The Lipedema (Lipohyperplasia dolorosa) is a symmetric lipodystrophy (fat distribution disorder), appearing at the buttock, the upper and often lower legs as well, sometimes even extending down to the ankles. Feet and toes are not affected. People suffering from lipedema experience black and blue marks, even from the smallest hits (hematomas) plus from water retention during the second half of the day. Further typical signs of a lipedema may include a dull sensation of swelling, hypersensitivity to touch and pressure as well as sensitivity to cold. In approx. 60 percent of all patients the arms are also affected.
Should a strong tendency towards bruising, water retention and pain be missing, we are talking about a lipohypertrophy which is optically similar to a lipedema, however, only a variation of the body shape and not a real disease.
Vom Lipödem betroffen sind fast ausschließlich Frauen. Deshalb ist Lipedema almost exclusively occurs in females; that is why it is likely that hormonal causes play an important role. The disease usually emerges at the end of puberty, during pregnancy or during menopause, however, the onset can be at any time. A lipedema is progressive, i. e. it worsens over the years and causes folds of fat, knock-knees and a partly substantial malfunction of the gait pattern. Psychological stress due to the personal look leads to depression. Additionally, in the advanced stage after 15 to 18 years, a lymphedema may develop.
The fatty tissue of a lipedema can neither be controlled by diet or sports nor by medication; only by a targeted treatment. This is not a „reserve fat“, as it occurs in overweight patients; in fact the fat cells of the extremities are formed differently.
As the majority of patients has already unsuccessfully tried all kinds of diets and weight loss treatments since puberty, in order to change the shape of their legs, they usually end up with a carelessness towards food intake and thus a significant overweight.
Manifestations of a lipedema
Type I: Increase in fatty tissue in the area of buttocks and hips (saddle bag phenomenon)
Type II: The lipedema extends down to the knees; folds of fat develop in the area inside of the knee
Type III: The lipedema extends from the waist down to the ankles
Type IV: Arms and legs are affected
Type V: Lipolymphedema
Depending on the severity level of the disease it is divided into stages:
Stage 1: Orange skin, slightly nodular skin surface (Fig. 1)
Stage 2: Mattress skin, strongly nodular skin surface with larger indents
Stage 3: Large deformed folds of fat (Fig 2).
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Figure 1 – Lipedema stage 1
Figure 2 - Lipedema stage 3