Understanding Lipoedema

Lipoedema (LIE-poh-dee-muh) is a chronic inflammatory condition of excess adipose tissue (fat) affecting primarily women. It goes beyond simply having trouble losing weight in certain areas, and is a complex interplay between fat tissue, connective tissue, and the lymphatic system, leading to a painful and often frustrating imbalance of fat distribution.

What is Lipoedema?

Lipoedema is characterized by an abnormal build-up of fat cells, primarily in the legs, hips, and sometimes the arms. However, unlike regular fat gain, Lipoedema involves abnormal fat tissue and underlying connective tissue dysfunction. This abnormal fat tissue is resistant to weight loss efforts like diet and exercise, and it can be quite painful and tender to the touch.

The Role of Connective Tissue in Lipoedema

Healthy connective tissue provides structure and support to the body. In Lipoedema, the connective tissue becomes weak and dysfunctional. This impaired function disrupts the proper drainage of fluids through the lymphatic system, leading to further swelling and discomfort.

Genetics and Inflammation in Lipoedema

While the exact cause of Lipoedema remains under investigation, a genetic predisposition is suspected, and many families report multiple generations of Lipoedema. Additionally, chronic low-grade inflammation seems to play a role. This inflammation can further disrupt the function of connective tissue and lymphatic drainage, worsening Lipoedema symptoms. Lipoedema tends to present or worsen either during times of hormonal change such as pregnancy, puberty or perimenopause, or times of intense stress and upheaval. Research is still determining what, if any, hormonal involvement is triggering the genetic changes of Lipoedema.

What are the signs of Lipoedema

• Disproportionate but symmetrical fat growth in the legs, hips, buttocks, thighs, arms or abdomen.

• Skin has a lumpy, “mattress-like” or nodular appearance in these areas, with pea-like lumps palpable under the skin in later stages.

• Cuffing or “bracelet’ effect may occur at the ankles or wrists with the feet and hands usually spared.

• A feeling of heaviness, pain, aching or discomfort in affected areas.

• Increased discomfort and swelling in hot weather.

• Reduced hair growth is often present on affected areas.

• Easy bruising and pain on touch to affected areas.

• Affected areas can often feel cold to touch.

Different Presentations of Lipoedema

• Type 1: Affecting the hips, buttocks and upper thighs.

• Type 2: Affecting hips, buttocks and thighs generally to the knees, with little change to the lower legs.

• Type 3: Typically affecting the legs from the hips down, with a symmetrical appearance and a distinct "culotte" or "riding breeches" form. The feet are usually spared.

•  Type 4: This presentation can involve the upper arms and can progress to the lower arms

• Type 5: Presents only in the lower legs from knees to ankle with cuffing present.

• Other areas: Many patients report Lipoedema tissue in the abdomen, breasts, groin and even scalp.

• Lipoedema in Men: While rare, Lipoedema can also occur in men, often with a later onset and a different distribution pattern.

Co-morbidities and Prevalence of Lipoedema

• Lymphedema: Chronic fluid accumulation due to compromised lymphatic drainage.

• Joint hypermobility

• Pain, inflammation and reduced mobility impacting quality of life

• Extreme fatigue and brain fog

• Allergies

• Thyroid dysfunction

• Digestive problems

• Obesity can occur alongside Lipoedema, usually due to disordered eating from trying to manage undiagnosed Lipoedema and loss of mobility.

• Psychosocial impact: The disproportionate fat distribution can lead to misdiagnosis and weight-related social stigma.

Estimates suggest Lipoedema affects around 10-11% of women, but its is vastly under-recognised and under-diagnosed.

Living with Lipoedema

Whilst there is currently no cure for Lipoedema, a combination of therapies can help manage symptoms and improve quality of life. These might include:

• Manual lymphatic drainage (MLD): A specialized massage technique to promote fluid drainage. This can be performed by massage therapists, myotherapists or physiotherapists trained in MLD.

• Compression garments: These garments can help reduce swelling and discomfort. There are many different types and strengths of compression garments available. Some therapists offer measurement and custom fitting of compression garments. Attending a Lipoedema Australia conference can allow you to see and try many types of compression in person.

• Exercise: Regular physical activity can promote natural lymphatic movement and reduce overall inflammation. Generally non-weight bearing movement is easier for those with Lipoedema such as swimming or using a rebounder. Finding movement that you enjoy and works for you without causing pain is key.

• Healthy diet: There are many ways of eating that have been recommended and researched for Lipoedema. The common thread between all diets is a focus on anti-inflammatory foods. Working with a naturopath or nutritionist who specialises in Lipoedema can help you identify what works best for you.

• Naturopathic support: herbal medicines and nutritional supplements can help support the leaky lymphatics and vascular tissue and reduce pain and inflammation common in Lipoedema. Naturopathic support can also help modulate hormone fluctuations which seem to be correlated with Lipoedema progression. Adaptogens and nervous system support from a Naturopath can assist with the psychosocial and mental health challenges associated with living with Lipoedema.

• Liposuction: In some cases, liposuction performed by a qualified professional specializing in Lipoedema can be helpful. This is major surgery and not currently covered by Medicare or private health insurance in Australia. There is some evidence that Lipoedema can regrow or start to grow in other body areas after surgery, so conservative management remains vital even after surgical treatment.

The Road to Lipoedema Awareness

Lipoedema is a complex condition that often goes undiagnosed. By raising awareness about its symptoms and presentations, we can empower women to seek proper diagnosis and treatment. If you suspect you might have Lipoedema, you should consult your doctor first. There are resources available on the Lipoedema Australia website that you can take with you to support your request for diagnosis and help further the understanding of medical professionals. You may have to seek your own support team of experts to help manage your Lipoedema as there is still little awareness. Early diagnosis and management can significantly improve your quality of life.

For more information and support you can go to the Lipoedema Australia website, or book a free discovery call to find out more about naturopathic support for Lipoedema.

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