Lipedema is a fat distribution disorder in which there is increased fat storage in the buttocks and hips, and in more severe cases, throughout the legs and arms. Mostly women are affected. Lipedema cannot be cured, but the symptoms can be alleviated by conservative therapies.
What is lipedema?
Lipedema is the ancient Greek word for “fat swelling.” It is a fat distribution disorder that mostly affects women. The condition is also often referred to as the riding pants syndrome. There is an increased accumulation of body fat on the legs and arms. The middle of the body, on the other hand, remains slim, as do the hands and feet. When the swelling has spread completely from the buttocks to the ankles, it is also called “pillar leg“. Diagnosis of lipedema is difficult because in the early stages it is accompanied by the symptoms of obesity. In addition, not many doctors are familiar with lipedema. Lipedema cannot be cured. The symptoms are usually contained by manual treatments with a physiotherapist. Liposuction, which could go the farthest in correcting the problems that occur, is not covered by public health insurance.
Causes
Even if it is quickly imputed to the affected persons, a wrong diet and associated overweight is not the cause of lipedema. However, obesity can worsen the course of the disease if it breaks out. Lipedema is genetically determined and usually occurs in phases in which the hormone system has to undergo major changes, for example during puberty, menopause or pregnancy. In men, lipedema occurs extremely rarely and when it does, it is usually as a result of hormone treatment.
Symptoms, complaints and signs
Fat cells in the subcutaneous tissue of the legs and arms multiply and swell to a larger volume. Increased storage of body fat occurs, especially in the lateral areas of the hips and thighs. The body fat usually settles symmetrically. In addition, it is suspected that the capillaries in the affected tissue become more permeable, which also affects the lymphatic system. As a result of the upper body remaining slim, the proportions of the body become incongruous. The legs can appear much thicker than they actually are. For very many sufferers, this leads to psychological problems as well as feelings of shame that prevent them from visiting the swimming pool or wearing fashionable, short clothing. In addition, water retention occurs in the affected areas, which becomes more pronounced when standing or sitting for long periods of time, as well as in warm weather. Affected people often first notice their lipedema by suffering from heavy legs in the evening. Lipedema is often accompanied by other complaints. These include pain in the corresponding parts of the body, cellulite, a feeling of pressure or tension in the affected areas, spider veins and a sensitivity to bruises.
Diagnosis and course of the disease
Lipedema is diagnosed by visual and palpatory findings and, if necessary, by ultrasound. Furthermore, the treating physician should rule out other diseases that may cause similar symptoms. These include obesity, lymphedema and lipohypertrophy, which are harmless accumulations of fat. In the early stages, lipedema is visually almost indistinguishable from the onset of obesity. As the disease progresses, the accumulation of body fat in the specific locations becomes more pronounced. The disease is divided into five types or degrees of severity, each depending on the spread. Lipedema begins on the buttocks and hips, then spreads, sometimes forming fat flaps, over the knees to the ankles and wrists. In the most severe stage, pronounced lipolymphedema develops, which can even reach the backs of the hands and feet to the fingers and toes. The stages of the skin change are also recorded. Initially, fine nodules appear in the skin surface, the so-called orange peel skin. As it progresses, these lumps become larger and larger dimples appear in the skin. In the worst case, misshapen skin flaps develop.
Complications
Excessive water retention is referred to as lipedema, which of course can cause various complications. In most cases, lipedema is associated with long-lasting pain that does not subside even at rest.If treatment by a doctor is completely dispensed with, the water retention can increase considerably. The affected person is very severely restricted in daily life, so that urgent medical and drug treatment should take place. However, with the right medication, rapid improvement or complete recovery can be achieved. In particularly bad cases, inflammation or the formation of an abscess can even occur. If an abscess or rather the formation of pus is recognizable, a visit to a doctor should take place promptly. Only through appropriate treatment can various complications and complaints be alleviated or eliminated. If this is not done at all, there is even an acute risk of consequential damage. Anyone who does not want to take this risk should see a doctor at the first signs and symptoms of lipedema.
When should you go to the doctor?
