Lipedema Causes and Management
What is Lipedema?
Lipedema (Lipodema) is a fat disorder involving loose connective tissue, appearing primarily in women. Co-morbidities include non-lipedema obesity, lymphedema, venous disease, and hyper-mobile joints. The cause of lipedema is unknown, and it is estimated that 10 percent of women are affected. Medical professionals often misdiagnose lipedema as obesity.
Medical professionals perform a clinical exam with diagnostic criteria to help guide the clinical diagnosis of the disease.
Lipedema most often affects the hips and legs—disproportionately more significantly than the upper body, though lipedema can affect the arms. Over time, if left untreated, Lymphedema can occur. The condition is known as secondary lymphedema or lipo-lymphedema.
Who is at risk?
Lipedema occurs mainly in women and is hereditary. It is common for a maternal grandmother, mother, and daughter to develop lipedema.
How can I tell if I have Lipedema?
Lipedema is a long-term condition that causes abnormal fat buildup in the lower part of your body, usually in your legs, but it can also be in your arms1. You can develop lipedema at various ages, with symptoms appearing around puberty, pregnancy, or perimenopause. Major trauma, gynecological surgery and significant periods of stress can trigger lipedema.
Symptoms vary from person to person and may include:
- Excess fat that accumulates bilaterally, causing buttocks, thighs, calves, and arms to become significantly larger.
- Bumps on the skin that feel like there's something underneath the fat layer.
- Pain, ranging from mild to severe, that is constant or occurs only with pressure.
- A sensation of weightiness in the legs
- Swollen legs and feet
- Skin that bruises easily
How can you manage is Lipedema?
Though there is no cure for lipedema, you can maintain an active and healthy life with therapy from a certified lymphedema therapist or trained medical professional. Conservative decongestive therapy (details below) can help decrease pain and hypersensitivity, increase mobility, and minimize additional issues such as swelling or lymphedema.
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Massage Therapy:Manual lymph drainage is a unique technique that may encourage the flow of lymph fluid out of the affected area of your body.
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Exercises:Moving your affected limb through light exercise can help decrease lipedema symptoms. Learn more about how exercising can help change your life in our Steps to Better Health blog, which focuses on lipedema and exercise.
- Diet:Health professionals advise people with lipedema to eat an anti-inflammatory healthy diet that includes whole grains, healthy fats, fruits, vegetables, and fish to promote optimal weight. This diet helps boost the body's immune system, which will help reduce and manage infections. Visit Juzo’s Steps to Better Health blog to learn about a healthy diet.
How do Medical Compression Garments help with Lipedema?
Graduated compression therapy is an absolute must-have when it comes to managing the debilitating symptoms of Lipedema. It can improve mobility, reduce pain, limb fatigue & heaviness, swelling, and improve shape and comfort. This therapy is an indispensable tool in the fight against this condition. Don't let Lipedema control your life! Take control by incorporating medical graduated compression into your treatment plan.
Compression needs vary depending on patient presentation, pain, and physical ability to don/doff garments or compression bandages. Per the U.S. Standard of Care, the therapist, or fitter needs to carefully select the correct compression garments, depending on the lipedema stage and size of the patient. If there are many lobules or deep skin folds present, it may be necessary to combine types of compression therapy. For example, you may need to be fitted for an adjustable in-elastic compression wrap or flat knit knee-high or thigh-high with the Juzo Sensation capri or shorts style combined with a lower-leg garment. Juzo Sensation features micro massage technology, a high waistband and extra gluteal panel, and medical-grade compression throughout the garment.
Learn more about our full line of Lipedema Compression Garments by clicking here.
It is important to check that the garment fits well and does not cut into tissues, especially at the ankles and knees. Below are recommended compression guidelines from the U.S. Standard of Care for Lipedema.
Standard of Care for Lipedema in the United States
Compression class level (CCL) recommendations for lipedema*
Micro massage garment
(10-20 mmHg) as needed.
Micro massage;
CCL I or CCL II as tolerated when pain, swelling or heaviness are present.
Micro massage;
CCL I or CCL II as tolerated when pain, swelling or heaviness are present. May have to layer different garments.
CCL should be determined individually based on patient presentation, physical ability & tolerance & caregiver support. May have to layer different garments.
*CCL I = 20-30 mmHg CCL II = 30-40 mmHg
For more education on lipedema, read about the new Lipedema Standard of Care in our Steps to Better Health article.
The New Lipedema Standard of Care
If you’re concerned that you may have lipedema, consult a trained MLD therapist or your primary care provider for a proper evaluation.
Stage 1 The skin is smooth, but the fat tissue is enlarged. The fat buildup is mainly around the pelvis, buttocks, hips, and upper arms. There may be pain and bruising.
Stage 2 The skin is uneven and has indentations and lumps. The fat buildup extends from the pelvis to the knees or the wrists. There may be more pain and swelling.
Stage 3 The skin and fat tissue form large bulges and deformities, especially on the thighs and knees. The fat buildup reaches the ankles or the lower arms. There may be mobility issues and joint problems.
Stage 4 The lipedema progresses to lipolymphedema, which is a combination of lipedema and lymphedema. The skin and fat tissue have large overhangs and fluid accumulation. There may be skin ulcers, infections, and blood clots.
Types I to V describe the location of lipedema tissue.
Type I Buttocks: Fat is between your pelvis and knees.
Type II: Buttocks, Hips and Thighs: Fat is between your pelvis and ankles.
Type III: Hips, Thighs and Calves: Fat is between pelvis and ankles.
Type IV: Arms: Fat is between your shoulders and wrists.
Type V: Calves: Fat is between your knees and ankles.
Understanding the differences between lymphedema and lipedema can be difficult due to their similarities. To help you differentiate between the two, here are some key points to keep in mind:
Lymphedema:
Lymphatic dysfunction is a medical condition where the lymphatic system is the primary issue. This can cause the affected area to swell, undergo tissue changes, and occur in the upper or lower extremities. It can be congenital or caused by something secondary like breast cancer surgery, radiation therapy, chemotherapy, or pelvic surgery where lymph nodes have been removed. Typically, one limb is more affected than the other.
Lipedema:
Lipedema is a condition that almost exclusively affects women and usually involves the distal lower limbs or upper arms. It is characterized by an abnormal adipose tissue accumulation between the hips and the ankles, typically symmetrical and bilateral. Unlike fluid accumulation, the swelling is caused by dysfunctional adipose tissue. This condition is also known as painful fat syndrome and should not be confused with Lymphedema, although Lipedema can lead to Lymphedema.
To learn more about lipedema and lymphedema, you can read about the experiences of patients who have these conditions.
Living with Lyphedema & Lipedema