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LipeGuide
Understanding lipedema

Lipedema, obesity, cellulite or lymphedema: what differences to look for?

Lipedema is a disproportionate, symmetrical buildup of fat tissue, often painful to the touch, that usually spares the hands and feet and responds little to weight loss. Obesity is excess fat spread throughout the body, which responds to diet and exercise. Lymphedema is a buildup of fluid caused by a failure in lymphatic drainage, and it usually affects the feet and hands too. Cellulite is a change in skin texture, very common and painless. These conditions can appear together, and telling them apart is a job for a professional.

In short

  • Lipedema: disproportionate, symmetrical fat, often painful, that usually spares the hands and feet
  • Obesity: fat spread throughout the body, which responds to weight loss
  • Lymphedema: fluid buildup caused by a failure in lymphatic drainage, which also affects the feet and hands
  • Cellulite: skin texture, painless
  • Lipedema and obesity can coexist, and so can lipedema and lymphedema

Lipedema and obesity

In obesity, fat is distributed throughout the whole body, including the torso, and usually decreases proportionally with weight loss. In lipedema, the buildup is concentrated in the hips, legs and sometimes the arms (the lower belly can also be affected), often hurts to the touch and changes little with diet and exercise. When a person loses weight, she loses more from the torso, and the disproportion becomes even more visible.

One does not rule out the other: obesity is a common associated condition. Treating obesity reduces metabolic complications and may relieve symptoms, even if the lipedema tissue changes little.

Lipedema and lymphedema

Lymphedema is a buildup of fluid caused by a failure in drainage by the lymphatic system. Unlike lipedema, it usually affects the foot and the hand too.

One sign used in the assessment is the Stemmer sign: the professional tries to pinch the skin on the top of the second toe. In lipedema, it can usually be pinched. When it cannot, that is a sign of lymphedema, but the reverse does not hold: lymphedema can exist even when the skin can be pinched, which is why the assessment does not stop at this test.

Lipedema and cellulite

Cellulite is a change in skin texture, with dimples and an orange-peel look, reported in 80% to 90% of women after puberty. It does not cause pain or a disproportionate increase in volume.

When the conditions add up

Over time, some people with lipedema may also develop lymphatic involvement, a condition called lipolymphedema. Associated obesity is also frequent. That is why the assessment looks at the whole picture, not at a single feature.

What we know and what we don't know yet

What we know

  • How the volume is distributed, the symmetry, the pain and whether the hands and feet are involved help tell the conditions apart
  • These conditions can coexist in the same person

What we don't know yet

  • There is no single test that reliably separates lipedema from obesity
  • There is no way to predict who with lipedema will develop lymphatic involvement

When to seek professional care

  • If you are unsure which condition explains what you feel
  • If the swelling has started to affect your feet or hands, or has become larger on one side
  • Urgently, if only one leg swells and hurts, or if your legs become red, warm and painful along with flu-like symptoms: it could be a blood clot (thrombosis) or an infection

Frequently asked questions

Can I have lipedema and obesity at the same time?+

Yes, and it is common. That is why the diagnosis considers how the volume is distributed and the symptoms, not just weight.

Does lipedema turn into lymphedema?+

In some people, over time, associated lymphatic involvement may develop. This does not happen to everyone, and regular follow-up helps you notice changes.

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