Lipoedema (or Lipedema if you’re American!) is a little known and poorly understood condition that affects the way the body stores fat. It generally affects the lower half of the body but in some cases can also involve the arms. In extreme cases it can cause considerable swelling, pain and tissue enlargement leading to difficulty getting around. But in milder cases it can just seem like a person has “big legs”.
Lipoedema has been recognised since the 1940’s and was once thought to be rare, however recent research has indicated that 5 to 11% of women may suffer from this condition – which is definitely not rare!
Characteristics of Lipoedema:
- It only affects women (except a very small amount of cases involving men with hormonal issues)
- The lower body seems large in proportion to the upper body
- Feet look normal and often look small compared to the rest of the leg (there is often a “cuff” or “bracelet” where the tissue gathers in abruptly at the ankle)
- Easy bruising
- Tissue is tender to touch
- Skin texture is bumpy (kind of like cellulite) and often cool to the touch
- People may diet and lose weight in the rest of their body, but the size of their legs never changes.
- It is symmetrical
- In a minority it can also affect the upper body
Lipoedema is a build up of fat in the tissue just under the skin, there is also often an increase in the number of blood vessels in this tissue.
It is thought that that there is a genetic component to Lipoedema, with many women identifying other women in their family that they think may have it, though often un-diagnosed. There is also a hormonal factor with onset usually happening around the time of puberty or other periods of hormonal change.
The course of Lipoedema is hugely variable, some people are affected very badly and others only ever very mildly, but it is not understood why.
There is a link between Lipoedema and the condition lymphoedema and they can sometimes be confused with one another. Lymphoedema is a condition that affects the fluid transport through the body, leading to swelling. It can look quite similar to Lipoedema (though the feet are usually involved too). Advanced Lipoedema, if left untreated can lead to lymphoedema, as the build up of fat in the tissues makes it hard for the body’s fluid transport system to work properly. This condition is called Lympho-lipoedema.
The treatment for Lipoedema and lymphoedema is quite similar and is best started as soon as possible after diagnosis. It can involve:
- Lymphatic massage
- Compression (wearing of specially fitted leggings, pantyhose or stockings)
- Physical activity
- Diet (it is best to get advice from a professional about this)
- Psychosocial support
Many women are not diagnosed until later in life, and this can be a very emotional experience. Most women have never understood why they have such large legs and have spent a life-time being embarrassed about them. Years of dieting and battling with body image issues without ever seeing results, can take a toll on mental health. There can be massive feelings of bitterness and anger when diagnosed. Gaining the right professional support to support women psychologically through this process is invaluable.
Tumescent liposcution is a special type of liposuction that can help to reduce leg size for those with Lipoedema. This is a final option once other forms of management have been explored. It is important to understand that Lipoedema cannot be cured. So after liposuction it is necessary to wear compression garments on a daily basis to prevent the limbs increasing in size. As with any surgical procedure, there are risks to liposuction. Thorough research should be conducted by the patient first so that people can make a fully informed decision that is right for them.