In lipedema (from ancient Greek “fat swelling,” from λίπος lípos “fat” and οἴδημα, oídēma, “swelling”; synonyms: Adiposalgia; Adipositas dolorosa; Lipalgia; Lipohypertrophia dolorosa; Lipomatosis dolorosa of the legs; Riding trouser lipedema; Riding trouser syndrome; Riding trouser obesity; Painful lipedema syndrome; Painful columnar leg; ICD-10-GM R60.9-: Edema, unspecified) is a chronic progressive, dysproportional, symmetric subcutaneous fat proliferation.
Lipedema is characterized by hyperplasia and hypertrophy of adipose tissue.
It occurs mainly on the legs and buttocks, leaving out the feet, at least initially. In up to 30% of cases, the arms are also affected.
Gender ratio: Lipedema occurs almost exclusively in women. In men, lipedema-typical changes only occur in hypogonadism (endocrine (hormonal) dysfunction of the testes leading to testosterone deficiency), after hormone therapy in the context of tumor disease (cancer) or in alcohol consumption-induced liver cirrhosis (liver shrinkage).
Frequency peak: Lipedema usually begins during or after puberty, after pregnancy or during menopause (menopause). Hormonal contraceptives (birth control pills) and hormone replacement therapy may also potentially trigger it. The maximum incidence of lipedema is between the 3rd and 4th decade of life.
The prevalence (disease frequency) is about 8% in adult women in Germany.
Course and prognosis: In half of the cases, more than ten years pass between the onset of the disease and the diagnosis. In the course of the disease, peripheral edema (water retention) occurs. Lipedema is usually a spontaneously progressive disease, the progression of which can be slowed down or stopped by appropriate therapy (wearing compression stockings; complex physical decongestive therapy). Furthermore, it is particularly important to prevent secondary complications (see below secondary diseases) at an early stage or to aim for the earliest possible therapy. Note: Lipedema is not a self-inflicted cosmetic defect; the disease is also not to be equated with lifestyle-related obesity!
Comorbidities (concomitant diseases): Lipedema is associated with venous insufficiency (chronic venous stasis syndrome, CVI)/varicosis). Nearly one in three patients with lipedema has obesity (body mass index [BMI] greater than 30).
