Its’s Not My Fault: Lipoedema, a Fat Disorder
Although lipoedema affects millions of women, it still doesn't seem to be a huge issue in the world. Lipoedema is often misunderstood and confused with obesity and often misdiagnosed.
Lipoedema is a disease of fibrotic loose connective (adipose) tissue (LCT) on the lower abdomen, hips, buttocks, and limbs of females, sparing the trunk, hands, and feet. Lipedema is rare in men. A trigger for the development of lipedema tissue may be an increase in fluid and connective tissue remodeling that occurs alongside body changes during puberty, childbirth, menopause, stress associated with lifestyle change, or by altering tissue structure after surgery or trauma. A hallmark of lipedema tissue is inflammation, resulting in tissue fibrosis and pain, and in some cases, the tissue may become numb.
How lipoedema looks like?
In the beginning, lipoedema is often just a significantly disproportionate "pear" shape. Often women wear a different size on top than on the bottom.
One part of the body (often the hips and upper thighs at first) tends to be much larger than the rest of the body. Some people think of this as "thunder thighs" but it's more than just legs that rub together a bit.
As time goes on, more and more fat begins to be preferentially deposited in the legs and hips. Often the area around the knees begins to develop extra fat pads, and the area just above the ankles starts to get thicker. If you look closely at the picture on the left, you can see the beginnings of these deposits.
In lipoedema, the lower half of the body typically is disproportionately larger than the rest of the body and can become even more disproportionate with time.
There are some exceptions to this; some women with lipoedema also have significantly larger arms and sometimes chest too. Sometimes there's a lot of fat between the waist and the knees but the lower legs are not nearly as affected. However, the majority of women with lipoedema start off with the classic "pear" shape and a lower body that is larger than the rest of her body.
Although lipoedema affects millions of women, it still doesn't seem to be a huge issue in the world. Lipoedema is often misunderstood and confused with obesity and often misdiagnosed.
Lipoedema is a disease of fibrotic loose connective (adipose) tissue (LCT) on the lower abdomen, hips, buttocks, and limbs of females, sparing the trunk, hands, and feet. Lipedema is rare in men. A trigger for the development of lipedema tissue may be an increase in fluid and connective tissue remodeling that occurs alongside body changes during puberty, childbirth, menopause, stress associated with lifestyle change, or by altering tissue structure after surgery or trauma. A hallmark of lipedema tissue is inflammation, resulting in tissue fibrosis and pain, and in some cases, the tissue may become numb.
How lipoedema looks like?
In the beginning, lipoedema is often just a significantly disproportionate "pear" shape. Often women wear a different size on top than on the bottom.
One part of the body (often the hips and upper thighs at first) tends to be much larger than the rest of the body. Some people think of this as "thunder thighs" but it's more than just legs that rub together a bit.
As time goes on, more and more fat begins to be preferentially deposited in the legs and hips. Often the area around the knees begins to develop extra fat pads, and the area just above the ankles starts to get thicker. If you look closely at the picture on the left, you can see the beginnings of these deposits.
In lipoedema, the lower half of the body typically is disproportionately larger than the rest of the body and can become even more disproportionate with time.
There are some exceptions to this; some women with lipoedema also have significantly larger arms and sometimes chest too. Sometimes there's a lot of fat between the waist and the knees but the lower legs are not nearly as affected. However, the majority of women with lipoedema start off with the classic "pear" shape and a lower body that is larger than the rest of her body.
One of the most defining characteristics of lipedema is that it ends at the ankle and does NOT involve the feet.
As lipoedema progresses, it often looks like you've worn socks that were too tight and this has left a ring on the skin. This "ring" around the ankles is a classic sign of middle-stage lipedema. If you look carefully, you can see that "ring" in these two pictures.
In time many women with lipedema develop a bump of fat just above the ankles, as you can see in this close-up just above the "ring." This is what gives the leg the "stepped" appearance.
In the later stages of lipoedema, the bump gets large enough that it is very distinctive. Many lipedema resources talk about this characteristic "bracelet" of fat just above the ankles on both legs. Some doctors call this bracelet of fat "inverse shouldering" or "overshouldering."
In lipoedema, the skin starts smooth in the early stages, but as the condition progresses, the skin often develops an appearance some people compare to cottage cheese, a mattress, or an orange peel. Beneath the skin, you may feel little nodules or lumps of fat that feel like little peas or beans under the skin.
Other Symptoms of Lipoedema
Although the strongest characteristics of lipoedema are the ones described above, there are other symptoms commonly found among many people with lipedema. These include:
Treatment of Lipoedema
Signs and symptoms of lipoedema can be treated to maintain and improve quality of life including pain, edema, and mobility; earlier treatment provides better results.
Mental health consultation should be offered to people with lipedema when there are signs and symptoms of depression, anxiety or eating disorders
2. Medications.
There are no known medications that specifically treat lipoedema.
Medications that increase edema should be avoided in people with lipoedema
Long-term use of diuretics should be avoided in people with lipoedema. Diuretics do not treat the main cause of edema in lipoedema which is inflammation.
Metformin should be considered for people with lipoedema and metabolic complications. Metformin inhibits hypoxia-induced fibrosis in adipose tissue, and can reverse fibrosis after injury.