If there is swelling on the body or deformity, a doctor should be consulted. If there is an uneven distribution of fat on the upper body and limbs, a medical checkup is necessary. The proportions of the body become inconsistent in case of a disease. They should be clarified by a doctor so that the cause of the disorder can be determined. If water retention is noticed in the arms or legs, a visit to the doctor should be made immediately. If the deposits increase when standing or in a sitting position, this is an indication of lipedema. A doctor should be consulted so that treatment can be initiated. If the affected person has the feeling of puffiness in the hip or thigh area, he or she should discuss the irregularities with a doctor. If the shape of the legs increases in circumference, there is cause for concern. The repeated occurrence of bruises, a disturbance in sensitivity or sensory disturbances on the skin should be examined and treated by a physician. If locomotion is difficult or mobility disorders occur, a doctor should be consulted. If emotional or mental problems arise as a result of the visual changes, the affected person needs help. If there are mood swings, a social withdrawal or behavioral problems, a visit to the doctor is advisable.
Treatment and therapy
Lipedema cannot be cured, but symptoms can be contained. Initially, therapy is based on reducing the swelling that occurs due to additional edema. For this purpose, a physiotherapist performs regular lymphatic drainage. In addition, compression stockings can be used, which must be worn consistently. Since the increased fat in the legs and arms does not come from a poor diet, dieting is of little help in lipedema. However, additional excess weight should be avoided as it can exacerbate the problem. Exercise can alleviate the symptoms of lipedema. Water sports are particularly recommended, as they are easy on the joints and have a similar effect to lymphatic drainage. The only long-term remedy for lipedema is liposuction. However, the costs of liposuction for lipedema are not covered by statutory health insurance. Homeopathic treatment of lipedema may also be worth a try. In alternative medicine, Schüssler salts and jojoba oil are used.
Outlook and prognosis
Lipedema is not curable, but the progression of the disease can be slowed down. As a result, patients no longer suffer from all the typical symptoms. The circumference of the legs is reduced. Lipedema almost exclusively affects women; it can occur in men, but this is atypical. Scientists suspect genetic causes as the trigger. The progressive disease usually begins after puberty and two-thirds of all cases affect only the legs. In the other third, the arms are also affected. Signs of lipedema are a burden on life, especially during menopause and pregnancy. If treatment is refused, additional lymph fluid builds up. This causes the tissue to swell further. Movement disorders are the result. Short distances can become a challenge. For those affected, the adverse appearance also represents a psychological burden. The quality of life suffers. Treatment promises the elimination of many complaints, both in the early stages and later.Therefore, a favorable prognosis results when treatment is initiated. If the disease may not be eliminated causally, feelings of tension and pain can be abolished.
Prevention
Since lipedema is caused genetically or hormonally, there are no reliable methods of prevention. Only the risk factors can be curbed. These include alcohol consumption and smoking. A generally healthy lifestyle with a balanced diet and plenty of exercise can also be effective. If lipedema occurs in the future, a lower weight will reduce the suffering.
Follow-up care
In most cases, lipedema results in persistent and severe pain that does not subside even when the patient is at rest. As a result, the quality of life and everyday life of those affected are sometimes severely restricted. Affected individuals mostly suffer from their external appearance. Therefore, aftercare focuses on promoting a self-confident approach to the disease. The help and support of relatives is necessary in order to be able to cope with everyday tasks. The help of a professional psychologist can be supportive. This can sometimes also prevent the development of severe depression and other mental illnesses. Sharing experiences with others who are equally affected can help to better accept the suffering associated with the disease and thus promote quality of life. Thus, the focus of aftercare is primarily on reducing the mental burden of the symptoms and continuing treatment. Failure to receive continuous treatment from a physician may result in significant sequelae.
Here’s what you can do yourself
Lipedema is not curable. However, some precautions can be taken in everyday life, through which the disease progresses more slowly. The most important goal in the everyday life of lipedema patients is to avoid an increase in fatty tissue. This is helped by a healthy diet with a moderately high number of calories and regular exercise. On the one hand, this helps to maintain body weight or even lose weight. On the other hand, sport or exercise reduces the amount of water retention in the tissue. Endurance sports are particularly suitable. Targeted muscle building in the affected areas, on the other hand, is not advisable. Recommended are sports that are easy on the joints, such as swimming, water gymnastics, cycling or even walking. Another measure that lipedema patients can take themselves is proper skin care. The skin often tends to develop small cracks in the affected areas of the body, which can become infected and inflamed. The risk of this can be reduced by using unscented, pH-neutral washing lotions and by applying cream regularly. In addition, it is important that patients with lipedema cooperate well with their therapies. Decongestive therapy is an essential pillar of treatment. It is intended to remove excess fluid from the lymphs. For this, it is important that the patient wears the prescribed compression stockings regularly in everyday life.
