Lipedema

Overview

What is Lipedema?

Lipedema is a condition that causes excess fat to accumulate in the lower part of the body. Lipedema most often involves the buttocks, thighs and calves. The upper arms can also be affected. The condition does not affect the hands or feet.

Lipedema is sometimes confused with lymphedema, but these are different conditions. However, lipedema can lead to lymphedema.

Symptoms and Causes

What causes lipedema?

The exact cause of lipedema is unknown. But the condition runs in families and may be inherited. The condition occurs almost exclusively in people assigned female at birth, and usually starts or gets worse at the time of puberty, pregnancy or menopause. Because of this, there is likely a connection to hormones. Lipedema is not caused by obesity but more than half of patients with this condition have overweight/obesity. Dieting can cause you to lose weight in your upper body without changing the areas affected by lipedema. Symptoms of lipedema include:

  • Fat build-up in buttocks, thighs, calves, and sometimes the upper arms. Diuretics, elevating your legs and support stockings do not help the affected areas. There is typically no swelling in feet, or hands unless the patient has chronic venous insufficiency or lymphedema.
  • Pain.
  • As the condition gets worse, lipedema can affect your ability to walk.
  • Many patients with lipedema have emotional symptoms, such as being embarrassed, anxious and depressed as the lower part of their body grows larger.
  • Over time, as more fat accumulates, it can block the lymphatic pathway. This causes a build-up of fluid called lymph. The condition is known as secondary lymphedema or lipo-lymphedema.

Management and Treatment

Lifestyle Changes

A heart-healthy diet may help slow the progression of lipedema, especially if you learn about your condition early on. Exercise, especially swimming, biking and walking, are helpful for mobility and to reduce swelling.

Decongestive Therapy and Compression Therapy

Your doctor may suggest noninvasive treatments, such as:

  • A gentle form of skin stretching/massage called manual lymphatic drainage therapy
  • Special wrapping techniques called complex decongestive therapy

Invasive Therapies

Liposuction may be used to reduce the size of fat deposits but standard liposuction is not recommended. Wet-jet assisted liposuction is less likely than total tumescent liposuction to cause damage to the lymph vessels and is recommended. If you have lipedema and obesity, you doctor may recommend bariatric surgery.

Last reviewed by a Cleveland Clinic medical professional on 05/24/2019.

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