A health condition that causes abnormal fat buildup on both sides of the lower part of the body (most of the time, in the legs) is called lipedema. Sometimes, people with lipedema may experience a fat buildup in the arms. While people with lipedema may experience pain, it may negatively affect their daily routine. Unfortunately, this condition cannot be treated with dietary changes and physical exercise, and it cannot be cured. That’s why the treatment goal is to relieve the symptoms and improve your quality of life.
In other words, lipedema is a chronic (long-term) condition in which the fat builds up abnormally in the body. Furthermore, this condition can be mistaken for obesity (excessive body weight) or lymphedema. In rare cases, untreated lipedema may lead to lymphedema.
According to some research, lipedema affects about 1 in 72,000 people. However, it is difficult to estimate how many people suffer from this condition because it can be mistaken for obesity.
Types of Lipedema
Healthcare professionals have divided this condition into five types based on where the symptoms occur. Some people may develop multiple types of lipedema at the same time. Check some examples below:
- I – In this case, fat builds up between the belly button and hips.
- II – Fat is mostly localized between the pelvic area and knees.
- III – People with the third type of lipedema have a fat buildup between the pelvis and ankles.
- IV – This type causes fat buildup between the shoulders and wrists.
- V – This is the last type of lipedema. It causes fat buildup between the knees and ankles.
What Are The Symptoms of Lipedema?
Usually, people who develop this condition experience the following symptoms. Examples include:
- Swelling
- Extreme tiredness (fatigue)
- A heavy feeling in the legs
- Pain that ranges from mild to severe
- Fat buildup inside the buttocks, thighs, calves, and upper arms (in rare cases)
Do not hesitate to visit a doctor if any of the previous symptoms occur. While it may look like obesity, some people may have lipedema. Leaving this condition untreated may lead to unpleasant outcomes.
Causes and Risk Factors
While experts do not know the exact cause of lipedema, between 20% and 60% of cases run in families. This means you may inherit this condition from one of your biological parents. Furthermore, lipedema may have a connection with hormone changes because it often worsens during puberty, pregnancy, menopause, and in women who take birth control pills. It is important to understand that excessive body weight does not cause lipedema.
Healthcare professionals have identified some factors that may increase your risk of this condition. Check some examples below:
- Family history of lipedema
- Sex – This condition mostly affects women.
- Excessive body weight – A BMI index higher than 35 may also contribute to lipedema.
- Connective tissue disorders – According to some research, people who already have connective tissue disorders (including hypermobile Ehlers-Danlos syndrome or hEDS) are at increased risk for lipedema.
What Are The Long-Term Effects of Lipedema?
People who ignore the symptoms and do not get treatment may also experience some complications. Check some of them below:
- Chronic venous insufficiency (CVI) – There are a lot of people with lipedema who also develop CVI. It happens because an excessive amount of fat localized in the legs puts extra pressure on the veins. As a result, it may lead to spider veins, varicose veins, and venous hypertension (high blood pressure).
- Cellulitis and skin infections
- Mobility problems and joint damage – Large amounts of fat in the legs may affect your gait and cause damage to the joints.
- Psychological impact – Some people with lipedema may also experience chronic stress, depression, anxiety, low self-esteem, and even eating disorders.
- Secondary lymphedema
- Flat feet
The previous list does not contain all possible complications. However, doctors may help reduce the risk or even prevent some of them. In addition, this condition cannot be prevented because doctors do not fully understand what exactly causes it.
Diagnosis
First, physicians will perform a physical examination to check for irregularities linked to the disease. They may also ask some questions about your symptoms and medical history to gather more information about your condition. In most cases, doctors perform the following tests to exclude other conditions similar to lipedema. Check some of them below:
- Blood tests
- DEXA scan
- Ultrasound
- MRI (magnetic resonance imaging) scans
- CT (computerized tomography) scans
- Nuclear medicine imaging
Lipedema Stages
Typically, this condition gets worse over time. Check the stages of lipedema below:
- 1 – In this case, the skin looks normal, but you can feel something (such as pebbles) under the skin. Some people may also have pain and bruising.
