Lipoedema

What is a lipoedema?

A lipoedema is a chronic disease. It’s a fat distribution disorder – especially on the upper and lower legs and in the hip area. Sometimes the arms are also affected. Lipoedema are generally not curable. However, the symptoms can be treated and reduced through consistent therapy. It’s essential that patients accept the disease and manage it responsibly.

Causes and risk factors: How does a lipoedema develop?

Lipoedema almost exclusively affects women and girls. Men, in contrast, rarely suffer from lipoedema. The specific causes of lipoedema have not yet been sufficiently researched. The timing of hormonal changes is often associated with the onset of lipoedema.

Are hormones a cause of lipoedema?

Experts suspect the influence of hormones as a cause, because symptoms often manifest or worsen during phases of hormonal changes. In addition, the tendency to lipoedema seems to be genetically determined, as a familial disposition has been observed. Lipoedema usually appear

• towards the end of puberty,
• during pregnancy or
• during the menopause.

Strong patients and their very individual stories

The symptoms of a lipoedema: Are you overweight or do you have a fat distribution disorder?

It requires close observation to detect a lipoedema and to distinguish it from being “normally” overweight or obese.

The nature of the symptoms is very individual. Typical symptoms, especially of a lipoedema of the legs, are:

• unequal proportions from the torso to legs: rather slim upper body with thicker legs (often a difference of several clothing sizes)
• blue spots occur quickly and easily (bruising, haematomas)
• tenderness on palpation and touch
• orange-peel or wavy skin with nodules under the skin
• tenderness on palpation and touch
• a symmetrical, relatively spontaneous “unexplained” increase in volume on both legs. This leads to “columnar” changes, and over time, to deformations of the legs
• further progression: bead formations mainly on the inner thigh

Saddle bags: Diet-resistant fat deposits

The fat pads on the buttocks, hips and the inside of the knees are commonly called saddle bags. If the fat pads resist any diet and sporting activity, the so-called saddle bags can be an indication of a lipoedema.

Test: Detect lipoedema yourself

If you suspect that you’re suffering from a lipoedema, this self-test can give you initial pointers. This test does not replace a professional diagnosis. Please consult your general practitioner or a specialist in lymphology.

Stages and pictures of lipoedema

Mixed forms of lipoedema treatment

Lipoedema are different from lymphoedema (accumulations of lymphatic fluid in the tissue due to a flow disorder in the lymphatic vessel system).
More information on diagnosis and lymphoedema therapy.

Lipo-lymphoedema: When a lymphoedema develops in addition to a lipoedema

Depending on its severity, a lipoedema puts a strain on the lymphatic system: the transport capacity of the lymphatic vessels can be limited to such an extent that fluid accumulates in the tissue. Consequently, a lipoedema can cause a secondary lymphoedema. This symptom is called lipo-lymphoedema.

Lipoedema with accompanying obesity

This mixed form displays the symptoms of a lipoedema plus a generalised increase in fat throughout the whole body.

Differences between lipoedema and lymphoedema

Lipoedema and lymphoedema can be clearly distinguished with the help of these three main characteristics:

Treating lipoedema: Diagnosis and therapy

Until lipoedema is clearly diagnosed, many people affected have a long history of suffering, often accompanied by severe mental stress. The right therapy can do a lot to alleviate the symptoms. People affected usually seek medical advice only when sport, exercise and diets fail to bring success, pain is an added factor and the mental stress becomes too great.

There are two main aims in lipoedema therapy:

1. Eliminating or improving the findings and symptoms (especially pain, oedema and disproportion).
2. Preventing complications. As the severity of the findings progresses with an increase (especially) in leg volumes, the risk of dermatological (e.g. infections such as erysipelases), lymphatic (e.g. lymphoedema) and orthopaedic (gait abnormalities or impairments, axillary malformations) complications increases.

Various therapeutic approaches are available for this.

Complex decongestive therapy (CDT)

Complex decongestive therapy (CDT) is a comprehensive therapy that consists of the following pillars:

Liposuction: Fat removal via an operation

Another therapy option is liposuction (fat removal). In this procedure, the pathologically increased fat cells are sucked out from under the skin by using cannulas. The operation is usually performed under anaesthesia. Experts recommend wearing compression stockings in order to preserve the results of the operation.

Psychotherapy

Lipoedema patients often suffer from a low level of self-esteem, depression and eating disorders. Psychotherapy that supports patients in dealing with the condition can usefully supplement the treatment.

Which doctor treats lipoedema?

Do you suspect that you’re suffering from lipoedema? Please discuss your observations with your general practitioner. If necessary, he/she will refer you to a specialist, such as a phlebologist (vein specialist), vascular specialist or lymphologist.