema typically advise daily light to moderate exercise in combination with an anti-inflammatory diet. While surgery such as liposuction can be valuable for some people to manage pain and improve mobility, the decision to undergo surgery must not be taken lightly and should be made in partnership with a qualified medical professional.
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“Hypertrophic adipocytes, increased numbers of macrophages and blood vessels, and dilation of capillaries in thigh tissue of non-obese women with lipedema suggest inflammation, and angiogenesis occurs independent of obesity and demonstrates a role of altered vasculature in the manifestation of the disease.”
This article describes the impact of the paper: Mobilizing the lymphatic system may help combat obesity-induced metabolic syndrome
"In new data collected, lipedema was associated with a low risk of diabetes (2%), dyslipidemia (11.7%) and hypertension (13%) despite an obese average body mass index (BMI) of 35.3 ± 1.7 kg/m2."
"CONCLUSIONS: Internal metrics of tissue sodium and adipose content are elevated in patients with lipedema, potentially providing objective imaging-based biomarkers for differentially diagnosing the under-recognized condition of lipedema from obesity."
“Lipedema adipose cells not only differ in their lipid storage capacity but also in their adipokine expression pattern.“
"CONCLUSIONS: The significantly lower prevalence of DM2 in people with lipedema compared with DD may be due to the greater amount of gynoid fat known to be protective against metabolic disorders. The high percentage of hypermobility in lipedema patients indicates that it may be a comorbid condition. The location of fat, high average daily pain, presence of lipomas and comorbid painful disorders in DD patients may help differentiate from lipedema."