Lipedema is a problem that occurs due to a loss of fat from the hips and legs. This condition is often confused with lymphedema since the affected areas are the same. Since both conditions are due to underlying problems it is important to make sure the correct diagnosis is made and a treatment plan is established.

Lipedema is a condition that causes the legs and hip area to be extremely swollen. This is a difficult condition to diagnose, since it often presents with a mixture of symptoms.

Lipedema is a condition, sometimes referred to as liposarcoma, that affects both men and women. It occurs when fat tissue in the legs and body increases, causing the skin to thicken and the muscles to become more prominent. The condition can be primarily located in one area of the body – such as the buttocks, thighs, shin or calves – or in many areas.

Updated on the 21st of June 2021, according to a medical opinion from

Have you have big feet, hips, thighs, arms, or a big saddle? Are they disproportionately large in comparison to the rest of the body? Are they uncomfortable or prone to bruising?

You may have lipedema if you answered yes to one or more of these questions (called lipedema in the UK and Europe). Lipedema is a condition characterized by an excessive buildup of fat in the lower body that mostly affects women. This fat causes a lot of discomfort.

Your upper body may react to diet and exercise or have a normal waistline, but you may have lumpy legs with stubborn extra fat from your waist down.

You’re hoping to learn how to lose weight while living with lipedema or how to halt the uncomfortable buildup of fat on your thighs and legs.

Don’t be concerned. Then you’ve arrived to the correct location. This article is intended to help you get a better understanding of lipedema, a complicated and often misunderstood disease that affects women. In addition, the inspirational anecdotal stories of women who follow the ketogenic diet to cure lipedema are described in our companion article.

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All rights reserved. Image courtesy of Lipedema Simplified, LLC. 2014-2021. With permission, this image has been used.

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1. What is lipedema and what causes it?

Lipedema is a chronic and progressive (i.e., it becomes worse over time) disease caused by a change in fat metabolism.

The disease was first characterized as a disproportionate and symmetrical buildup of adipose tissue in the lower half of the body, accompanied by water retention, when it was originally reported in 1940.

The significance of fluid buildup in the lymphatic system in the early stages of lipedema has lately been disputed, despite the term being a mix of the medical words lip (fat) and edema (oedema produced by excess fluid). Some even propose renaming the condition lipalgia, which means “painful fat.”

Lipedema Simplified, LLC. All rights reserved. Figure 2017-2021. With permission, this image has been used.

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However, there is little question that, as the illness progresses and obesity increases, the obstruction of lymphatic drainage may result in leg edema. Secondary lymphedema is the term for this condition.

2. Is lipedema simply a symptom of obesity?

No. Obesity and lipedema are two distinct diseases that often coexist (comorbidities). Lipedema affects around 80% of women who are either overweight or obese.

Lipedema symptoms may be more severe if you are overweight. Additionally, if you have a genetic tendency to develop lipedema. They may acquire weight and fat tissue more readily than others as a result. From today’s perspective, the two states are locked in a vicious cycle.

Lipedema affects how many women? The figures fluctuate, with current estimates ranging from less than 5% to 18%. According to some studies, approximately 10% of all women are affected.

Many health experts, however, are still unaware of the disease. This implies that properly diagnosing women with lipedema may take more than 20 years. Many individuals are informed that their female obesity is merely pear-shaped.

Do you have heavy legs and your symptoms are being ignored, or are you being told to eat less and exercise more? You’re not the only one who feels this way.

Many women with lipedema feel guilty and embarrassed about their illness since they contributed to it by overeating and being sluggish. They are often advised to make more efforts to reduce weight via diet and exercise.

Some ladies do this: they work out and eat all the time, yet their painful feet just grow larger and heavier. As a consequence, women with lipedema are more likely than the general population to suffer from eating disorders, anxiety, despair, poor self-esteem, and cosmetic issues.

Despite its severe effect on the physical and emotional health of afflicted women, lipedema has been mostly neglected by scientific study and therapeutic trials until recently.

Lipedema was finally given an international classification and illness code in September 2020, when it was included in the World Health Organization’s International Classification of Diseases (ICD-11). As a consequence, it is anticipated that more women would get an accurate diagnosis in a timely manner.

Summary

Lipedema is a complicated feminine disorder characterized by painful fat accumulation in the lower body. The illness is often misinterpreted as a feminine version of obesity, which adds to the disease’s high incidence of eating disorders, self-harm, anxiety, despair, and appearance-related issues among women.

