Lipoedema. The disease they called 'fat'.
Lipoedema is a common, but under-recognised medical condition which causes an abnormal build-up of fat and fluid, most commonly in the legs. It almost exclusively affects women and creates a disproportionate body shape.
The fatty tissue affected by lipoedema is pathologically different from normal body fat. It does not respond in the same way to diet, exercise, or weight loss, and may feel heavy, tender, or prone to swelling and bruising.
Lipoedema is influenced by genetics and hormonal fluctuations. Symptoms often begin or worsen during puberty, pregnancy, periods of high stress, and/or menopause.
Recognising Lipoedema
Lipoedema may be recognised by a disproportionate build-up of fat in the legs, hips, buttocks, and sometimes arms, following characteristic distribution patterns (Types I–V). The affected tissue often feels dense, heavy, lumpy, tender or uneven, and does not respond well to diet, exercise, or weight loss.
Many women experience tenderness or pain with pressure, such as from tight clothing, a child sitting on their lap or a blood pressure cuff. They may experience heaviness, swelling, muscle strain, and easy bruising. Over time, lipoedema may contribute to fatigue, varicose veins, low exercise tolerance, joint discomfort, and reduced mobility.
Lipoedema is an inherited condition, with many women recognising lipoedema symptoms in other female family members. Recognising these symptoms and patterns can help distinguish lipoedema from general weight gain, and support appropriate assessment and care.
Swelling, pain, or disproportionate body change isn’t “just fat”.
Lipoedema is a complex syndrome which leads to distinct pathological changes in fat tissue, hormonal disruption, poor circulation and impaired lymphatic function. The subcutaneous adipose tissue (SAT) in affected areas exhibits adipocyte hyperplasia and hypertrophy; impaired blood and lymphatic capillary function; extracellular matrix remodelling with increased fibrosis, and disrupted endocrine signalling pathways. Lipoedema affected SAT is NOT 'just fat'.
Without appropriate assessment and management, lipoedema symptoms progress — leading to enlargement of the affected areas, body disproportion, pain, reduced mobility, joint pain and deterioration, secondary lymphoedema, compromised mental health and compromised skin health.
Image credit: Dr Michael Schwartz
Personalised Lipoedema Therapy
The first step to lipoedema management, after recognising the symptoms, is to obtain a proper assessment and management plan through your general practitioner or an Accredited Lymphoedema Practitioner.
Lipoedema is a complex condition, with wide ranging variations in the way it impacts each woman. Management strategies should be personalised around each client's assessment, progression, impacts on daily life, goals, comorbidities and other health factors.
Management may include:
- Complex Decongestive Therapy
- Remedial Lymphatic Decongestion (massage) to reduce fibrosis, oedema, inflammation, discomfort, pain and adiposity.
- Compression or support garments
- Personalised nutritional guidance, and anti-inflammatory nutrition
- Appropriate exercise such as swimming, aquatic exercise, low impact exercise
- Physiotherapy/Exercise physiology to improve mobility
- Vascular assessment with a phlebologist or vascular surgeon
- Referral to a Plastic Surgeon who specialises in lipoedema
- Certain medications to improve symptoms or assist in weight loss