Women's Health

Lipedema

Lipedema affects up to 11% of women. It occurs when fat is deposited abnormally beneath the skin, usually in the buttocks and legs. Although it begins as a cosmetic concern, it can progress to cause pain and other problems.

Symptoms of Lipedema

The typical symptoms of lipedema are a disproportionately large lower half and column-like legs, which are often tender and bruise easily. For example, the top half of the body may be a size 8, but the bottom half may be a size 16.

As the condition progresses, fat continues to accumulate and the lower body grows heavier. Over time, expanding fat cells block the vessels of the lymphatic system, which normally helps balance body fluid levels and protect against infection. This blockage prevents the proper drainage of lymph fluid, leading to a buildup of fluid called lymphedema.

If not treated, lymphedema can lead to problems such as infections, delayed wound healing, development of scar-like tissue called fibrosis, and loss of function in the legs.

Causes of Lipedema

The cause of lipedema is not known, but doctors suspect female hormones play a role. That's because the condition affects mostly women and it often begins or worsens at puberty, during pregnancy, following gynecologic surgery, and around the time of menopause.

Scientists also believe genes are involved, because many women with the condition have family members with the condition.

Lipedema Treatments

Unfortunately, dieting and exercising will not reduce the fat involved in lipedema. A weight loss diet and exercise may leave you thinner on the top, but not change fat on the lower affected half.

Surgery for lipedema is also ineffective. Obese women with lipedema who undergo bariatric surgery lose fat mostly from above the waist. Liposuction might seem a reasonable solution, because it is designed to remove fat from beneath the skin. But experts warn that removing enough fat to improve the appearance of the legs would likely cause death.

Although there is no way to eliminate the excessive fat accumulation of lipedema, treatment called complete decongestive therapy can ease painful symptoms. Complete decongestive therapy involves:

Manual lymphatic drainage. A form of massage that uses gentle, rhythmic pumping movements to stimulate the flow of lymph around blocked areas to healthy vessels, where it can drain into the venous system. This helps relieve pain and prevent fibrosis.

Compression. The use of stretch bandages or custom-fitted panty hose, panties, and/or spandex shorts to increase tissue pressure in the swollen legs and decrease the reaccumulation of fluid.

Exercise. Helps reduce fluid buildup, increase mobility, and maintain or improve function.

Meticulous skin and nail care. Helps decrease the risk of wounds and infection.