Thyroid function should be assessed in people with lipoedema.
Diosmin can be considered for treatment of lipedema tissue. Diosmin, a biologically active polyphenol often in combination with its precursor, hesperidin, reduces oxidative stress markers in people with chronic venous disease, improves venous elasticity, functions as a lymphagogue reducing edema, reduces microvascular permeability, and improves vascular, neuropathic and radicular pain.
Vitamin D levels decrease with increasing BMI. Vitamin D levels should be monitored and normalized for people with lipoedema.
3, Diet
Eating plans for people with lipoedema should minimize postprandial insulin and glucose fluctuations and be sustainable long-term.
Healthy eating patterns for lipoedema can be whole food, enzyme rich, plant-based, anti-inflammatory or ketogenic diet.
4. Exercising
People with lipoedema may benefit from postural and core exercises, muscle strengthening exercises, swimming, yoga, gait training, whole body vibration and walking. Deep abdominal breathing increases lymphatic flow and stimulates the parasympathetic system.
5, Manual Lymphatic Drainage
Standard manual therapy for lipoedema includes soft tissue mobilization to reduce pain, inflammation and musculoskeletal restrictions, and manual lymphatic drainage as part of an individualized comprehensive therapy program to stimulate lymphatic flow and reduce edema.
6. Compression garments
Compression garments for lipoedema provide comfort and reduce pain by supporting the tissues.
Source:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8652358/?fbclid=IwAR0Mc7-LHEnqLqMKY9fXyGnybI7IHbaZ3_FLwqLGupnsRt3IDi3QmdnyFsA
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8652358/#bibr3-02683555211015887
As lipoedema progresses, it often looks like you've worn socks that were too tight and this has left a ring on the skin. This "ring" around the ankles is a classic sign of middle-stage lipedema. If you look carefully, you can see that "ring" in these two pictures.
In time many women with lipedema develop a bump of fat just above the ankles, as you can see in this close-up just above the "ring." This is what gives the leg the "stepped" appearance.
In the later stages of lipoedema, the bump gets large enough that it is very distinctive. Many lipedema resources talk about this characteristic "bracelet" of fat just above the ankles on both legs. Some doctors call this bracelet of fat "inverse shouldering" or "overshouldering."
In lipoedema, the skin starts smooth in the early stages, but as the condition progresses, the skin often develops an appearance some people compare to cottage cheese, a mattress, or an orange peel. Beneath the skin, you may feel little nodules or lumps of fat that feel like little peas or beans under the skin.
Other Symptoms of Lipoedema
Although the strongest characteristics of lipoedema are the ones described above, there are other symptoms commonly found among many people with lipedema. These include:
- High sensitivity to pain in the legs
- Tendency towards easy bruising on the legs
- Cold legs and feet
- Edema/swelling at times
- Spider veins/varicose veins
- Tendency towards unexplained weight gain
- Difficulty losing weight, especially in the lower body
Treatment of Lipoedema
Signs and symptoms of lipoedema can be treated to maintain and improve quality of life including pain, edema, and mobility; earlier treatment provides better results.
- Mental Health.
Mental health consultation should be offered to people with lipedema when there are signs and symptoms of depression, anxiety or eating disorders
2. Medications.
There are no known medications that specifically treat lipoedema.
Medications that increase edema should be avoided in people with lipoedema
Long-term use of diuretics should be avoided in people with lipoedema. Diuretics do not treat the main cause of edema in lipoedema which is inflammation.
Metformin should be considered for people with lipoedema and metabolic complications. Metformin inhibits hypoxia-induced fibrosis in adipose tissue, and can reverse fibrosis after injury.
Thyroid function should be assessed in people with lipoedema.
Diosmin can be considered for treatment of lipedema tissue. Diosmin, a biologically active polyphenol often in combination with its precursor, hesperidin, reduces oxidative stress markers in people with chronic venous disease, improves venous elasticity, functions as a lymphagogue reducing edema, reduces microvascular permeability, and improves vascular, neuropathic and radicular pain.
Vitamin D levels decrease with increasing BMI. Vitamin D levels should be monitored and normalized for people with lipoedema.
3, Diet
Eating plans for people with lipoedema should minimize postprandial insulin and glucose fluctuations and be sustainable long-term.
Healthy eating patterns for lipoedema can be whole food, enzyme rich, plant-based, anti-inflammatory or ketogenic diet.
4. Exercising
People with lipoedema may benefit from postural and core exercises, muscle strengthening exercises, swimming, yoga, gait training, whole body vibration and walking. Deep abdominal breathing increases lymphatic flow and stimulates the parasympathetic system.
5, Manual Lymphatic Drainage
Standard manual therapy for lipoedema includes soft tissue mobilization to reduce pain, inflammation and musculoskeletal restrictions, and manual lymphatic drainage as part of an individualized comprehensive therapy program to stimulate lymphatic flow and reduce edema.
6. Compression garments
Compression garments for lipoedema provide comfort and reduce pain by supporting the tissues.
Source:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8652358/?fbclid=IwAR0Mc7-LHEnqLqMKY9fXyGnybI7IHbaZ3_FLwqLGupnsRt3IDi3QmdnyFsA
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8652358/#bibr3-02683555211015887
