Also known as the “painful fat disease,”lipedema is an inflammatory condition where fat develops disproportionately on the hips, legs and arms. It most often occurs in women and runs in families. The exact cause is unknown but we do see it develop at times of hormonal changes like puberty, pregnancy, menopause or high stress.
Why is it important? Lipedema fat is highly resistant to diet, exercise and even bariatric surgery. It is a common condition that is poorly understood by the medical community and is often misdiagnosed as lymphedema or obesity. The disease and associated stigma can have a profoundly negative impact on quality of life.
Some key features of lipedema:
Overall disproportion, as lipedema progresses, the body will form a “pear shape”
A cuff appearing at your wrists and ankles despite a normal appearing foot
Painful tissue nodules in the limbs sparing the hands and feet
Easy bruising
Legs appear symmetrically swollen and does not leave an indentation when you press on it (non- pitting edema)
Does not respond to diet and exercise
Treatment focuses on reducing inflammation, improving lymphatic flow and pain management.
These options include:
Daily use of medical grade compression stockings
Manual lymphatic drainage
Dry brushing
Lymphatic pumps
Vibration plates
Walking
Liposuction can be extremely helpful, but the high cost and limited number of surgeons who are specialized in treating lipedema makes this option inaccessible for most.
Another emerging area of research, is investigating whether the GLP1 and GIP/GLP1 receptor agonists could benefit lipedema. Inflammation is a hallmark of lipedema and these medications have been suggested to have an anti-inflammatory mechanism of action, in addition to facilitating weight loss. Many women with lipedema have reported an improvement in symptoms and reduction in lipedema fat nodules with the use of semaglutide/tirzepatide, although more research is needed to better understand its benefits.