- 2 – When this stage occurs, the skin surface is uneven and may look like quilted stitching or cottage cheese.
- 3 – This is a more severe stage in which the legs look similar to inflated rectangular balloons, and you may also have large folds of skin and fat.
- 4 – This is the most serious stage, and when it occurs, people have lipedema and lymphedema at the same time.
Treatment
Doctors often prescribe different treatments for people with lipedema because they depend on several factors. For example, the stage of the disease, existing health problems, age, sex, and preferences. Check below some options often recommended by doctors for people with lipedema:
Simple Treatments
These include:
- Physical exercise (including biking, swimming, and walking)
- Anti-inflammatory and heart-healthy diets
- Compression stockings
- Skin moisturizer
- Medicines and supplements (for example, amphetamines, phentermine, metformin, resveratrol, diosmin, and selenium)
- Antioxidant herbal medications
Noninvasive Treatments
- Lymphatic drainage massage
- Complex decongestive therapy
- Pneumatic compression devices
Surgery
In more advanced stages of the disease, doctors may recommend liposuction to remove excess fat from the legs, which often helps improve pain and mobility. Commonly, physicians prescribe wet-jet-assisted liposuction because the standard form can cause damage to the lymph vessels. People who have excessive body weight may also need bariatric surgery.
Frequently Asked Questions
What is the difference between lipedema and obesity?
Lipedema is a chronic medical condition that causes abnormal fat accumulation, usually in the legs and sometimes the arms. Unlike obesity, the affected fat does not respond well to diet or exercise, and the feet are usually spared. People with lipedema may also experience pain, tenderness, and easy bruising.
Is lipedema the same as lymphedema?
No. Lipedema is a disorder of abnormal fat distribution, while lymphedema is caused by a buildup of lymph fluid due to impaired lymphatic drainage. However, advanced untreated lipedema can sometimes lead to secondary lymphedema, a condition known as lipolymphedema.
Who is most likely to develop lipedema?
Lipedema occurs almost exclusively in women and often develops or worsens during periods of hormonal changes such as puberty, pregnancy, or menopause. A family history of lipedema also increases the risk.
Can men develop lipedema?
Although rare, men can develop lipedema, particularly if they have hormonal disorders, liver disease, or other conditions that affect hormone balance. However, the vast majority of cases occur in women.
Does losing weight cure lipedema?
No. Weight loss may improve overall health and reduce obesity-related complications, but it usually does not eliminate the abnormal fat deposits caused by lipedema. Even after significant weight loss, the affected areas often remain disproportionately enlarged.
Is lipedema painful?
Yes. Many people with lipedema experience pain, tenderness, heaviness, or sensitivity to pressure in the affected areas. Easy bruising and discomfort after standing or walking for long periods are also common symptoms.
Can lipedema get worse over time?
Yes. Without proper management, lipedema often progresses through different stages, leading to increased fat accumulation, worsening pain, reduced mobility, and, in some cases, secondary lymphedema. Early diagnosis and treatment can help slow its progression.
What lifestyle changes can help manage lipedema?
Although lifestyle changes cannot cure lipedema, regular low-impact exercise, maintaining a healthy weight, wearing compression garments, following an anti-inflammatory eating pattern, and practicing good skin care may help reduce symptoms and improve mobility.
Is liposuction an effective treatment for lipedema?
For carefully selected patients, liposuction performed by surgeons experienced in treating lipedema can reduce pain, improve mobility, and remove abnormal fat deposits. However, it is not considered a cure, and ongoing conservative treatments may still be necessary.
When should I see a healthcare provider about lipedema?
You should consult a healthcare provider if you notice persistent, symmetrical swelling or fat buildup in your legs or arms, especially if it is painful, bruises easily, or does not improve with diet and exercise. Early evaluation can help distinguish lipedema from other conditions and allow treatment to begin sooner. If you have any other questions, ask your doctor.
