Big legs, protruding buttocks – often, lipedema is wrongly judged as being overweight or obese. But lipedema has nothing to do with being overweight. Lipedema is the result of a pathological build-up of fat cells in the extremities. Typically, it affects the legs. Since lipedema occurs almost exclusively in women, experts assume hormonal causes.
Despite a conscious diet and exercise, the affected women typically gain weight in their legs and/or, less commonly, arms. The increased accumulation of fat cells cannot be reduced by calorie reduction.
There is no exhaustive research on lipedema yet. One thing is certain though – this chronic disease is not caused by improper nutrition or excessive food intake. Experts presume a genetic predisposition as well as hormonal triggers.
Lipedema often starts during puberty. However, oral contraceptive use, pregnancy, and menopause also seem to be triggers. In men, lipedema-like changes have only been described in the context of hormonally active therapeutic agents, pronounced hormone imbalances (for example, hypogonadism), or liver cirrhosis.
Experts divide lipedema into three stages. Symptoms of lipedema can vary greatly from person to person -- not all patients, for example, reach stage three.
Stage I: The skin appears smooth. If pressed on, uniformly thickened subcutaneous tissue with soft consistency.
Stage II: The skin shows an irregular texture that resembles the skin of an orange. Subcutaneous nodules that vary in size are palpable.
Stage III: The volume increase of the subcutaneous fat tissue has progressed further with larger and more prominent indurations than in Stage II. Deformed lobular fat deposits that may cause considerable distortion of the limb profile are present.
Have you been diagnosed with lipedema? This chronic, progressive disorder is marked by the individual variability and unpredictability of its clinical course.
Therefore, treatment consists of several therapeutic approaches that should be combined as necessary.
Manual lymphatic drainage helps to activate the lymphatic vessels and to ensure faster drainage of the lymphatic fluid. This reduces swelling in the legs. Also, the use of compression wear helps by reducing the development of swelling and the painful sensation. Exercise and skin care are also important parts of physical therapy.
Exercise, such as walking, swimming, or hiking, are good for body and mind and help to alleviate discomfort.
The psychological strain of living with lipedema can be considerable. They may hear snide remarks: eat less, exercise more... Statements like these could further reduce their self-esteem; the stress could lead to depression and eating disorders. A person with lipedema may feel insecure about his or her appearance and experience a loss of self-esteem. In some cases, these feelings can lead to depression, eating disorders, and other psychological problems. Psychotherapy may be recommended to help build coping skills.
Surgery is indicated if, despite thorough conservative treatment, symptoms persist or worsen. If present, morbid obesity should be therapeutically addressed prior to liposuction. Following liposuction, patients should wear compression garments for several weeks.