This blog is about lipedema. It is a really painful and debilitating condition that can have serious consequences for those affected. It affects 10-18 percent of women aged 25-65. Despite its prevalence, the condition is often overlooked and misunderstood by medical professionals and even the general public.

In people with lipedema, fat cells swell mainly on the legs or arms, but these symptoms are often mistaken for obesity or simply dismissed as an aesthetic problem. In addition, most don't realize how emotionally difficult living with lipedema can be, from feeling invisible because doctors don't acknowledge it, to facing discrimination from strangers when patients try to do everyday things, such as shopping at clothing stores meant for those who fit societal body mass index (BMI) norms.

In this blog post, we'll discuss what lipedema is and why it needs more attention for treatment options so that sufferers can finally get the answers - and the help - they need!

What are the causes of lipedema?

The exact cause of lipedema is not known, but there are some factors that can increase the risk of developing lipedema:

Hormonal imbalance: this can be caused by fluctuations in hormones such as oestrogen, progesterone and testosterone.

Genetic predisposition: Certain genes may be associated with an increased risk of developing lipedema.

Age: Lipedema is more common in middle-aged women than in men and children, probably because their hormones change during this time.

Obesity: Being overweight or having a higher than average body mass index (BMI) can increase the risk of developing lipedema.

Sedentary lifestyle: Insufficient physical activity can contribute to the development of lipedema.

Stress: Persistently high levels of stress can lead to an increased risk of lipedema.

Diet: A diet high in fat, sugar and calories can increase the risk of developing lipedema.

History of trauma: Previous injuries or trauma to the legs and hips can contribute to the development of lipedema.

Occupations: Certain occupations that involve standing for long periods of time, such as in the hospitality industry, can increase the risk of developing lipedema.

Medical conditions: Certain medical conditions such as diabetes, hypothyroidism, kidney disease and lymphedema can increase the risk of developing lipedema.

Medication: Certain medications, such as those used to treat cancer, can cause lipedema.

What are the symptoms of lipedema?

• Pain in the affected areas (legs, arms, buttocks) when pressure is applied
• Sensitivity to touch (the affected area feels painful to the touch)
• Swelling of the legs/arms (also known as "stovepipe" or "pillar legs")
• Abnormal fat distribution and enlargement of the feet and ankles
• Feeling of "heaviness" in the legs or arms
• Dimples on the affected skin area, similar to an orange peel
• Visible and palpable fat deposits without corresponding weight gain
• Inability to lose excess fat through exercise or dieting
• Restricted freedom of movement in the affected area
• Skin irritation/dryness in the affected area

The above symptoms are common in women between the ages of 25 and 65 and can be easily diagnosed by a healthcare professional such as a lymphologist or vein specialist. It is important to see a doctor as soon as possible so that the condition can be treated appropriately. In this way, further complications or negative physical effects of lipedema can be avoided.

What causes lipedema?

It is still unclear whether the enlargement of fat cells (hypertrophy) or an increase in fat cells (hyperplasia) is responsible for this clinical picture. A combination of both mechanisms is also possible. As it almost exclusively affects women, genetic predisposition and the effect of female hormones are also being discussed as causes. 

The constant strain on the lymphatic vessels leads to degenerative changes in the lymphatic vessels, which reduces their transport capacity. As a result, fluid remains in the tissue and leads to edema.

If this condition persists over a longer period of time, inflammation and collagen deposits occur in the affected areas. This collagen leads to irreversible fibrosis of the fatty tissue and the overlying skin.

Recognizing lipedema: What are the symptoms?

In the early stages, it can be difficult to distinguish lipedema from obesity. As the disease progresses, it is possible to distinguish between the two based on the disproportionate distribution of fatty tissue. While the extremities swell, the hands and trunk remain slim.

The lipedema pain can be so severe, especially in the later stages, that patients are also significantly restricted in their everyday lives due to their limited mobility. The symptoms of lipedema also include an increased tendency to haematomas. Even slight pressure causes bruising, even though there is no blood clotting disorder.

The stages of lipedema

Lipedema can be divided into three stages based on its anatomical appearance and the pressure findings. The severity of the symptoms or the volume of the edema is irrelevant.

Stage I: smooth skin surface, thickened subcutaneous fatty tissue, fine nodular fat structure.

Stage II: uneven skin surface, rough, nodular fat structure.

Stage III: rougher and harder skin surface and subcutaneous tissue, large lobulated, deformed fat flaps.

The right diet for lipedema

Patients can reduce their symptoms and pain by up to 80 percent with a long-term change in diet. This was shown in a study conducted by the Center for Vascular Medicine in Hamburg, Germany, with obese lipedema and lymphoedema patients. In addition, less therapy was required.

Healthy indulgence: tips for a healthy and balanced diet

A healthy and varied diet and sufficient fluid intake can support the positive effects of therapy and counteract possible complications.

Fruit and vegetables:

Lots of colorful and fresh fruit and vegetables provide you with all the important substances your body needs. We recommend two portions of fruit and three portions of vegetables a day. Vegetables can be eaten in larger portions as, unlike fruit, they do not affect blood sugar levels. This ensures that you feel full for longer. Use the traffic light principle for variety on your plate: treat yourself to green, yellow and red fruit and vegetables.

Healthy fats:

Fat is not always bad. Linseed oil, seeds, avocados and nuts are very important for the body. You should reduce fats from baked goods, margarine and sunflower oil.

Meat, sausage and cheese:

Reduce your consumption of meat, sausage and cheese products.

Less salt:

Reduce your salt consumption, as salt binds water in the tissue

Breaks between meals

A lot of energy is consumed during a meal that the body does not use immediately.

This excess energy is stored in the body in the form of fat or glycogen, which is a carbohydrate. The body draws on this between meals. If there is not enough time between meals, your body absorbs more energy than it needs. This is then stored as fat deposits.

Recognizing the symptoms of lipedema early is essential for effective treatment. By staying informed, seeking medical advice promptly, and incorporating compression therapy, you can manage your condition better and improve your quality of life.