Lipedema is a genetic fat deposition disorder that mostly affects women, causing painful swelling in the lower legs. Treatment options include manual lymphatic drainage, compression garments, diet, and exercise, but fat deposits cannot be lost once formed. Patients must exercise extreme care to avoid complications.
Lipedema is a fat deposition disorder in which fat accumulates in the lower legs and causes painful swelling over time. This condition occurs mostly among women and appears to have a genetic component. Treatment options are available to manage, but not cure, this condition. Patients with lipedema will need to exercise extreme care throughout their lives to avoid the complications that can develop when fat deposition becomes significant.
Changes in hormone levels appear to trigger lipedema, as it tends to occur during puberty, pregnancy, after gynecological surgery, or during menopause. Patients may notice that they are gaining weight in their legs at a disproportionate rate. If the condition is not diagnosed correctly or the patient does not intervene, the disparity between the upper and lower halves of the body can become extreme; the patient’s bottom half may be twice her top half, for example.
As fat builds up, it can create small nodules under the skin. It will be painful, and the skin folds that inevitably develop with significant weight gain will be prone to rashes and infection. Patients may also experience limited mobility with lipedema, as it can be very difficult to move the legs comfortably and easily. Skin infections and severe pain that can become chronic can occur.
Treatment requires getting the disease as early as possible to provide interventions. Manual lymphatic drainage (MLD), a special massage technique to promote lymphatic circulation, may be helpful. Patients can also wear compression garments to increase comfort. These garments must be worn very carefully, as they can cause pain and irritation or can cut off circulation if they are too tight or made with the wrong fibers. A doctor can help a patient find an appropriate level of compression.
Diet and exercise can also help with lipedema. Once fat deposits are formed, fat cannot be lost, but patients can limit the formation of further deposits by keeping their weight tightly controlled. Exercise can also increase range of motion and reduce stress on joints. For heavier patients who cannot perform impactful exercises such as running and aerobics, options such as swimming may be helpful. Patients should also be aware that they have an increased risk of obesity with lipedema and that treatments such as liposuction to remove fat or bariatric surgery to limit food intake and change metabolism will not solve the problem.
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