What we know about lipedema

Lipedema, a condition predominantly affecting women, involves disproportionate accumulation of fat in the legs and sometimes arms, accompanied by pain in the affected fat tissue. The cause of this pain is believed to be a mild inflammation within the fat tissue, that might be exacerbated by psychosocial factors such as depression, anxiety, and chronic stress, which heighten pain perception. It is known that chronic pain can lead to discouragement, depression, anxiety or stress. Science is currently investigating the influence of these factors on pain perception.

The two major criteria, according to the International Lipoedema Association (ILA) are:

1. disproportional fat tissue in the legs (and sometimes in the arms)
2. pain in this fat tissue

The recommended therapy for lipedema, as outlined by the International Lipoedema Association (ILA), targets the specific symptoms and challenges faced by patients. This includes:

• addressing pain in the fat tissue
• psychological issues
• weight management
• self-confidence issues related to societal beauty standards

Recommended therapy according to the ILA:

1. Exercise and physical movement therapy
2. Compression therapy
3. Psychosocial support
4. Weight management (including specific weight loss medication or bariatric surgery for those with marked obesity)
5. Self-management, to build bridges so that the patient is able to transfer her achievements during the therapy into daily life and work.
6. Liposuction under certain circumstances

While patients with pure lipedema do not typically experience lymphatic insufficiency or edema, compression therapy can still be beneficial due to its anti-inflammatory effects on the fat tissue. However, the term “lipedema” itself may be misleading, as it implies edema where none exists, leading to discussions about alternative nomenclature such as “lipalgia-syndrome”.

There is ongoing exploration into the potential benefits of manual lymphatic drainage (MLD) for managing pain in lipedema patients by stimulating the parasympathetic nervous system, although scientific evidence to support this hypothesis is currently lacking.