What Is Lipedema?

Lipedema is a disorder of fat deposition where fat builds up in the lower legs and causes painful swelling over time. This condition occurs primarily among women and appears to have a genetic component. Treatment options are available to manage, but not cure, this condition. Patients with lipedema will need to exercise extreme care throughout their lives to avoid the complications that can develop when the fat deposition becomes significant.

Changes in hormone levels appear to trigger lipedema, as it tends to break out at puberty, during pregnancy, after gynecological surgeries, or during menopause. Patients may notice that they are gaining weight in their legs at a disproportionate rate. If the condition is not diagnosed properly or the patient doesn't take action, the disparity between the upper and lower halves of the body may become extreme; the patient's lower half may be twice the size of her upper half, for example.

As the fat builds up, it can create small nodules under the skin. It will be painful, and the skin folds that inevitably develop with significant weight gain will be prone to rashes and infections. Patients may also experience limited mobility with lipedema, as it can be very hard to move the legs comfortably and easily. Skin infections and severe pain can occur and may become chronic.

Treatment requires catching the disease as early as possible to provide interventions. Manual lymphatic drainage (MLD), a special massage technique to encourage lymph circulation, can be helpful. Patients may also wear compression garments to increase comfort. These garments need to be very carefully fitted, as they can cause pain and irritation or may cut off circulation if they are too tight or made from the wrong fibers. A doctor can help a patient find an appropriate level of compression.

Diet and exercise measures can also help with lipedema. Once the fat deposits form, it is not possible to lose the fat, but patients can limit the formation of further deposits by keeping their weight tightly controlled. Exercise can also increase mobility and reduce stress on joints. For heavier patients who cannot perform impact exercise like running and aerobics, options like swimming can be helpful. Patients also need to be aware that they have an increased risk of obesity with lipedema, and that treatments like liposuction to remove the fat or bariatric surgery to limit food intake and change the metabolism will not resolve the problem.