Lipoedema: Understanding this little-known condition

Lipoedema is a chronic disorder marked by an uneven, often painful accumulation of fat in specific areas of the body, most commonly the legs and occasionally the arms. It is not the same as simple weight gain.

Because its outward signs can look like other issues, lipoedema is frequently mistaken for obesity or lymphoedema—even though the three are distinct. Obesity involves generalised fat gain without localised pain, while lymphoedema is swelling caused by trapped lymphatic fluid rather than fat.

Causes and aggravating factors

Lipoedema is overwhelmingly a women’s health issue and rarely occurs in men, yet it often goes undetected because its symptoms can mirror those of other conditions. While researchers haven’t pinned down its exact roots, the very first signs of lipoedema almost always coincide with major hormonal shifts—puberty, pregnancy or menopause. There’s also a clear familial link: if a close relative (say, your mother) has lipoedema, your own risk goes up.

Although lipoedema isn’t the same as obesity, many who live with it also carry extra weight, and that additional bulk can deepen lipoedema’s painful, uneven fat deposits.

Symptoms of lipoedema

Symptoms of lipoedema can take many forms, but the most common ones are:

• A disproportionate build-up of fat mainly in the buttocks, thighs, calves and sometimes the upper arms. This accumulation is usually symmetrical, appearing evenly on both sides of the body.
• The hands and feet are often spared.
• Small lumps or nodules can be felt under the skin in the areas where fat has gathered.
• Pain—ranging from mild discomfort to severe tenderness—is frequent and may be felt both at rest and when gentle pressure is applied to the affected regions.
• Bruises (also called ecchymosis) form easily in the affected areas, even after minor bumps.

Stages of lipoedema

Lipoedema evolves in stages, and its progression varies from person to person. In some cases, the condition remains stable and does not advance, while in others, it can accelerate quickly. There are three primary stages:

Stage 1

The skin appears normal, but you may notice small, tender nodules beneath the surface. Fat deposits remain light and localized.

Stage 2

The skin takes on a dimpled texture, reminiscent of cellulite, and the surface becomes uneven. Fat accumulation grows more pronounced, with nodules becoming both larger and more numerous.

Stage 3

Deeper indentations and substantial bulges characterize this stage. Fat deposits are significant and may even create overhanging pockets of excess skin.

Pain and easy bruising can occur at any stage of lipoedema.

Available treatments

Although there’s no cure for lipoedema yet, a range of therapies can help ease pain and calm inflammation. Health professionals typically advise starting with conservative measures before moving on to surgical options. Getting an early diagnosis and tailored care from a qualified provider is key to managing symptoms effectively and improving quality of life.

Conservative approaches

Physical exercise

Regular, low-impact movement can help decrease swelling and support emotional well-being. Keeping active also aids in weight management, which may ease lipoedema symptoms.

Compression therapy

Wearing specially designed compression garments helps control inflammation and relieve discomfort. Proper fitting is crucial to ensure they work effectively and safely for each individual.

Balanced nutrition

A diet rich in whole, nutrient-dense foods and low in processed items supports overall health. While it won’t cure lipoedema, maintaining a stable weight can mitigate symptom severity.

Psychosocial support

Living with lipoedema can take an emotional toll. Connecting with peer support groups or seeking professional counselling often makes a meaningful difference in quality of life.

Surgical approaches

More invasive options may be on the table when conservative measures don’t bring the desired relief. Liposuction, which is removing excess fatty tissue through suction, is the most common surgical treatment for lipoedema. It aims to reduce painful fat deposits and improve limb contour, but should always be discussed in detail with a qualified specialist to weigh benefits, risks and realistic outcomes.