Lipedema

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Lipedema
Synonyms	Lipoedema, lipödem
Pronounce
Specialty	Vascular medicine, Dermatology
Symptoms	Symmetrical swelling of the legs, pain, easy bruising
Complications	Lymphedema, Obesity, Joint pain
Onset	Usually around puberty or other times of hormonal change
Duration	Long-term
Types	N/A
Causes	Unknown, possibly genetic
Risks	Family history, female sex
Diagnosis	Based on physical examination and medical history
Differential diagnosis	Lymphedema, Obesity, Chronic venous insufficiency
Prevention	None known
Treatment	Compression therapy, Liposuction, Manual lymphatic drainage
Medication	Pain management
Prognosis	Variable, often progressive
Frequency	Estimated to affect 11% of women
Deaths	N/A

Lipedema is a chronic disorder of adipose tissue that occurs almost exclusively in women, characterized by a symmetrical and disproportionate accumulation of subcutaneous fat, primarily in the lower body. This condition is often misdiagnosed as simple obesity or lymphedema, but it has distinct clinical features and requires specific management.

Clinical Features

Lipedema is marked by the following characteristics:

• Symmetrical Fat Distribution: The fat accumulation in lipedema is typically symmetrical, affecting both legs equally from the hips to the ankles. The feet are usually spared, which helps differentiate it from lymphedema.
• Pain and Tenderness: Patients often report pain, tenderness, and easy bruising in the affected areas. The skin may feel soft and doughy.
• Progressive Nature: Lipedema tends to worsen over time, with fat deposits becoming more pronounced and potentially leading to mobility issues.
• Hormonal Influence: The condition often appears or worsens during periods of hormonal change, such as puberty, pregnancy, or menopause.

Pathophysiology

The exact cause of lipedema is not well understood, but it is believed to involve a combination of genetic, hormonal, and inflammatory factors. The condition is thought to result from an abnormal response of adipose tissue to hormonal signals, leading to excessive fat deposition and changes in the microcirculation.

Diagnosis

Diagnosis of lipedema is primarily clinical, based on the characteristic distribution of fat and the presence of pain and tenderness. Imaging studies, such as ultrasound or MRI, may be used to assess the extent of fat deposition and rule out other conditions.

Management

Management of lipedema focuses on symptom relief and improving quality of life. Treatment options include:

• Compression Therapy: Wearing compression garments can help reduce swelling and improve circulation.
• Manual Lymphatic Drainage: This specialized massage technique can help reduce fluid retention and improve lymphatic flow.
• Liposuction: In some cases, liposuction may be considered to remove excess fat and improve mobility.
• Exercise and Diet: While diet and exercise alone cannot cure lipedema, they can help manage symptoms and prevent further weight gain.

See also

• Lymphedema
• Obesity
• Adipose tissue
• Hormonal imbalance