Lipedema – Fat Tissue Growth in the Limbs

The lipedema is a rare but complex condition characterized by the abnormal accumulation of adipose tissue and associated edema. It typically occurs in women, and patients often experience pain, sensitivity, and a tendency to bruise easily in the affected areas of skin. Recognizing and diagnosing this condition can be particularly challenging, as symptoms are frequently misinterpreted, despite estimates suggesting that its prevalence in the female population may be as high as 10%.

Characteristics and Symptoms of Lipedema

The primary characteristic of lipedema is the disproportionate distribution of body fat in the limbs, while the torso appears relatively slim. The subcutaneous adipose tissue in the affected areas grows symmetrically and in a circumscribed manner, while the hands and feet usually remain unaffected. Symptoms of the disease often manifest during hormonal changes, such as puberty, pregnancy, or menopause.

The pain sensation characteristic of lipedema, skin sensitivity, and the increased tendency to develop bruises also deserve attention. The thickening of subcutaneous adipose tissue and body image issues, such as self-esteem disorders, can have serious psychological effects on patients. The diagnosis is established based on medical history and clinical examinations, where specialists observe symptoms, skin condition, and changes in limb circumference.

Causes and Development of Lipedema

The exact cause of lipedema is not yet fully understood; however, several theories exist regarding the condition. Genetic predisposition may play a significant role, as a considerable number of patients have affected first-degree relatives. Based on familial clustering, it is suspected that inheritance follows an autosomal dominant pattern, but this does not always result in clinical symptoms.

Hormonal factors, particularly the role of estrogen, are also suggested, as lipedema typically appears during times of hormonal changes. In the course of the disease, an increase in the number or size of fat cells and the development of abnormal lymphatic and blood capillaries may also raise suspicion. Patients with lipedema often experience increased pain, which may be a result of inflammation of local nerve fibers.

During the diagnosis, it is important to exclude other conditions with similar symptoms, such as lymphedema and lipohypertrophy. Several clinical stages and types are also distinguished, depending on where the fat deposits occur in the body.

Treatment Options for Lipedema

The treatment of lipedema is complex and primarily aims to alleviate symptoms. Key elements of conservative therapy include manual lymphatic drainage, compression therapy, exercise therapy, and skincare. It is essential to emphasize that the treatment is not aimed at improving the aesthetic appearance of the limbs, but rather at reducing pain and sensitivity of the adipose tissue.

Psychosocial support and dietary counseling also play a significant role in the treatment process, as the development of pathological obesity is common among patients with lipedema. While normalizing body weight does not resolve lipedema, it may contribute to reducing symptoms.

If conservative treatment does not yield satisfactory results, lymph-sparing liposuction may be the next step, although its effectiveness has yet to be fully proven. Continuous monitoring of weight, limb circumference, and pain sensation is crucial during the management of the disease to ensure that the effectiveness of the treatment can be evaluated consistently.