Have you ever looked in the mirror and thought, "My upper body is normal, but why are my legs so big?" Maybe no matter how much you diet and exercise, the fat on your legs and buttocks just won't go away. While others may think this is normal fat, it can be a big problem for you. In fact, this is not normal fat, but a special condition called Lipedema . Let's talk about this clearly, simply, and in a way that you can understand.
What exactly is Lipedema?
Simply put, Lipedema is a long-term condition in which fat deposits accumulate abnormally, especially in the lower body. It most commonly affects your buttocks, thighs, and calves . Some people may also experience this condition in the hips or upper arms. But, most notably, this fat deposition does not affect your palms or soles.
Many people confuse Lipedema with being overweight or Lymphedema (swelling associated with lymph nodes). However, these are three different conditions. However, when Lipedema is severe, Lymphedema can also occur. Many people with Lipedema have a Body Mass Index (BMI) of more than 35.
If you have Lipedema, the biggest problem is that even if you lose weight in your upper body when you diet or exercise, you won't lose fat in your lower body, such as your legs, which are affected by Lipedema.
Are there different types of lipedema?
Yes, Lipedema can be divided into several types depending on where the fat is deposited on your body. Sometimes a person can have more than one of these types. Let's see what they are.
| Type | Fat storage site |
|---|---|
| Type I | Fat accumulation in the area between the buttocks and hips. |
| Type II | Fat accumulation between the pelvis and knees. |
| Type III | Fat accumulation from the pelvis to the ankles. |
| Type IV | Fat deposits between the shoulders and wrists (in the arms). |
| Type V | Fat deposits between the knees and ankles (in the groin area). |
What are the symptoms of Lipedema?
There are several symptoms that can help identify this condition. These are not seen in normal people.
- Symmetrical fat deposition on both sides of the body: Fat is deposited equally on both sides of the body, especially in the buttocks, thighs, hips, and sometimes the upper arms.
- Feeling like lumps under the skin: When you touch the areas where this fat is deposited, it feels like there are small lumps or bones under the skin.
- Pain: This is one of the main symptoms of Lipedema. This pain can range from a mild ache to severe pain. Sometimes it just hurts, other times it hurts only when you press on it.
- Feeling of heaviness in the legs: The legs feel so heavy that they feel like they could be lifted off.
- Swelling: Legs swell at the end of the day or after standing for a long time.
- Bruising easily: The skin turns blue easily (bruising), even if it's just a small bump, or maybe not.
- Fatigue: Feeling more tired than usual is also a symptom of this.
Why does Lipedema occur? What are the risk factors?
The exact cause of lipedema is not yet known, but there are several factors that are thought to contribute to it.
- Hereditary: This is a condition that runs in families. Studies have found that between 20% and 60% of cases are hereditary. If your mother or grandmother had this condition, you are more likely to have it too.
- Hormonal influences: This disease is most commonly seen in women . It is very rare in men. Therefore, it is strongly believed that it has a hormonal connection. This condition begins or increases especially during these periods of hormonal changes:
- Puberty
- Pregnancy
- Menopause
- Time to take birth control pills
Importantly, obesity does not cause lipedema. However, more than 50% of people with lipedema have a body mass index (BMI) greater than 35. This means that both conditions can coexist.
What are the possible complications of lipedema?
If lipedema is not properly treated or controlled, various complications can develop over time.
- Difficulty walking: Excessive fat deposits in the legs make it difficult to walk.
- Psychological problems: Psychological problems such as shame, anxiety, and depression about body appearance can occur.
- Lipo-lymphedema: A condition in which the lymphatic vessels are blocked due to fat deposits, preventing lymph fluid from flowing properly, and causing the legs to swell even more.
- Venous disease: Conditions such as varicose veins in the legs.
- Flat feet.
- Joint problems: Pain and disability due to excessive weight-bearing on joints like knees and ankles.
- Knock knees: A condition in which the knees knock together while keeping the legs straight.
How does a doctor diagnose this condition?
Your doctor will diagnose this condition primarily based on a physical exam and your medical history .
Normal fat deposits are not painful. However, in Lipedema , the pain of the fat is the main distinguishing feature. Also, people with Lipedema may notice a clear difference in size between the affected and unaffected legs.
Diagnostic tests
There is no specific test to diagnose lipedema, but your doctor may refer you for certain tests to rule out other medical conditions and to see if there are other conditions that accompany lipedema.
