Lipedema is a long-term condition that causes an abnormal type of fat to build up. Many people live with lipedema for years before receiving the correct diagnosis.
People with lipedema often feel responsible for their condition, but you are not to blame. Empowering yourself with knowledge about lipedema can help you improve your health and quality of life.
Lympha Press Chief Medical Officer Dr. Karen Herbst, PhD, discusses the causes, symptoms, complications, treatment, and life impacts of lipedema.
What is Lipedema?
Lipedema is the growth of abnormal fat tissue. This chronic condition primarily affects women, and it often starts around puberty.
“Lipedema fat is a firm (fibrotic) type of fat that is different than typical body fat, which is usually softer in texture,” says Dr. Herbst. She emphasizes that lipedema is a complex condition involving many physiological changes and is not simply a result of overeating or lack of exercise.
What Causes Lipedema?
The causes of lipedema are not well understood, but researchers are gathering more insights into how lipedema develops and progresses. The onset of lipedema appears to involve leaky blood vessels and inflammation.
“When fluid leaks from blood vessels into the space between the fat cells, it moves the fat cells away from the blood vessels that provide oxygen,” says Dr. Herbst. The immune system responds to this low-oxygen environment by forming tissue that thickens and hardens over time.
What Are the Risk Factors for Lipedema?
Risk factors are traits that increase the likelihood of developing a condition. Factors that may increase the risk of developing lipedema include:
- Allergies and mast cell activation conditions
- Family history of lipedema
- Metabolic disease
- Venous disease
What Are the Symptoms of Lipedema?
Common symptoms of lipedema include:
- Fat deposits that usually begin in the legs and hips and later develop in other areas, such as the arms and torso. New research shows that lipedema fat can develop in any area of the body. Diet and exercise don’t reduce this type of fat.
- Pain or heaviness in the legs. Pain may be mild or severe, and knee pain is especially common.
- Connective tissue (fascia) damage in the areas where lipedema fat nodules form. Joint problems can result since fascia surrounds, protects, and supports bones, organs, and other structures.
How is Lipedema Diagnosed?
Providers diagnose lipedema primarily with a clinical exam. “I look for uneven fat distribution, where there’s more on the legs,” says Dr. Herbst. “I feel the tissue for nodules and lift it to see how heavy it is.” Lipedema can be challenging to diagnose, especially if excess weight is present.
Dr. Herbst believes there may be different lipedema subtypes, and knowing them would enable more tailored treatment. However, researchers have not yet clearly defined lipedema subtypes or what they represent.
What Are Common Complications of Lipedema?
People with lipedema are at higher risk of developing other conditions and health challenges, such as:
- Lymphedema
- Joint pain
- Joint problems that may require joint replacement
- Metabolic disease
- Obesity
Common comorbidities, or co-occurring diseases, of lipedema include:
- Connective tissue diseases
- Venous disease
How Lipedema Impacts Life
Living with lipedema is challenging because it can affect nearly every aspect of life. Dr. Herbst says that the personal impacts of living with lipedema include:
- Anxiety and depression: People living with lipedema often experience mental health challenges, such as anxiety and depression. Dr. Herbst says that many people with lipedema experienced childhood trauma related to the condition.
- Clothing frustrations: There are limited options for clothes and shoes that fit the unique body shapes of people living with lipedema.
- Intimacy challenges: Self-consciousness, size, and other physical challenges can interfere with intimacy.
- Judgment from strangers: Dr. Herbst says that many people living with lipedema have experienced judgment when in public, such as while eating at a restaurant. This can affect mental health and lead to isolation.
- Physical limitations: Many people with lipedema were active when they were younger, but the progression of lipedema affects their mobility.
Treatment for Lipedema
“The first thing I always do is look for causes and ways to decrease inflammation,” says Dr. Herbst. “Whether it’s vascular inflammation or allergies or something else, if I can figure it out, there are specialists who can help. The other thing I recommend is prescribing a conservative therapy regimen.”
The main components of lipedema treatment are:
Conservative Therapy
Conservative therapy for lipedema includes:
- Manual Therapy: Manual lymphatic drainage (MLD) and deep tissue massage with a certified lipedema therapist (CLT) are key to ongoing treatment.
- Compression garments: Stretchy, tight-fitting garments help reduce swelling.
- Intermittent pneumatic compression (IPC) pumps: IPC like Lympha Press helps reduce swelling and prevent lipedema tissue from becoming more fibrotic.
- Nutrition and exercise: Eating a healthy, whole-food diet and getting regular physical activity can help reduce inflammation and swelling.
- Mental health care and mindfulness: Counseling for mental health challenges and mindfulness practices such as meditation and yoga can lower stress. Reducing stress can help reduce inflammation.
Medications
Dr. Herbst says several medications may be an effective part of lipedema treatment:
- Amphetamines in very low doses promote the breakdown of fat cells and can improve lymphatic drainage.
- Enzymes help break up fibrotic tissue.
- GLP-1 agonists in low doses help lower inflammation. However, Dr. Herbst notes that these medications can have serious side effects, such as appendicitis, pancreatitis, and small bowel obstruction.
- Metformin provides anti-inflammatory and antifibrotic benefits at a lower level than GLP-1 medications.
- Supplements such as diosmin and vitamin D reduce inflammation in veins.
Lympha Press IPC for Lipedema
IPC, like Lympha Press, is a critical part of lipedema treatment and is especially helpful for people who don’t have access to a CLT. Pumping helps move stagnant lymph fluid out of tissues, reducing inflammation around areas affected by lipedema. IPC also slows the formation and progression of fibrosis.
“I like to have my lipedema patients use IPC for not just the legs but also the pelvic and abdominal areas,” says Dr. Herbst. “I have them use Lympha Pants to treat those areas.”
IPC is simple to do at home, and Lympha Press garments are designed to treat areas of the body commonly affected by lipedema.
Lympha Press devices reduce swelling and improve the quality of life for people living with lipedema. Explore Lympha Press garments that target different areas of the body.
