Lipedema
Position Statement on Best Care Practices for Lipedema
A Comprehensive and Multidisciplinary Approach to Optimizing Care
Lipedema is a chronic condition characterized by a disproportionate accumulation of fat in the legs and sometimes the arms, accompanied by pain and increased sensitivity. This condition, which exclusively affects women, often coexists with other pathologies such as obesity, chronic venous insufficiency, and lymphedema. An appropriate, evidence-based approach to care is essential to optimizing the quality of life of those affected.
Specialized Assessment: A Crucial First Step
In Quebec, a certified therapist in chronic oedema/lymphedema treatment is currently the best specialist to consult to determine whether a person has pure lipedema, obesity, or a combination of lipedema with other conditions such as obesity, chronic venous insufficiency, and/or lymphedema. This assessment helps guide individuals toward the most appropriate care and establishes a personalized treatment plan.
The Pillars of Lipedema Treatment
A comprehensive therapeutic approach is essential to improving lipedema management. This approach includes several complementary interventions, prioritized based on their impact on the condition:
1️ Compression: The Foundation of Treatment
• Flat-knit or standard compression garments, depending on the case, are recommended to relieve pain, stabilize soft tissues, and improve mobility.
• A well-fitted compression wardrobe is essential to slowing disease progression and maintaining functionality.
2️ Weight Management and Adapted Physical Activity
• Physical activity is the most effective intervention after compression. It helps limit lipedema progression, alleviates pain, and improves overall physical condition.
• Guidance from a kinesiologist or participation in supervised exercise programs with a qualified trainer can promote adherence to an active routine.
• A balanced diet, supported by a registered dietitian-nutritionist, helps maintain a stable weight and prevent symptom worsening.
3️ Self-Management and Therapeutic Support
• Self-management, guided by a chronic oedema/lymphedema therapist, helps patients learn essential daily self-care techniques.
• This follow-up includes practical advice on skin care, pain management, and self-care education. Depending on individual needs, it may also involve manual lymphatic drainage sessions.
• Community resources, such as the AQL or Lipedema Canada, also provide valuable support for self-management learning.
4️ Psychological and Motivational Support
• Living with lipedema, with or without coexisting conditions, presents significant psychological challenges. Motivational support from a life coach, a perseverance-focused fitness trainer, or a psychologist can make a real difference.
• Appropriate emotional support helps individuals overcome discouragement and adopt a positive outlook on their care journey.
An Evolving and Personalized Approach to Care
Lipedema treatment is based on a multidimensional and personalized approach. Invasive surgical interventions such as bariatric surgery or lymphatic-sparing liposuction may be considered in certain cases, but only when conservative measures have been optimized and after a thorough evaluation. The surgical approach is currently under review by INESSS, and its findings are highly anticipated.
Patient education, professional guidance, and a commitment to an active lifestyle are the keys to effective and sustainable care.
By recognizing the importance of a holistic approach, the AQL emphasizes the need to train more qualified professionals in chronic oedema and lipedema, expand access to treatment, and inform patients so they can better manage their condition and preserve their quality of life.
Reference:
International Lipoedema Association
