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Lipoedema

Lipoedema


 What is Lipodema

Lipodema is a lymphatic and metabolic fat imbalance where fat deposits occur mainly in the legs, thighs and buttocks.

A person suffering from lipodema can have a slim upper body and be quite large from the waist down to the ankles. Generally, the feet are not affected. In some cases, lipodema can also spread to the torso and the arms. If untreated, the condition can deteriorate and swelling can occur because the lymphatic capillaries are impinged and can no longer function adequately to remove the excess fluid from the tissue. This situation is called lipo-lymphoedema.

Lipodema is quite widely spread but generally is very poorly diagnosed and often confused with being overweight. It appears to affect more women than men, which leads to believe that a hormonal imbalance may be at the root of the problem. It typically manifests at puberty and worsens after pregnancy or at the onset of the menopause. It is also believed to be genetic with a family history of weight problems, fluid retention and/or venous insufficiency. Unlike the fat associated with excess weight, lipodema cannot be exercised away, does not respond to diet, and there is no cure for it. This is why most people feel confused, frustrated and alone in their quest for good health. However, the good news is that compression therapy and manual lymphatic drainage massage can help decrease the pressure sensitivity, reduce and control both lipodema and lymphoedema.

The focus of the treatment is to alleviate the symptoms and control the condition. The results are gradual and require a lot of patience and dedication by the patient. The sooner the condition is recognised, the sooner the management plan can be implemented.

 Lipedema Diagnosis / Clinical symptoms & characteristics:      

Patients tend to gain weight in lipedemic areas but lose it only in non-lipedemic areas. Obese lipedema patients who undergo surgery will lose fat, but primarily from the waist up. Even anorexic women can starve and exercise away “normal” fat but retain lipedemic fat. In many cases, surgery can make the condition worse.

The classic early stage lipodemic profile is a woman who looks like a size 8 from the waist up and a size 16 from the waist down, with disproportionately large, column-like legs. As lipedema progresses, patients become increasingly heavy in the lower body and especially the legs, and they are increasingly at risk to develop obesity. The additional, expanding fat cells interfere with the pathways of lymphatic vessels and patients can develop secondary lymphedema, a condition known as lipo-lymphedema. Many lipedema patients cannot tolerate the compression garments associated with conventional lymphedema treatment because the underlying lipedemic fat is very painful, and those patients therefore are at risk for the side effects of uncontrolled lymphedema, including recurring blood infections and fibrosis.

Lipedema usually is triggered at puberty, but can trigger or worsen during pregnancy, following gynaecological surgery, and  especially at peri-menopause. If lipedema is diagnosed early, which currently is very rare, it may be possible to slow the expansion of lipedemic fat cells, to prevent secondary lymphedema, and to alert patients to their heightened risk of obesity so they can take appropriate action.