Lipedema Causes Stages Treatment and Tips for Living With It

Lipedema is a medical condition that affects the distribution of fat in the body, leading to abnormal fat accumulation in specific areas such as the legs and hips, with difficulty in reducing it through traditional diets or exercise. Although this condition is rare, it causes embarrassment and pain for many individuals and significantly impacts their quality of life. In this article by Dely Medical, we will explore the causes of lipedema, its stages of development, and the latest available treatments. We will also provide tips for coping with this condition and alleviating its physical and psychological effects. If you suffer from this condition or want to learn more about it, continue reading to discover everything you need to know.

What is Lipedema?

Lipedema is a chronic condition characterized by abnormal fat accumulation in the lower body, typically affecting areas such as the hips, thighs, and calves. It may also affect the hips or upper arms, but does not typically impact the hands or feet. Some may confuse lipedema with obesity or lymphedema, but they are different conditions. In some cases, lipedema may lead to the development of lymphedema.

People with lipedema often have a Body Mass Index (BMI) greater than 35. While diet and exercise may help with weight loss in the upper body, they do not improve the situation in areas affected by lipedema in the lower body.

How Common is Lipedema?

Studies suggest that approximately one in 72,000 individuals may have lipedema, though the actual number may be higher as many cases may be misdiagnosed as obesity or lymphedema. Some studies estimate that 11% of women suffer from lipedema, and it is extremely rare among men.

How Long Does it Take to Recover from Lipedema Treatment?

Recovery after liposuction can take 4 to 6 weeks, with a recommendation to avoid strenuous activities during this period. Patients who undergo obesity surgery may require several weeks of rest and complete recovery.

Can Men Have Lipedema?

While lipedema is more common in women, it can also occur in men, though it is far less common than in women.

Can Diet and Exercise Treat Lipedema?

While a healthy diet and exercise can improve general health, they do not effectively treat lipedema. Fat accumulation in areas affected by lipedema does not respond to traditional weight loss techniques.

Does Lipedema Return After Liposuction?

Fat cells affected by lipedema are permanently removed during liposuction, but if a healthy lifestyle is not maintained, fat may accumulate again in different areas of the body over time.

Is Lipedema Hereditary?

Yes, lipedema is often hereditary. If a family member has this condition, the likelihood of developing it increases significantly. It is more common in women, indicating a strong genetic and hormonal influence.

Types and Causes of Lipedema

Lipedema is a medical condition characterized by abnormal fat accumulation in certain areas of the body, particularly the lower body, such as the thighs and calves, and sometimes affecting the arms. It differs from obesity or lymphedema and is characterized by an uneven fat distribution in some areas while maintaining a natural fat distribution in others. Lipedema can be classified into different stages based on symptom severity and affected areas.

Types of Lipedema:

Lipedema Type 1 (Lipedema Stage 1)
- Characteristics: Fat accumulates smoothly under the skin, and affected areas (such as the thighs and calves) are soft and homogeneous.
- Symptoms: A feeling of heaviness in the legs or thighs, but no obvious changes in shape or skin signs.
- Treatment: Regular exercise and a healthy diet, along with wearing compression socks to stimulate circulation.
Lipedema Type 2 (Lipedema Stage 2)
- Characteristics: Greater fat accumulation with the appearance of "orange peel" skin, especially on the thighs and calves.
- Symptoms: Weight gain in specific areas, pain or a feeling of heaviness, and noticeable swelling.
- Treatment: Weight loss under medical supervision, lymphatic drainage therapy, and targeted exercise therapy.
Lipedema Type 3 (Lipedema Stage 3)
- Characteristics: Fat accumulates significantly in the legs, thighs, and hips, with noticeable lumps and rough skin texture.
- Symptoms: Persistent swelling in affected areas, chronic pain, and noticeable body shape changes.
- Treatment: Surgical liposuction is the most effective solution in this stage, along with targeted exercises.
Lipedema Type 4 (Lipedema Stage 4)
- Characteristics: This is the most advanced stage, with significant fat accumulation causing severe tissue lumps.
- Symptoms: Persistent swelling, skin ulcers, and changes in blood circulation.
- Treatment: Requires effective surgical treatments such as liposuction, along with comprehensive medical care to manage symptoms.
Lipedema with Lymphedema (Lipedema with Lymphedema)
- Characteristics: In some cases, lipedema may progress to lymphedema, leading to fluid retention and increased swelling.
- Symptoms: Increased swelling, heaviness, and a risk of infection due to fluid buildup.
- Treatment: A combination of medical treatment such as lymphatic drainage, surgical therapy, and exercise.

What Causes Lipedema?

