Lipedema – How can I recognize it?

Introduction

Lipoedema is often very stressful for the persons affected. They are characterized by a fat distribution disorder, which is particularly noticeable on the legs. Without a change in diet or activity level, large amounts of fat accumulate on the legs. The disease affects almost exclusively women and usually occurs during the menopause, more rarely as early as puberty. For this reason, a connection between the development of the disease and the hormone balance is suspected.

Definition

Lipedema is a progressive disease characterized by an atypical, symmetrical accumulation of fatty tissue on the sides of the hips and thighs. The subcutaneous fatty tissue increases slowly but steadily. The pathological distribution of fat can vary, so that sometimes the entire leg is affected.

In this case, one speaks of the so-called “column leg“, or the upper part of the thigh, the so-called “riding pants”. There are different stages of the disease. In later stages, fat bulges may even form above the knees or the ankle joints. Depending on how advanced the lipedema is, the ratio of the proportions of the upper and lower body no longer fits. This is particularly noticeable in normal-weight patients with lipedema in the later stages.

How do I recognize a lipedema?

Lipedema can often be recognized or at least guessed at a glance. Particularly noticeable are the thick legs, which become significantly thicker due to a misalignment of the fatty tissue. Lipedema is characterized by an unequal distribution of volume between the upper and lower body.

Often affected persons also have the feeling to have very heavy legs. Lipoedema can be recognized mainly by its localization, they are located mainly on the upper and lower legs. The formation of fat on the inside of the thighs can cause gait disorders and the legs can rub painfully against each other.

What could also be of interest to you in this respect: Heavy legs – What can I do? Many bruises can usually be seen on the skin, as lipedema is associated with a tendency to hematomas (bruises). In addition, the legs are often sensitive to pressure and pain.

In warm weather, after prolonged sitting or standing and in the evening, the edema causes a feeling of tension and pain. Those affected describe the pain predominantly as dull, oppressive and severe, although the symptoms usually worsen during the day. Aggravation in warmth, prolonged standing or sitting is characteristic of lipoedema.

Characteristic for the disease is that the symptoms always appear symmetrically. Thus, a single leg or arm is never affected. The symptoms usually begin in the legs and can only be detected in the arms in later stages of the disease.

Typical for a lipedema is also the orange peel skin. Due to fat and water retention, small nodules form in the subcutaneous fatty tissue, which cause dents that resemble the surface of an orange. Lipedema is only present, however, if hands and feet are not affected.

In stage 1 of lipedema there is already a visible tendency towards the typical “jodhpurs” form. The skin is smooth and even, but shows an “orange peel” texture when pushed together (pinch test). The subcutaneous tissue already feels thickened and soft at this stage, sometimes structures can be felt that feel like polystyrene balls in a plastic bag, especially on the inside of the thighs and above the knees.

In the second stage a distinct “breeches” shape appears and the skin already shows a coarse knotted surface with large dents and walnut to apple sized knots (“mattress skin”). In stage 2, the subcutaneous tissue is thickened, but still soft. The third stage of the lipedema is characterized by a pronounced circumferential increase and strongly thickened and hardened subcutaneous tissue. The affected persons suffer from coarse, deformed fat flaps on the inner thighs and knee joints, sometimes fat bulges hang over the knees and ankles. This often results in a knock-knee position and chafing wounds on the knees.