3. The main signs and symptoms

Lipedema causes an excessive accumulation of fat in the lower body in all women. Other symptoms are prevalent in some women, but not all. Other signs and symptoms may include:

  • To the touch or pressure, the fat in your legs and thighs may feel uncomfortable, sensitive, or painful. This disease was formerly known as adiposis dolorosa, which literally means “painful fat.”
  • Slight bruising: Even the tiniest bump may bruise your feet and hips. Small varicose veins (telangiectasias) may produce bruising when they sit on the skin’s surface.
  • Excess fat on the upper arms: About 30% of women with lipedema also have excess fat on their upper arms.
  • When you massage the fat, you may see hard pea-sized lumps under the skin.
  • Shackles around the ankles or wrists: Because the feet and hands remain unaffected, swollen feet may resemble cuffs, particularly in the latter stages of the illness.
  • Edema: Although the significance of edema in lipedema is debatable, women in the early stages of the disease may feel swelling in their legs throughout the day, particularly if they stand for long periods of time (orthostatic edema).
  • Skin on the legs and thighs may sometimes feel cooler than skin on other areas of the body or in women who are not afflicted.
  • Hypermobile joints have a higher range of motion than normal joints, which may lead to joint injury, discomfort, and gait issues.

Advanced signs and symptoms

  • Obesity-related lymphedema may develop as the illness develops, meaning lymphatic drainage is obstructed, resulting in limb swelling.
  • Walking difficulties: Over time, the size, discomfort, and weight of your legs may cause joint deterioration and changes in your stride, preventing you from walking and leading to immobility.
  • Fibrosis: Scar tissue may form underneath the fat in the leg over time, most likely as a result of persistent inflammation. This scarring, known as fibrosis, is likely to restrict lymphatic circulation even further.

Symptoms that aren’t linked to each other

According to recent research, women with lipedema are more prone than other women to suffer from hypothyroidism, headaches, and depression.

Despite having a BMI that is often in the obese range, women with lipedema had reduced incidences of type 2 diabetes, hypertension, and metabolic syndrome, which is likely due to the fat being concentrated in the hips and legs rather than the waist and visceral organs.

Summary

Lipedema is characterized by excessive fat on the thighs and legs. Pain, easy bruising, cuffing of the legs or arms, hard lumps beneath the skin, fat on the upper arm, and swelling of the legs are all frequent signs.

4. What are the causes of lipedema?

Lipedema has an unknown etiology. Lipedema is thought to have a significant genetic component, since at least 60% of women with the disease have a family relative with it. B. having a mother, sister, or grandmother who suffers from big, painful hips and feet. Lipedema develops with hormonal transitions such as adolescence, pregnancy, and menopause. They’re believed to be linked to variations in estrogen levels, as well as life phases marked by higher amounts of circulating insulin (hyperinsulinemia). A variety of genes, most likely linked to fat storage, the lymphatic system, and sex hormone metabolism, may be implicated. In 2020, the first possible lipedema gene was identified, and it is linked to the metabolism of the sex hormone progesterone.

What occurs when a person has lipedema? Disrupted fat cells develop disproportionately on the hips, legs, and occasionally arms for unexplained reasons. The waist, chest, face, neck, arms, and legs get very little attention.

As previously stated, the lymphatic system’s role in this condition is debatable, but evidence suggests that when fat builds up, the lymph vessels beneath the adipose tissue leak fluid, causing more fat cells to form around the stagnant lymph, which then leaks and swells even more, creating a vicious cycle.

Other cellular abnormalities between women with lipedema and healthy women without lipedema have been discovered in recent years. The size of fat cells, as well as salt content, oxygen saturation, and inflammatory markers in fat cells, are all factors to consider.

Women with lipedema, for example:

  • Even though they are not overweight, they have bigger fat cells on their thighs and legs, as well as scar tissue (fibrosis).
  • Salt levels in the epidermis, connective tissue, and fat cells of the lower body have risen.
  • Even though they are not fat, they have inflammation in their adipose tissue, including the presence of inflammatory immune cells (macrophages).
  • Hypoxia occurs when fat cells are deprived of oxygen, resulting in fat cell death, enhanced inflammatory responses, and insulin resistance in individual cells.
  • The presence of a protein known as platelet factor 4 (PF4), which has been linked to various lymphatic diseases.

It’s yet unclear how these cellular changes contribute to lipedema’s origin and symptoms.

Summary

Lipedema has no known etiology, although it is related to variations in sex hormone levels and has a significant hereditary component. Recent research suggests that lipedema is caused by a variety of microvascular and cellular abnormalities.