While the exact cause of lipedema is not known, several factors may contribute to the development of this condition:

Genetics (Hereditary Factors): Lipedema is often hereditary. If a family member has this condition, the risk of developing it increases significantly. The condition is more prevalent in women, suggesting the significant role of genetics and hormones in its development.
Hormonal Changes: Hormonal changes are a major contributing factor in the development of lipedema. Symptoms typically begin during puberty, pregnancy, or menopause, where hormones like estrogen play a role in fat accumulation in specific areas.
Weight Gain and Obesity: Although obesity is not the primary cause, weight gain can exacerbate symptoms and fat accumulation in affected areas. In lipedema, fat accumulates unevenly, making symptoms more noticeable in areas such as the thighs and hips.
Lymphatic System Issues: A malfunctioning lymphatic system may contribute to lipedema, causing fluid retention in tissues, leading to swelling.
Environmental and Lifestyle Factors: Unhealthy lifestyles, such as lack of physical activity, chronic stress, or prolonged sitting, may contribute to an increased likelihood of developing or worsening lipedema symptoms. Regular physical activity helps improve circulation and reduce symptoms.
Unhealthy Diet: Diets high in saturated fats, sugar, and salt may contribute to fat accumulation in the body, exacerbating lipedema symptoms.
Disruption in Fat Tissue Function: Lipedema is thought to arise due to a disruption in how fat tissues respond to hormones, causing fat to accumulate in certain areas without being distributed normally throughout the body.

Stages of Lipedema

Lipedema is a condition characterized by abnormal fat accumulation in specific areas of the body, such as the thighs and calves, which leads to swelling and changes in body shape. It is more common in women and can develop gradually through different stages. The severity of symptoms increases as the condition progresses. Treatment options depend on the stage of lipedema:

Stage One: Early Fat Storage
- Characteristics: Fat begins to accumulate in specific areas such as the thighs and calves.
- Symptoms: Minimal swelling or fluid retention; slight changes in body shape.
Stage Two: Tissue Swelling
- Characteristics: The surrounding tissues begin to swell, leading to fluid retention in the affected areas.
- Symptoms: Noticeable swelling in the thighs and calves, heaviness or pain, and an uneven body appearance.
Stage Three: Severe Swelling and Lumps
- Characteristics: Tissues begin to form lumps or nodes in areas of fat accumulation.
- Symptoms: Severe swelling, visible lumps, and persistent pain or discomfort in the legs and thighs.
Stage Four: Permanent Tissue Damage
- Characteristics: The affected tissues become permanently damaged and changes occur in the appearance of the skin and tissue.
- Symptoms: Large lumps, chronic pain, and skin lesions, making movement difficult.

How is Lipedema Diagnosed?

Diagnosing lipedema can be complex initially, as its symptoms may resemble other conditions like water retention or localized obesity. Diagnosis typically involves a combination of factors, including medical history, clinical examination, imaging tests, and blood tests to confirm the diagnosis and differentiate it from other conditions.

Medical History and Clinical Examination
- Medical History: The doctor typically starts by reviewing the patient’s medical history to understand the current and past symptoms. They focus on family history, as lipedema is often hereditary. If a first-degree relative has lipedema, the likelihood of the patient having it increases.
  - The doctor will inquire about the onset of symptoms: When did the swelling or fat accumulation begin? Which areas of the body are affected (e.g., thighs, calves, arms)?
  - The doctor may also ask about other health issues related to the condition, such as varicose veins or hormonal imbalances.
- Clinical Examination: The doctor will perform a physical examination to observe swelling and lumps in areas like the thighs and calves.
  - Skin elasticity and the degree of swelling will be checked, along with the presence of any lumps or abnormal tissue clumping.
  - The doctor may press on swollen areas to determine if the swelling disappears or remains after pressure is applied.
Imaging Tests
- Ultrasound: Used to detect fluid retention in tissues and to assess the presence of fat accumulation in the affected area. It helps distinguish between swelling caused by fat or fluid retention.
- Magnetic Resonance Imaging (MRI): MRI is an effective tool for diagnosing lipedema as it can detect fat swelling and changes in deeper tissues like muscles and fat. It is used when there are concerns about other conditions that may present similar symptoms, such as lipomas.
- X-rays: Sometimes required to identify structural issues or to assess the impact of lipedema on bones and joints.
Blood Tests
- Hormonal Tests: Since lipedema is more common in women, hormone tests (such as estrogen and progesterone levels) may be requested to rule out hormonal disorders affecting fat distribution.
- Other Tests: The doctor may also order blood tests to check cholesterol levels, diabetes, or thyroid disorders to exclude other health conditions.
Exclusion of Other Conditions
Before making a final diagnosis, the doctor will need to exclude other conditions that may mimic lipedema, such as:
- Fluid Retention: Can cause swelling in the same areas as lipedema but does not involve fat accumulation.
- Localized Obesity: Fat accumulation in the same areas but without the swelling or lumps associated with lipedema.
- Varicose Veins: Can cause swelling in the legs but is usually not associated with fat accumulation or tissue clumping.
Supplementary Tests
In rare cases, the doctor may recommend a biopsy (tissue sample) to exclude lipomas or other health conditions that may cause similar symptoms.

Lipedema Treatment with Medication

Although surgical options like liposuction are considered the most effective treatment for advanced stages of lipedema, there are some medications and treatments that may help alleviate symptoms, especially in the early stages or when surgery is not an ideal option.

