What is Lipodedema?

Lipoedema is a disorder that predominantly develops in women, and is characterised by diseased fat that often causes pain. Conservative figures show that approximately 11% of the female population are affected.

Diseased fat usually accumulates disproportionately body and is often found in the legs, buttocks, and sometimes the arms. It is not uncommon for the waist to be a couple of clothing sizes smaller than the buttocks, hips and thighs.

Due to the physical appearance of excess fat, lipoedema is frequently misdiagnosed as obesity. Although people can be affected by both diseases at the same time, they are different conditions.

Unlike obesity, weight loss strategies such as diet and exercise (and even weight loss surgeries) are not generally successful in reducing fat in affected areas.

The condition is often progressive, and has a tendency to advance at times of strong hormonal changes such as puberty, pregnancy, and menopause.

Signs and Symptoms of Lipoedema

All or some of these may be present with lipoedema:

• Excess fat build up in both legs and/or buttocks and arms.
• Fat in affected areas doesn’t seem to budge with diet and exercise, (or weight-loss surgeries) although you can loose weight elsewhere.
• Feeling of heaviness, aching or discomfort in affected areas
• Easy bruising of affected areas
• Affected areas are sensitive to touch
• Small, hard, grainy lumps may be felt when you push on the affected tissue
  (especially the inner knee area on the thigh and calf, the hip area, and the underside of the upper arm)
• Fat pads around knees
• Ankle or wrist ‘cuffs’ where excess fat stops accumulating and doesn’t affect the foot or hand
• Affected tissue may feel cold or cold to the touch
• Skin may have an uneven appearance with indentations
• Hypermobile joints
• Spider veins or varicose veins
• Female family members have a similar body shape (familial links are common)
• Lymphoedema (accumulation of fluid in both legs)
  
  

Classification of Lipoedema

Lipoedema is classified into different types by where lipoedema fat accumulates.

Type I – Buttocks

Type II – Buttocks, hips, and thighs down to knees

Type III – Buttocks, hips, thighs, and legs down to ankles (the foot is not affected)

Type IV – Arms (often accompanies type III)

Type V – Calves from knee to ankle

Lipoedema is also classified into stages (stage 1, 2 or 3) by how far lipoedema has progressed.

Lipoedema Management

Lipoedema symptoms may be managed conservatively, or with surgery.  It is important to note that what works for one person may not necessarily work or feel right for you.

Conservative treatments will not cure lipoedema, but can reduce the symptoms. They are thought to slow growth and potential progression of the disease, reducing the risk of complications such as decreased mobility, early joint deterioration and secondary lymphoedema.

• Compression therapy – compression garments, use of a compression pump and leg sleeve (SIPC)
• Manual lymphatic drainage (MLD)
• Psychological support eg counselling
• Reduce ‘lifestyle fat’ by eating well and participating in regular exercise
• Nutrition – anti-inflammatory diet
• Remedial massage
• Exercise – choose activities that you enjoy and works well for your body. Swimming or exercise in water is great, as you simultaneously receive the benefit of exercise as well as compression therapy from being in water.
• Rebounding (mini tramp) is great to stimulate the lymphatic system.
• Using a vibration plate – another tool for stimulating lymphatics.
• Self massage
• Dry brushing

Surgery – some women choose to go with the surgical option of liposuction.  When choosing a surgeon, it is important to ensure that they specialise in liposuction specifically for lipoedema.  The extraction of lipoedema fat requires a special technique to ensure that all of the diseased fat is removed, and does not damage the potentially already fragile lymphatic system.  Surgeries are costly, and several procedures are generally required.

Surgeons often have a prerequisite for patients to have been consistently utilising conservative therapies before their procedure to get the best result, and generally advise to continue practicing them post surgery.

Lipoedema that is not managed may progress, and can lead to:

• Increase in diseased fat growth
• Reduced mobility due to fat growth and tissue fibrosis (thickening and stiffening of tissue) due to chronic inflammation
• Changed gait causing early joint deterioration, especially knees (caused by excess fat on legs
• Lymphoedema caused by excess fat affecting the flow of lymphatic fluid (the condition is then called lipolymphoedema)
• Increased pain, aching, and heaviness in limbs
• Cellulitis infection (bacterial infection that can quickly lead to sepsis and become life threatening)
  
  

Find out how we can help you to manage your lipoedema

Resources

Lipoedema Australia

The Lipedema Project

Lipedema Mamas Podcast

The Lipoedema Podcast