5. Lipedema diagnosis, nature, and stage

Lipedema can’t be confirmed using laboratory testing or diagnostic imaging investigations right now. Lipedema is diagnosed based on a woman’s medical and family history, as well as a physical examination to establish how many typical symptoms she has.

The diagnosis of lipedema is classified into five categories based on where the extra fat collects. Type 1 consists of the buttocks, hips, and pelvis. From the buttocks to the knees, Type 2 is present. Type 3 refers to the area between the buttocks and the ankle. Type 4 entails the addition of upper arms. Type 5 – solely affects the lower leg.

2014-2021 image The Lipedema Project, Inc. is a non-profit organization dedicated to helping people with lipedema With permission, this image has been used. All intellectual property rights are retained.

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Depending on the degree of illness advancement and the degree of fat buildup, discomfort, and lymphatic damage, the diagnosis also includes one of four phases of disease development.

Lipedema Simplified, LLC. All rights reserved. Figure 2017-2021. With permission, this image has been used.

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Summary

The woman’s anamnesis and clinical examination are used to determine if she has lipedema. This disease is divided into five categories based on where the fat is located. The development of fat buildup and fluid retention determines the stage of lipedema, which ranges from 1 to 4.

6. How to Lose Weight When You Have Lipoma

Until recently, it was believed that losing weight with lipedema with traditional diet and exercise was almost impossible.

One of the diagnostic criteria in a woman’s medical history is her inability to shed fat from her thighs and legs while toning the upper half of her body.

Even bariatric surgery, which involves reducing the size of the stomach, may not be entirely successful. Even if a woman loses a lot of weight, she may still have uncomfortable extra fat in her legs and thighs.

One reason why women with lipedema have such a hard time losing weight is that many of them have been on a yo-yo diet for years, restricting their calorie intake in order to decrease the amount of fat in their lower body.

What can women do to shed fat from lipedema, relieve discomfort, and decrease water retention without slowing down their metabolism? Perhaps a ketogenic diet is in order.

Ketogenic diet (#7)

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A ketogenic diet restricts carbohydrate consumption by severely restricting any items that contain or are processed as sugar, such as bread, pasta, rice, potatoes, and fruit. This causes the body to enter a condition known as ketosis, in which fat rather than glucose is used for energy.

Is it possible to manage stubborn fat and lipedema symptoms like pain and fluid retention with a ketogenic diet?

The information currently provided is limited and preliminary. Several tiny studies, as well as anecdotal evidence and clinical experience, indicate that it may be helpful.

Read our article on the increasing number of women with lipedema who are losing weight and having less symptoms by adopting a ketogenic diet.

A short research in California looked at the efficacy of a ketogenic diet in 12 overweight individuals with secondary lymphedema (11 women and one male). Carbohydrate restriction and ketosis maintenance not only decreased lymphatic fluid retention, substantially reduced the size of swollen limbs, and enhanced the participants’ quality of life, according to the research.

On clinicaltrials.gov, Norwegian researchers have filed a randomized controlled trial of a ketogenic diet for the treatment of lipedema. Effect of ketosis on pain and quality of life in individuals with lipedema is the title of the study (Lipo diet).

The study’s goal is to enroll 80 Norwegian women with lipedema by 2023 and randomly assign them to one of three diets for 10 weeks, two of which are ketogenic and the third non-ketogenic.

At baseline and shortly after the operation, pain and quality of life will be assessed. A ketogenic diet may be an effective therapy for reducing pain and improving quality of life in women with lipedema, according to research.

The findings of a tiny, unpublished pilot research that formed the foundation of a master’s thesis at the University of Oslo prompted the Norwegian clinical trial. The ketogenic diet was followed for six weeks by nine women with lipedema in the 2019 pilot trial.

For the next six weeks, they followed the Norwegian government’s recommendations for a healthy, high-carbohydrate diet.

The nine ladies dropped an average of 4.3 pounds during the ketogenic diet phase, and their limb circumference decreased, but most importantly, their limb discomfort improved substantially.

The individuals maintained their weight reduction when they moved to a healthy Norwegian diet, but their limb pain returned to pre-study levels almost immediately.

Why may ketosis assist with lipedema?

A ketogenic diet may help reduce the fat buildup, discomfort, and swelling associated with lipedema for a variety of theoretical and physiological reasons.

An article written by lipedema experts and published in the Journal of Medical Hypotheses 2021 discusses the science of lipedema and summarizes why a ketogenic diet can help with weight loss, pain, mood swings, inflammation, prevention of progression, etc.