Medications to Reduce Pain and Inflammation
- Pain Relievers: Drugs like ibuprofen or acetaminophen can help reduce temporary pain and inflammation in affected areas.
- Nonsteroidal Anti-inflammatory Drugs (NSAIDs): Medications such as naproxen and ibuprofen can reduce swelling and inflammation in the affected fatty tissues.
Medications to Improve Circulation
- Some supplements and medications that improve blood circulation may be useful in treating lipedema. They work by stimulating blood flow to the affected areas, helping to reduce swelling and improve the appearance of the skin.
- Ginkgo Biloba Supplements: May help improve circulation and reduce fluid retention.
Medications to Reduce Fat
- In some cases, doctors may recommend medications that help reduce abnormal fat in the body, such as those that lower cholesterol and fat levels in the blood. Statins are some of the most common, though they are not primarily used to treat lipedema.

Topical Treatments for Lipedema

While liposuction is the most effective treatment for lipedema, there are various pharmaceutical and supplementary treatments that can help alleviate symptoms or improve the condition, particularly in the early stages or when surgery is not an option. Here are some key treatments:

Medications to Treat Obesity (Orlistat)
- Orlistat is a medication that helps reduce fat absorption in the digestive system, thus reducing excess fat accumulation in the body. However, its impact on lipedema is limited because it does not directly affect the fat tissue in the affected areas.
- Benefits: Helps reduce overall fat accumulation and may contribute to overall weight loss.
- Risks: Can cause gastrointestinal issues like diarrhea and bloating. Its effect on treating lipedema is insufficient.
Topical Treatments
- Circulation-Stimulating Creams: These may contain caffeine or retinol, which can help reduce fluid retention in fatty tissues and promote cell regeneration.
  - Benefits: Improves skin elasticity and reduces cellulite and water retention.
- Collagen-Containing Topicals: These help improve skin elasticity and reduce wrinkles or sagging that may occur after fat reduction in affected areas.
Hormonal Medications
- Since hormones play a role in fat accumulation in areas like the thighs and hips, hormone therapy may help alleviate symptoms associated with lipedema, especially during pregnancy or menopause.
- Hormone Replacement Therapy (HRT): Can help rebalance hormones in the body, which can assist in reducing fat accumulation in areas such as the thighs or hips.
  - Benefits: Improves the hormonal distribution of fat and helps reduce the effects of hormonal changes on the body.
Diuretics (Water Pills)
- In some cases, diuretics may be used to help reduce fluid retention and swelling associated with lipedema.
- Medications like Hydrochlorothiazide help reduce excess fluid in the body, reducing swelling.
  - Benefits: Alleviates swelling and fluid retention.
  - Risks: Does not treat the underlying cause of lipedema and may lead to dehydration or mineral imbalances.
Vitamin and Mineral Supplements
- Some dietary supplements may help improve skin and vascular health, which may help alleviate the symptoms of lipedema.
- Vitamin D: Strengthens bones and tissues, improving skin health.
- Vitamin K: Helps reduce swelling and improves circulation in the affected tissues.
- Magnesium: Helps reduce swelling and supports hormonal balance in the body.

Surgical Treatment for Lipedema

When symptoms are severe or when medications or topical treatments are not sufficient, surgery can be an effective option to improve the patient's condition. Below are the primary surgical options used:

Laser Liposuction
- Uses laser energy to heat and break down fat cells, which are then extracted using a specialized device.
  - Benefits: Significantly reduces fat accumulation, improves skin appearance, and reduces sagging.
  - Risks: Pain or swelling after the procedure, with a very low risk of skin injury or infection when performed by a skilled surgeon.
Traditional Liposuction
- Involves inserting a thin tube (cannula) through small incisions in the skin to suction out fat from the affected areas.
  - Benefits: Helps reshape the body and balance the upper and lower parts.
  - Risks: Scarring may be noticeable in some cases, with a longer recovery time compared to laser liposuction.
VASER Liposuction
- Uses high-frequency sound waves to break down fat before extracting it from the body.
  - Benefits: More precise in fat removal with less impact on surrounding tissues, stimulates natural skin elasticity.
  - Risks: Swelling or pain after surgery, with some patients experiencing temporary changes in skin sensation.
Fat Grafting (Tissue Grafting)
- In some cases, fat from other areas of the body is transferred to the areas needing volume enhancement.
  - Benefits: Natural body reshaping and improved skin appearance in areas that were previously sagging.
  - Risks: Slower recovery compared to other methods, potential for fat lumps if the procedure is not performed with precision.
Excision Surgery
- In advanced stages of lipedema, excess sagging skin may be removed after fat is removed.
  - Benefits: Body reshaping and removal of excess skin, improving body proportions.
  - Risks: Longer recovery compared to other options, visible scarring from the surgery.
Endermologie
- A non-invasive procedure using a mechanical device to stimulate blood circulation and reduce fat lumps.
  - Benefits: Non-surgical, improves skin elasticity, and reduces fat clumps.
  - Risks: Results are not as permanent as surgical procedures.
EMSculpt
- Uses electrical muscle stimulation to tone muscles and reduce fat simultaneously.
  - Benefits: Improves body shape and strengthens muscles.
  - Risks: May require multiple sessions to see visible results and does not replace surgery for severe lipedema cases.