Lipoedema awareness

Overview

Lipoedema is a long-term condition where fat builds up unevenly in the body, usually in the legs and sometimes the arms. This fat is different from regular body fat — it can be painful, bruise easily, and does not go away with diet or exercise. It is not the same as being overweight or having lymphedema.

Lipoedema is not rare — it is estimated to affect about 1 in 10 women, though many cases go undiagnosed or are mistaken for obesity.

It mainly affects women, especially during times of hormonal change like puberty, pregnancy, or menopause. Men can get it, but it is very uncommon.

Symptoms

Common symptoms

• Fat buildup that is symmetrical (same on both sides), often in the legs, thighs, buttocks, and sometimes arms.
• Pain, tenderness, or a heavy feeling in the affected areas.
• Easy bruising, even from minor bumps.
• Swelling that gets worse during the day or after standing for a long time.
• Skin that feels cool to the touch or has small, dimpled areas (like cellulite).
• Feeling of tightness or sensitivity when touched.

Symptoms in children

• Lipoedema is very rare in children. If a child has unusual fat deposits that are painful or bruise easily, a doctor should check for other conditions first.
• Sometimes symptoms start during early puberty, with legs feeling heavy or swelling at the end of the day.

Symptoms in older adults

• In older adults, lipoedema can become more noticeable as the fat deposits may get larger and more painful over time.
• Mobility may become harder, and the skin may become more fragile or prone to swelling and infection.

Causes

Main causes

• The exact cause is not fully understood, but it appears to be linked to hormones — it almost always affects women and often starts during hormonal changes.
• There is a strong genetic factor – it often runs in families.

Risk factors

• Being female is the biggest risk factor.
• Family history of lipoedema.
• Hormonal events such as puberty, pregnancy, or menopause may trigger or worsen it.

When to see a doctor

See a doctor urgently if:

• If you have sudden, severe swelling or pain (especially in one leg).
• If you have a high fever with redness or swelling that is spreading.

Book a routine appointment if:

• If you have had painful, uneven fat on your legs or arms for a while that does not improve with diet or exercise.
• If you bruise easily and have tender skin that feels heavy.
• If you think your legs are getting larger but your feet or hands are not affected.

Diagnosis

Lipoedema is usually diagnosed by a doctor who is familiar with the condition, such as a GP or a specialist called a lymphologist or vascular specialist. They will ask about your medical history and examine your body.

Tests that may be done

• There is no single test for lipoedema. The diagnosis is based on the typical pattern of fat distribution, symptoms like pain and easy bruising, and ruling out other conditions.
• Sometimes an ultrasound or lymphoscintigraphy (a scan that looks at lymph flow) is done to rule out lymphedema or other problems.

What to expect at your appointment

The doctor will look at where the fat is, whether it is the same on both sides, and whether your hands and feet are free of swelling. They may also check for a family history. Getting a diagnosis may take time, so it helps to be persistent.

Treatment

There is no cure for lipoedema, but treatment can help manage symptoms, slow progression, and improve quality of life. A team approach with different specialists often works best.

Self-care at home

• Wear compression garments (stockings or sleeves) — these can reduce pain and swelling and help the skin. Always get fitted by a specialist.
• Do gentle exercise like swimming, walking, or cycling to improve circulation and reduce discomfort.
• Keep your skin well-moisturised to prevent dryness and injury, and protect your legs from bumps.
• Elevate your legs when resting to help reduce swelling.
• Avoid sitting or standing for long periods without moving.

Medical treatments

Medical treatment may include manual lymphatic drainage (a type of massage done by a trained therapist) to reduce swelling. Pain relief can be managed with over-the-counter or prescribed medicines — always speak to your doctor or pharmacist about what is safe for you. Physical therapy can help with mobility. Some people benefit from psychological support for body image concerns.

When is surgery considered?

In more advanced cases where symptoms are severe and other treatments have not helped enough, a type of liposuction specifically for lipoedema may be considered. This is only done by experienced surgeons and after careful assessment by a specialist. It is not the same as cosmetic liposuction.

Living with this condition

Living with lipoedema means being aware of your body and taking steps to manage pain and swelling daily. Many people find a routine of gentle movement, compression, and skin care helps them feel better. It is important to listen to your body and rest when needed.

Lifestyle tips

• Try to stay active with low-impact exercises like swimming, yoga, or cycling.
• Maintain a healthy weight through balanced eating — even though lipoedema fat won't go away, losing regular fat can help overall health.
• Avoid crash diets or extreme weight loss programmes — they do not affect lipoedema fat and can be harmful.
• Wear comfortable shoes and clothes that do not dig into your skin.

Diet and exercise

There is no specific diet for lipoedema, but an anti-inflammatory diet rich in fruits, vegetables, whole grains, and healthy fats may help reduce discomfort. Drinking plenty of water and limiting salt can also help control swelling. Exercise should be gentle and low-impact to avoid further stress on your legs. A physiotherapist can design a safe plan.

Mental health and emotional wellbeing

Lipoedema can affect how you feel about your body, especially since it changes your shape and can be painful. It is common to feel frustrated, embarrassed, or anxious. Talking to a counsellor or joining a support group can help. You are not alone, and mental health support is part of good care.

Prevention

Lipoedema cannot be prevented because it is largely genetic and hormone-related. However, taking good care of your skin, staying active, and maintaining a healthy weight may help slow progression and reduce complications.

Complications

If left untreated

• The fat deposits can become larger and more painful over time.
• Mobility may become difficult, making everyday tasks harder.
• Secondary lymphedema can develop — where fluid builds up because the lymphatic system is overloaded.
• Skin infections like cellulitis are more likely.
• Emotional distress and poor body image can affect mental health.

Long-term outlook

With early diagnosis and proper management, many people with lipoedema lead active and fulfilling lives. While the condition does not go away, symptoms can be controlled, and progression can be slowed. Support from healthcare professionals and loved ones makes a big difference.

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