Here are several studies that show a ketogenic diet may be beneficial:

  • Many studies show that individuals in the general population eat less and lose weight when they severely restrict carbs while eating as much protein and fat as they need to feel satisfied. The metabolic changes that occur when glucose and fat are burnt on a ketogenic diet may enable women with lipedema’s bodies to finally access and use the fat stored in their lower bodies.
  • Reduced insulin levels: Studies indicate that women with lipedema have a lower risk of developing type 2 diabetes, even if they are fat and have a high BMI, indicating that they are still insulin sensitive. However, fat in the thighs and legs seems to be more resistant to the effects of insulin at the cellular level. This issue may also develop when a woman’s body is more resistant to insulin than a man’s (during puberty, pregnancy and menopause). Insulin acts as a key in a lock, allowing fat stores to be used as fuel. Insulin resistance makes this key ineffective. The ketogenic diet reduces insulin levels, allowing fat to be utilized as fuel and drawing on fat stores in the extremities (lipolysis).
  • Pain Management: A ketogenic diet has been proven in a number of trials to decrease joint pain and chronic pain in obese individuals, as well as pain that isn’t linked to weight reduction. Adipose tissue pain may be decreased through a variety of methods, including decreasing inflammation. An growing quantity of anecdotal and scientific data suggests that pain may be substantially decreased as soon as a few days after beginning the diet, long before weight reduction.
  • Excess moisture is removed: In the early days of the ketogenic diet, individuals lost weight by drinking a lot of water. This is due to the fact that the glucose stored in the muscle (called glycogen) includes water, which is lost when it is used up. The diuretic impact of a low-carb diet is what it’s termed. The release of water from the tissues may aid in the reduction of fluid retention in women with lipedema. As previously stated, a tiny research showed that a ketogenic diet helped obese individuals with lymphedema lose weight and height while also decreasing the quantity of lymph fluid retained in their afflicted limbs.
  • Excess salt is eliminated from the body as a result of the ketogenic diet’s ability to decrease insulin levels and release water weight. This may be helpful for women with lipedema, who have greater salt concentrations in the adipose tissue of their thighs and legs.
  • Reduced inflammation: A ketogenic diet has been found to lower a variety of inflammatory markers in studies. Ketosis may assist women with lipedema decrease inflammatory markers in their adipose tissue.
  • Improved mental clarity and reduced anxiety and depression: A ketogenic diet has been proven in many trials to enhance mental clarity and decrease anxiety and sadness. This exposure may assist women with lipedema enhance their quality of life.

Clinical knowledge

Clinical experience with the ketogenic diet and lipedema is quite limited at this time. Many lipedema experts, however, advise women with lipedema to avoid all sugar, meals with a high glycemic index, and processed foods. As a result, most lipedema experts already advocate for a low-carb diet in theory.

For more than ten years, a German clinic has been treating women with lipedema with a protein-optimized ketogenic diet.

In November 2020, Dr. Gabriele Faerber of Hamburg’s Center for Vascular Medicine presented the findings of her clinical study at the Virtual Symposium on the Ketogenic Diet for Lymphatic/Gravitational Diseases. Dr. Faerber performed a follow-up study of 100 lipedema patients who followed a ketogenic diet for an average of three years, but his results have not yet been published in the journal. Most women who followed the keto diet lost weight, had less discomfort, had smaller leg circumferences, and had a better quality of life.

The following are Dr. Faerber’s clinical findings:

  • The typical weight reduction was about 5 pounds, while some individuals dropped as much as 45 pounds.
  • Even without substantial weight reduction, there was an improvement in symptoms in 83 percent of cases:
    • The sensations of heaviness and tightness in the legs are alleviated.
    • Regardless of how much weight is lost, there is a significant decrease in leg discomfort.
    • Leg circumference was reduced significantly, with some patients decreasing their thigh circumference by more than 21 cm.
    • Mental clarity, greater focus, reduced daily tiredness, and better sleep are all benefits of improved physical and mental performance.
    • The tissue in the patients’ legs grew softer and less elastic, according to physiotherapists.

To avoid recurrence of symptoms or development of lipedema, Dr. Faerber recommends that patients with lipedema adopt a ketogenic diet and carbohydrate restriction as a lifetime behavioral adjustment.

At the Ketogenic Diet for Lymphatic/Fatty Disease Symposium in November 2020, many ladies with lipedema will discuss their good experiences with the keto diet. Some people have reported dropping over 100 pounds and being pain-free within days of beginning a ketogenic diet, even before reducing weight.

Since 2012, Lipidema Simplified has assisted over 50,000 women with lipedema via a membership club (Lipedema TRIBE Community), instructional seminars, webinars, and online support groups.

