Lipedema: Therapy

Causal therapy, that is, therapy that addresses the causes of the disease, is not known. Symptom-relieving procedures are first-line agents.

General measures

  • Note: Lipedema is not to be equated with lifestyle-related obesity! Nevertheless, lipedema is associated with an increased risk of developing morbid obesity (BMI (body mass index, body mass index) > 40).
  • Aim for normal weight! Determination of BMI or body composition by means of electrical impedance analysis and, if necessary, participation in a medically supervised weight loss program.

Surgical therapy

  • Liposuction (liposuction) – several sessions may be necessary; after surgery, physical therapy should be continued and a special compression bandage (phlebological compression bandage (PKV)) should be wornLiposuction causes a significant improvement in the tendency to swelling and hematoma (bruising) and, consecutively, the tension and pressure pain.

Medical aids

  • Wearing compression stockings can prevent evening edema in early stages (recommendation: compression should be worn when edema is present!).

Nutritional medicine

  • Nutritional counseling based on nutritional analysis
  • Note: Lipedema is not the same as lifestyle-related obesity! Regardless, calorie balancing, i.e. healthy balance between calorie intake and calorie burning, should be continued throughout life.
  • Dietary recommendations according to a mixed diet, taking into account the disease at hand. This means, among other things:
    • A total of 5 servings of fresh vegetables and fruit daily (≥ 400 g; 3 servings of vegetables and 2 servings of fruit).
    • Once or twice a week fresh sea fish, i.e. fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
    • High-fiber diet (whole grain products).
    • In the day should be about 2.5 liters of fluid from food and beverages (unless there are contraindications to it).
  • See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
  • Detailed information on nutritional medicine you will receive from us.

Sports Medicine

  • Endurance training (cardio training) and strength training (muscle training).
  • Athletic exercise in (under) water (swimming, aqua jogging, aqua gymnastics, etc) are particularly well suited; furthermore, any kind of hiking, walking or similar. (with compression stockings)
  • Preparation of a fitness or training plan with suitable sports disciplines based on a medical check (health check or athlete check).
  • Detailed information on sports medicine you will receive from us.

Physical therapy (including physiotherapy)

  • Complex physical decongestive therapy (CPD) – exercise/movement therapy, skin care, and regular manual lymphatic drainage (MLD) – to improve drainage of lymphatic vessels – followed by compression therapy (compression garments; custom-made: class II-III; in stage III: initial therapy by multi-layer compression bandaging before fitting compression garments); implementation:
    • Decongestion phase (phase 1 of CPE): 1-2/day (outpatient or inpatient).
    • Maintenance and optimization phase (phase 2 of CPE): MLD only 1-2/week.
  • KPE causes a decrease in tension and pressure pain, possibly also decrease in hematoma tendency.
  • CPE must be repeated regularly:
    • Stage I: often intermittent therapy is sufficient.
    • Stage II and III: continuous therapy, lifelong.