What Is Lipedema

Overview

There is a silent struggle plaguing millions of people, affecting both their bodies and spirits: it is lipedema. Lipoedema is an illness that causes fat to accumulate in your thighs, hips, bottom, and sometimes your arms over time. There is an equal impact on both sides of the body. Women are more likely to experience it than men, who are only rarely affected. It is not the same as obesity. It may have a significant effect on certain people's everyday lives, their physical health, and mental wellness.

Types of lipedema

Bodily sites are used to categorize different lipedema types.

• Type I lipedema - the fat is spread from the umbilicus to the hips, covering the pelvis and buttocks
• Type II lipedema - fat is distributed from the pelvis to the knees
• Type III lipedema - stretches from the pelvis through the ankles, excluding the dorsum of the foot and having a large cuff at the ankle
• Type IV covers the wrists and shoulders
• Type V is uncommon as fat is distributed from or below the knees, spreads into the ankles, and spares the dorsum of the foot

Combinations of Type II and IV or III and IV are frequent. The distribution of fat on the arm might vary depending on whether it involves the elbows or the shoulders.¹

Stages of lipedema

In many individuals, lipedema gradually gets worse over time. Stages of lipedema include:

Stage 1: While the appearance of your skin is normal, you can feel what seem like stones below, which causes discomfort.

Stage 2: You may have dimpling on your skin that looks like cottage cheese, a walnut shell, or irregular quilted stitching.

Stage 3: You may have enormous folds of skin that might be challenging if your legs are fat and protruding.

Stage 4: Both lipedema and lymphedema are present concurrently⁶

Causes of lipedema

It is unclear what specifically causes lipedema. However, between 20% and 60% of the time, the problem is inherited. Women and AFAB individuals are virtually entirely affected by the disorder.

Because it typically begins or worsens during:

• Puberty
• Pregnancy
• Menopause
• Taking hormone-containing birth control tablets

Lipedema is not brought on by obesity, however, more than half of those who have it have a BMI above 35.

Signs and symptoms of lipedema

Symptoms include:

• A general term used to describe the enlargement of the legs and arms, but not usually the feet or hands
• Areas are affected by pain, discomfort, heaviness, or tenderness
• You can bruise easily on your body, sometimes without knowing why
• Thick, lumpy legs with dimples; fat may protrude to the knees
• When it is hot or after activity, the swelling tends to get worse in the afternoon and evening
• In the legs, you may have spider veins or varicose veins
• A change in the shape of your legs, like heavy legs, or flat feet makes it difficult to walk
• The symptoms of lipoedema might also include depression, anxiety, and compulsive eating

Any of these symptoms should be discussed with your doctor. You can get advice and help from them on how to manage your symptoms ⁷

Management and treatment for lipedema

Currently, there is no cure, but there are things that can help and prevent it from getting worse. The severity and impact of your symptoms will determine your treatment. The main treatments are:

• Maintaining a healthy weight, eating healthily, and exercising more
• To make walking easier, wear compression stockings or bandages
• Using moisturizers regularly to prevent skin drying is one way to look after your skin
• Feeling depressed and unable to cope with your symptoms? You might want to consider psychotherapy or CBT
• For severe symptoms, liposuction can be used to remove fat
• Lipoedema treatment occasionally involves compression therapy. Your assessment and recommendation for the best kind of compression will be made by a doctor with specialized training

Diagnosis

A Physical examination and a review of your medical history allow a healthcare professional to diagnose you. Lipedema differs from normal body fat, which is painless, in that it contains painful fat deposits. A lipedema patient's unaffected feet and afflicted legs clearly differ in size from one another.

Test requests might include: 

• Ultrasound - which uses sound waves
• DEXA scan - an X-ray-based bone density test
• Magnetic resonance imaging (MRI) - a scan that combines a large magnet, radio waves, and a computer
• Computed tomography (CT) - an X-ray and computer-based scan
• Nuclear medicine imaging - a scan that creates images from radioactive material injected into the patient

Risk factors

Here are some of the risk factors of lipoedema.

• Genetic factor - Since lipoedema frequently runs in families, there is an evidence to suggest that it may have a genetic component. Investigations into the inheritance patterns and particular gene variations associated with lipoedema have been made²
• Influences of hormones - Lipoedema may develop or get worse because of hormonal changes brought on by puberty, pregnancy, or menopause. The illness may be influenced by levels of estrogen and progesterone³
• Puberty onset: Lipoedema frequently starts or worsens during or after puberty, indicating that hormonal changes related to this period of life may have an impact on the condition's growth¹
• Family History: An increased risk of having lipoedema is thought to be associated with a positive family history of the disorder
• Dysfunction of the adipose tissue: Lipoedema is accompanied by abnormalities in the metabolism and function of the adipose tissue, such as reduced fat storage and elevated inflammatory markers⁴

Complications

Side effects are possible with every drug or natural supplement. If you experience challenging side effects, discuss them with your practitioner. Some of the potential side effect of liposuction or bariatric surgery include.

• Swelling
• Bleeding
• Infection
• Blood clots⁶

FAQs

How can I prevent lipedema

It is challenging to prevent lipedema since the precise reasons are unknown. However, you can try to maintain a healthy weight if you have the risk factors for having lipedema in your family and are designated female at birth. Discuss strategies for achieving your weight goals with your physician.

How common is lipedema

According to estimates, a sizable percentage of people, mostly women, suffer from lipoedema. According to various research and demographics, different prevalence rates apply.  In a sizable sample of women visiting a specialized lipoedema clinic in the United Kingdom, the prevalence of lipoedema was discovered to be 10%.⁵

What can I expect if I have lipedema

Chronic lipoedema is characterized by massive and abnormal fat cell accumulation, mainly in the lower body. Pain, discomfort, easy bruising, and a feeling of heaviness or swelling in the affected areas result, as well as an unbalanced body contour. Over time, the disease worsens due to fat build-up and related problems. For those with lipedema, proper care, including medicinal interventions and lifestyle changes, is essential to reduce symptoms and enhance quality of life.⁴

When should I see a doctor

It's crucial to see a doctor who specializes in lipedema if you think you could have the disorder or exhibit signs of it. If you see uneven fat distribution, persistent discomfort, soreness, deteriorating symptoms, or mental distress, or if you need confirmation and treatment alternatives, see a doctor. Early detection and effective treatment can improve symptom alleviation and general health.⁴

What questions should I ask my doctor?

You might wish to ask your provider the following questions:

What kind and stage of lipedema do I have?

What medical procedure is best for me?

How much has this procedure benefited those who have lipedema?

When do I need to schedule follow-up appointments?⁶

Summary

In Lipedema: fat cells accumulate abnormally in the lower extremities due to abnormal metabolism. It predominantly affects women and is often misdiagnosed or underdiagnosed. The exact cause of lipedema is unknown, but hormonal factors, genetics, and microvascular dysfunction are believed to be involved. Symptoms include disproportionate enlargement of the hips, thighs, and calves, pain, swelling, and reduced mobility in the affected limbs. Lipedema can have a significant impact on body image and quality of life, leading to psychological distress. Diagnosis is typically based on a clinical evaluation, medical history, and physical examination. Treatment options include conservative measures such as compression therapy and exercise, as well as dietary modifications and psychological support. In some cases, surgical interventions like liposuction may be considered, but should be performed by experienced surgeons familiar with lipedema.