Also Known As: Lipoedema, Lipedema

Lipedema, known as lipoedema in Europe, is a chronic disorder of the adipose tissue generally affecting the legs, which causes the legs, and sometimes the arms, but not the feet, to accumulate fatty tissue.[1] It is distinguishable by five characteristics: 1) it can be inherited; 2) it occurs almost exclusively in women; 3) it can occur in women of all sizes, from the seriously underweight to the morbidly obese; 4) it involves the excess deposit and expansion of fat cells in an unusual and particular pattern – bilateral,symmetrical and usually from the waist to a distinct line just above the ankles; and 5) unlike the typical fat of obesity, lipedemic fat generally cannot be lost through diet and exercise. Though there is debate about surgery as an intervention, there are surgeons in Germany, the Netherlands and the U.K. achieving success with medical liposuction. A specialized form of liposuction, usually performed with tumescent local anesthesia, one of the nuances is to ensure integrity of the lymphatic system while removing lipedemic adipose tissue.

Lipedema usually is triggered at puberty, but can trigger or worsen during or after pregnancy, at peri-menopause, and followinggynecological surgery, i.e., surgery of the uterus, ovaries, or fallopian tubes or any kind of general surgery with anesthesia. LIpedema can also be triggered by an extremely stressful situation such as a death in the family or a divorce because cortisol levels increase, causing an inflammation cascade, almost always misdiagnosed as weight gain. If lipedema is diagnosed early, which currently is very rare, it is possible to prevent a significant expansion of lipedemic fat cells, and to alert patients to their heightened risk for obesity so they can take appropriate action.

Estimates of the incidence of lipedema vary widely, and range as high as 11% of the post-puberty female population, with conservative estimates of 17 million women in the US, and 370 million women worldwide affected.

Medical treatment is designed primarily to address the secondary lymphedema part of the lipedema patient's condition. This treatment includes a course of manual lymphatic drainage and bandaging by a lymphedema therapist, followed by the wearing of custom-fitted compression garments or devices — usually stockings and sometimes biker shorts. Compression prevents recurrence of lymphedema, and in some lipedema patients can reduce the pain of lipedemic fat. There is currently no known uniform medical procedure to cure lipedema. It is, however, successfully managed through a variety of consistently applied techniques to improve the health of the legs and prevent the condition from returning in more difficult to manage levels. Management involves reducing dietary sodium intake, frequent, gentle exercise to promote circulation in the legs, such as rebound exercise, and treatments typical for lymphedema treatment.

Conversely, there is a growing number of woman who claim to have succeeded in reversing lipedema through elimination diets, low impact exercise, and an herbal protocol that addresses inflammation of the legs rather than edema of the legs. This group claims to eliminate inflammatory pain in legs by 1) changing food choices; and, 2) modulating the tumor necrosis factor (TNF) antagonists or TNF blockers in the adipose gland. This movement is gaining recognition in European and Australian medical circles.

It should be remembered that lipedema is a childhood disease that progresses throughout adulthood. Early diagnosis is the best treatment. It is now believed in Germany, for example, that liposuction of inner thigh pads in children can eliminate the loss of mobility in later years.

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