Lipedema is a chronic disorder of adipose tissue which causes the legs and sometimes the arms and abdomen to accumulate painful, fatty tissue. Lipedema occurs almost exclusively in women. Lipedema is a poorly understood disease in the United States; statistics show it is markedly under-diagnosed in this country. Lipedema is a painful fat disorder that, if untreated, can cause multiple health problems leading to mobility issues. The quality of life, emotionally and physically, for a Lipedema patient often suffers because the disease is typically dismissed as simple obesity. This disorder can be inherited; most cases gradually develop during puberty, although it may develop or worsen due to trauma, such as surgery, peri-menopause or pregnancy. Lipedema has been seen in morbidly obese and in anorexic women.
Early diagnosis of Lipedema is vital to stop symptoms from getting any worse.
A number of factors are taken into consideration when making a formal diagnosis of Lipedema:
- Disproportionately larger/fatter legs and hips compared to the upper body
- Swelling is symmetrical (both sides of the body are affected equally)
- Hands and feet are not affected
- Loose, floppy connective tissues around the knee joints
- Fat that looks like cellulite and feels soft
- Tenderness/pain and easy or spontaneous bruising to affected areas
- Skin of affected areas may be pale and cold
- Upper arms may also be disproportionately fatter
- Patients may report increased swelling in hot weather
At this time there are 4 recognized stages of Lipedema (FDRS, 2014):
Stage 1. The skin in the affected area is soft and smooth. Swelling increases during the day, but typically resolves with rest and elevation.
Stage 2. The skin develops indentations and the subcutaneous tissue starts to feel more tough and nodular. Lipomas (fatty lumps between your skin and the underlying muscle layer) may appear. Large fatty deposits begin to form on the upper and lower legs and around the ankles. Eczema and skin infections (erysipelas) may also be present. While swelling increases during the day, as in stage 1, it is less affected by rest and elevation.
Stage 3. There is more hardening of connective tissues and the swelling becomes consistently present and does not resolve with rest and elevation. Large masses of skin and fat cause deformations in the thighs and knees.
Stage 4. Lymphedema occurs. This stage is also called Lipo-Lymphedema. Larger masses of skin and fat overhang and the swelling is consistently present. Fibrosclerosis, possibly elephantiasis. Legs can become stiff and lymph fluid can begin to leak from lymphatic vessels.