Keto WOE [The Way of Eating] for Lipedema, a similar private Facebook community, has over 11,000 members, many of whom claim substantial weight reduction and symptom relief.

There is a need for more high-quality research, such as randomized controlled trials.

See our companion page for additional information on the anecdotal experiences of women who have used the ketogenic diet to treat lipedema.

Summary

A randomized clinical study is under underway, and there is theoretical evidence for the ketogenic diet’s potential effectiveness in lipemia, according to many small studies. The clinical experiences acquired as well as the women’s tales are reassuring.

8. Additional therapies

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Some symptoms of lipedema in women may improve with the following evidence-based treatments:

    • Exercise Being active and moving around a bit may assist circulate lymph, increase limb growth, enhance mental health, and perhaps keep weight off. Water gymnastics, such as walking or water exercises, are especially helpful since they are easy on the joints and provide additional support to the body. The water’s force also puts a little pressure on the legs, promoting lymphatic circulation. Women with lipedema may also exercise on vibrating platforms or rebounders (small trampolines).
    • Compression: Wearing flat compression stockings and wrapping the legs in compression bandages or specific compression velcro may assist relieve discomfort, movement, and lymph flow in the limbs. In addition, employing intermittent pneumatic compression, a cuff device that massages the legs rhythmically, some women have experienced an improvement in symptoms and a decrease in leg swelling.
    • Manual Lymphatic Drainage (MLD) is a kind of gentle, rhythmic massage that works in the direction of lymph flow. It is often prescribed for patients who develop lymphedema as a result of cancer therapy. Although it is typically done by professional therapists, you may learn to do it on your own limbs. MLD has been used to treat lymphedema since the 1930s, although its efficacy as a lipedema therapy has lately been questioned by certain specialists.

Previous research has indicated that it helps women with lipedema decrease pain and depression, manage swelling, and enhance their quality of life. MLD has lately benefited from the inclusion of a vibrating plate (which rattles the leg tissue) to improve symptoms and quality of life.

    • Liposuction: Liposuction is a controversial procedure for physically removing fat from the legs and thighs. Some experts believe it is ineffective, lacking in proof, and even harmful. Other specialists, on the other hand, claim that liposuction at lipedema clinics has a good study background and has been proven to decrease leg size and discomfort.

Summary

Other evidence-based therapies for women with lipedema include exercise, compression, manual lymph drainage, and potentially liposuction at specialist lipedema clinics.

Supplement

Lipedema is a complicated and poorly understood disease in which genetically predisposed women develop excessive and sometimes painful fat deposits on their thighs and legs.

Obesity may exacerbate the symptoms of lipedema, although the two illnesses are considered distinct but linked diseases that can lead to a vicious cycle.

You may have been labeled with a feminine type of obesity and chastised for eating too much and not exercising enough if you have lipoedema. However, most diets and workouts have been considered to be ineffective in treating this disease in the past.

The disease’s persistently progressive nature, which may lead to immobility and swelling of the limbs owing to lymphatic system disruption in late stages, leads to eating disorders, anxiety, sadness, and dread of looking in women.

A ketogenic diet has recently been suggested as a therapy for lipedema, and many modest promising trials have been performed, as well as a strong theoretical foundation. More study is required, but new clinical data and anecdotal evidence of a rising number of women with lipedema on the keto diet are promising.

Aquatic exercise, compression (with or without vibration therapy), manual lymph drainage, and liposuction are some of the other therapies that may assist with lipedema symptoms.

Read this article to discover more about the increasing number of women with lipedema who are experimenting with the ketogenic diet. Her encouraging results and encouragement urge other afflicted ladies to try this technique for weight loss and symptom relief, including discomfort.

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If you have an “out of shape” look to your body and you find yourself in pain, there could be a reason. It could be because you are carrying too much weight around the hips and your body has given up trying to cope and has decided to release some of the extra weight. If the pain is a result of weight loss, there is the chance you are suffering from lipedema.. Read more about lipedema life expectancy and let us know what you think.

Frequently Asked Questions

What are the signs of lipedema?

Lipedema is a condition where the body produces too much of a protein called adipose tissue which causes the fat to accumulate in the legs and arms. It can lead to swelling, pain, and discomfort.

Is lipedema fat or fluid?

Lipedema is a type of fat that accumulates in the legs and ankles.

Can you be skinny with lipedema?

I am not a medical professional, but I believe that lipedema is a condition in which fat accumulates primarily in the legs. It can be treated with medication and exercise.

This article broadly covered the following related topics:

  • lipedema vs cellulite
  • celebrities with lipedema
  • lipedema legs treatment
  • lipedema stages
  • lipedema treatment
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