- Ultrasound scan: Examination of the inside of the body using sound waves.
- DEXA scan: A test that measures bone density using X-rays.
- MRI scan (Magnetic Resonance Imaging): Obtaining detailed images using a magnetic field and radio waves.
- CT scan (Computed Tomography): Obtaining detailed images using X-rays and a computer.
Stages of Lipedema
For most people, lipedema gradually worsens over time. There are four main stages.
| Stage | Description of the situation |
|---|---|
| Stage 1 | The skin looks normal, but when touched, small pebble-like objects can be caught under the skin. Pain and bruising may occur at this stage. |
| Stage 2 | The surface of the skin becomes uneven, taking on a dimpling appearance, like an orange peel or the surface of a mattress. |
| Stage 3 | The legs appear to be swollen into a square shape. There are large folds of skin and fat. The fat bulges out, making it difficult to walk. |
| Stage 4 | At this stage, both Lipedema and Lymphedema occur together (Lipo-Lymphedema). |
What are the treatments for Lipedema?
Unfortunately, there is no cure for lipedema yet. However, there are many treatments that can help reduce pain and swelling and provide you with relief . They usually start with simple treatments and progress to more complex treatments if necessary.
Simple treatments that can be done first
- Exercise: Exercises like swimming, cycling, and walking can improve joint mobility and reduce swelling. Exercises in water (like swimming) are especially good because they put less weight on the joints.
- Anti-inflammatory diet: Following a heart-healthy diet can help prevent the worsening of lipedema. But remember, dieting won't make lipedema fat go away like regular fat.
- Compression stockings: Wearing specially designed compression stockings can reduce swelling and pain.
- Applying moisturizer to the skin: Prevents skin from drying out and cracking.
- Medications and supplements: Your doctor may prescribe certain medications (e.g. metformin) or supplements to control pain, swelling, and other problems.
Other non-surgical treatments
- Lymphatic drainage massage: A special massage technique that restores lymphatic fluid flow by gently massaging the skin.
- Complex decongestive therapy: A treatment method that involves massage followed by the application of compression wraps.
- Pneumatic compression device: A device worn on the legs and filled with air to compress the legs and reduce swelling.
Surgical treatment
- Liposuction: Surgery to remove fat. This can reduce pain and improve mobility. Doctors recommend a special method called wet-jet assisted liposuction because it minimizes damage to lymph vessels.
- Bariatric surgery: If you have lipedema and a body mass index of over 35, your doctor may refer you for weight loss surgery.
If you have Lipedema, how do you manage life?
Lipedema is a condition that can get worse over time, but for some people, the symptoms are mild and not as severe.
The most important thing is that complications can be prevented by diagnosing the disease at an early stage and starting treatment .
You can get good results from things like exercising and wearing compression stockings. Also, if you have other conditions like depression, obesity, or lymphedema, managing them properly is very important for controlling lipedema. If necessary, your doctor will refer you for counseling, a physical therapist, or pain management.
When do you need to see the doctor?
Regular appointments
Your doctor will visit you once a month or every few months to monitor the progress of your treatment. If you have any problems with your treatment, or if your treatment is not giving you the results you expected, talk to your doctor. He or she may be able to suggest a different treatment plan that is more suitable for you.
When do you want to go to ETU soon?
If you experience any of these symptoms, go to a hospital's Emergency Department (ETU) immediately :
- If your legs are red, painful, and swollen.
- If you have symptoms like fever.
These could be signs of a serious skin infection called cellulitis .
What questions should you ask the doctor?
When you go to see the doctor, asking these questions will be very helpful to you.
- "What type of Lipedema do I have? What stage am I in?"
- "What treatment is best for me?"
- "How successful has this treatment been for others?"
- "How often should I come for follow-up appointments?"
Lipedema can be a difficult condition to live with, as it limits your ability to move. But remember, you are not alone. There are other people who are going through the same problems. Connecting with online support groups can be a great source of mental strength.
Take-Home Message
- Lipedema is not just a common condition. It is a condition in which abnormal, painful fat deposits accumulate in the body, especially in the legs.
- Diet and exercise alone cannot eliminate lipedema, but they can help control the symptoms.
- This is a real medical condition . Don't be ashamed or hide it. It's often hereditary and related to hormones.
- By identifying and treating the disease at an early stage, pain, swelling, and quality of life can be controlled.
- If you have these symptoms, talk to your doctor without any hesitation. Getting the right guidance is the most important thing.
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