Lipoedema - a challenge for the body and mind
Lipoedema is a chronic fat distribution disorder that is often accompanied by pain, tightness and swelling in the arms and legs. It mainly affects women and is considered by experts to be the result of hormonal changes such as puberty, pregnancy or the menopause. Heredity plays an important role, and lipoedema can be inherited from both parents.
Around 85% of cases occur during puberty, a phase that is already associated with physical and emotional challenges. The painful and visible changes in the legs can exacerbate existing emotional conflicts and lead to considerable suffering.
At LipoVida, we understand the unique stresses that people with lipoedema face. We specialize in not only treating the physical symptoms, but also providing comprehensive mental health support. We develop individualized treatment plans that aim to improve our patients’ quality of life and support them on their journey to a healthier and happier life.
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What is lipedema?
Lipoedema is a chronic disease of the fatty tissue that affects only women and manifests itself as a symmetrical, usually painful, increase in fatty tissue, particularly in the extremities. In contrast to normal weight gain or obesity, lipoedema is characterized by an abnormal accumulation of fat cells that cannot be reduced by diet or exercise. Affected patients often complain of increased bruising without having been hit, a feeling of heaviness in the legs that increases over the course of the day, sensitivity to pressure and touch, a permanent feeling of cold in the skin, but also physical performance limitations with exhaustion, fatigue and depressive moods.
The exact causes of lipedema are not yet fully understood, but hormonal changes and genetic factors play an important role in its development.
Lipoedema can be classified into different stages and types to describe the severity of the condition. The classification is usually based on an internationally recognized system that is based on the extent of fat accumulation, the presence of lipolymphoedema and other clinical features. This classification helps doctors to assess the condition of lipoedema and to develop an individual treatment plan tailored to the needs of each patient.
At LipoVida, we understand the unique challenges that people with lipedema face and offer comprehensive support and treatment options to improve the quality of life of our patients and help them on their way to a healthier and happier life.
IMPORTANT: Lipedema is not related to weight or body mass index (BMI). Even slim and normal-weight people can be affected by this condition. It is important to understand that lipedema is a medically recognized condition that occurs independently of body weight and is not affected by weight loss or gain. While a healthy lifestyle can help to alleviate symptoms and improve quality of life, specialized treatment is required to address the underlying causes of lipedema and ensure appropriate care. If you are experiencing symptoms of lipedema, it is important to seek professional medical help, regardless of your weight or body size. Our specialist clinic, LipoVida, is here to help you to make an accurate diagnosis and to offer personalized treatment options tailored to your needs.
What are the symptoms of lipedema?
Lipedema is characterized by a symmetrical accumulation of fat tissue, particularly in the extremities, which often leads to pain, feelings of tension and swelling. Many women also experience increased sensitivity to pressure and touch in the affected areas. These symptoms can interfere with daily activities and affect psychological well-being.
However, diagnosing lipedema can be challenging because many women may not immediately associate their symptoms with the condition. Instead, they may dismiss them as normal weight gain or fluid retention. This can lead to a delayed diagnosis and compromise the opportunity for timely treatment.
The following symptoms are associated with lipedema:
- Pressure- and Touch-Sensitivity
- often "blue" spots
- painful feeling of tension in the arms and legs
- increased tissue water retention with a feeling of heaviness
- cool skin
- fine to coarse nodular hardening in the fatty tissue
- Fatigue with reduced performance
- Fatigue
- depressive mood
- Comorbidity with hypothyroidism, polycystic ovary syndrome (PCOS)
- Mattress phenomenon of the skin (wavy skin surface)
The different stages of lipedema
IMPORTANT: Lipedema is usually divided into three stages. However, this common classification does not take into account a very important parameter of lipedema, namely pain. Even in the early stages (stages 1-2), when the skin surface still appears very smooth, patients can suffer from severe pain.
We therefore tend to be skeptical of this typical classification, as it is precisely these patients, who are in an early symptomatic stage, who are not taken seriously enough even by their medical colleagues.
The clinical findings are classified as follows:
- Stage 1: smooth skin surface with a maximum of fine nodular tissue structure
- Stage 2: uneven and wavy skin surface with a coarse nodular tissue structure
- Stage 3: Increase in skin size, the tissue is coarse and hangs over (wattle formation on the knee, ankle, elbow, wrist)
Furthermore, a classification by type (affected areas) is carried out:
- Type 1: only jodhpurs are affected
- Type 2: thighs are affected
- Type 3: Legs are affected
- Type 4: Legs and arms are affected
This is how lipedema is diagnosed
An important first part of our consultation is the anamnesis. Here you describe your course of illness, your symptoms and complaints, and any relapses during hormonal changes (puberty, pregnancy, use of contraceptives, menopause). We also ask about any existing concomitant diseases or long-term medication.
This is followed by a clinical examination. The first step is to visually assess your findings. Is there a disproportion between the trunk and the extremities? Are there typical fat deposits for lipedema, what is the condition of the skin or is there, for example, a varicose vein condition?
This is followed by a manual examination of the skin and connective tissue. Are there any nodular hardenings in the fatty tissue, is there any pain on pressure or on touch, or does the tissue feel tight and tense?
Based on our many years of experience, this examination is usually sufficient for us to confirm or rule out lipedema.
We also use ultrasound imaging to visualize nodular changes in the fatty tissue, but above all to measure the thickness of the fat layer, which then helps us to plan your operation precisely.
Therapy options for lipedema
A basic distinction is made between conservative (non-surgical) and surgical therapy (liposuction). Common conservative measures include compression therapy, exercise therapy and manual lymph drainage. Incidentally, all of these measures are subject to the corresponding diagnosis of “special prescription requirements”, i.e. they can be prescribed by a panel doctor.
However, it should be noted that this therapy only helps to alleviate the symptoms, but cannot prevent the disease from progressing.
Surgical therapy, on the other hand, consists of a very thorough liposuction of all affected areas. It is important to remove the fat layer with the diseased fat cells as radically as possible to prevent the disease from recurring. This can stop lipedema, a chronic progressive disease, in its tracks. In addition, there are many arguments in favor of early surgical therapy, even in the early stages. As the fat layer is not yet as pronounced, fewer operations are usually required for comprehensive treatment, the skin is not yet as stretched, so that even after liposuction there is no risk of excess or even sagging skin, and last but not least, those affected have a much longer symptom-free life without restrictions due to lipedema.
It is therefore always advisable to have lipedema treated in a specialized clinic, as liposuction for purely aesthetic reasons would be insufficient and, above all, would not be successful in the long term.
Conservative therapy
Conservative therapy
Surgical approach
Surgical approach
Figures, data & facts
Lipoedema
Every 10th woman
Around one in ten women in Germany suffers from lipedema.
10 years
On average, it takes a full 10 years before a diagnosis is made.
+ 300 operations
we carry out at LipoVida every year