Severity levels
| Type | Severity description |
| I | Adipose tissue proliferation in the gluteal region (buttock region) and hips (saddle-breech phenomenon). |
| II | Lipedema extends to the knees, fat flap formations in the area of the inner side of the knee |
| III | Lipedema extends from the hips to the ankles |
| IV | Arms and legs are affected up to the wrists/ankles, thus excluding the feet and hands |
| V | Lipolymphedema with increased edema (water retention) in the backs of the hands and feet and fingers and toes |
The above classification of lipedema severity is controversial among clinically active angiologists because it suggests that lipedema progresses from proximal to distal. While this may be so, there are women with lipedema only on the lower legs, or like a column from the groin to the upper ankle, or only on the thigh, or only buttocks and thigh, etc. The localization can then remain like this for years or decades, but it can also spread.
Severity grades according to Stößenreuther
| Grade | Comments |
| 1 | Smooth skin surface, increased subcutaneous fat. |
| 2 | Uneven skin surface, nodular, nodular structure of subcutaneous adipose tissue. |
| 3 | Severe contour deformities, large nodules, and dewlaps (lobular soft tissue tumors) |
| 3 | Combination with secondary lymphedema |
Stages of skin lesions
| Stage | Description of skin changes |
| I | Fine nodular skin surface (colloquially: orange peel skin). |
| II | Coarse knotty skin surface with larger dents, medically also called “mattress phenomenon” |
| II | Large, deforming skin flaps and bulges |
Classification of lipedema according to localization (modified according to)
| Legs | Arms |
| Thigh type | Upper arm type |
| Whole leg type | Whole arm type |
| Lower leg type | Forearm type |