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Lipoedema is a condition involving the abnormal accumulation of fat cells. Fat accumulation is significantly more pronounced in the limbs than in other parts of the body. It most commonly affects the lower limbs, but is less commonly seen on the upper arms. Lipoedema is typically a disease of women and is very rare in men. The condition is caused by an abnormal proliferation of fat cells, i.e. a disease!

Development and symptoms of lipedema

Fat edema occurs after puberty, pregnancy or menopause, when estrogen levels change more significantly. It causes symmetrical lesions and abnormal fat accumulation on the limbs.

Fat wraps around the limbs like a riding breeches from the hips to the ankles. The feet, however, remain slender (in obesity, fat pads can be seen here as well).

A typical feature is a fat bulge above the hips, the kneecap is completely surrounded by fat pads and a transverse (ridged) skin fold develops below the knee. The fat pad on the shank of the leg extends to the ankles, covering them.

More rarely, the fat pad may also appear on the upper arm, being most pronounced on the inner side of the elbow.

In more severe cases, the fat pad impairs blood and lymphatic circulation and lymphoedema is "added", making the condition significantly worse. Poor circulation also increases the fragility of the vessel walls, so bruising may occur in areas of lipedema even with minor shocks. Lipoedema is often seen as blue-green patches on the limbs. The above tissue lesions cause the skin of the limbs to become sensitive and painful even with mild pressure.

A condition and not "just" obesity!

Few doctors are aware of the existence of lipedema. For a long time, people are treated as obese and are not given much attention beyond dietary advice.

It usually takes years before someone finally makes the diagnosis: fatty oedema.

It is very important for the patient to recognise that it is abnormal adipose tissue that is causing the fat accumulation.

If you are concerned, it is important to know that this is a disease that causes even with a normal diet, more intense fat deposition!

The most important thing to do is to pay more attention to a balanced diet. Strictly get only as many calories and nutrients into your body as you need. Excess calories are stored more quickly and are harder to get rid of, so don't eat more than you need.

You don't need to skimp on the calories either, because fat edema usually doesn't respond to even the most drastic diets.

Treating lipoedema

While you can live a full and active life despite lipoedema, it can be a serious psychological burden to keep your aesthetic appearance. It can lead to a lack of self-confidence, depression, isolation and even compulsive eating. Get help from a psychologist if you can't manage on your own! With lipedema, you should see a lymphedema specialist. Here, specialist nurses can give you lifestyle advice and teach you how to treat yourself at home.

There is currently no cure for lipedema. But you can stop it progressing and reduce symptoms. However, it requires a lifetime of attention and daily treatment. If you are affected, this is YOUR responsibility! No one will do it for you, you can only get advice! In other words, organise your life so that lipedema treatment is an integral part of it.

The mainstays of treatment are compression garments, manual and mechanical lymphatic massage and regular exercise.

Compression stockings

Wearing them is effective in preventing the worsening of symptoms and aids prevention. They promote the flow of blood and lymph fluid through the lymphatic system, preventing fluid retention and the development of oedema. The elastic dress moves fluid in the tissues upwards. Wearing a compression garment stops or slows down the progression and transformation of lipedema into lipo-lymphedema.

The type and degree of elasticity of the compression garment that is best for you will be selected and prescribed by a specialist!

Compression alone may be sufficient in the early stages of lipoedema, but it should be worn throughout the day.

Hand massage

Hand lymphatic massage is a special type of gentle massage that stimulates lymph flow and thereby reduces edema. It also relieves uncomfortable tension and possible pain. It is most effective in combination with other treatments, such as wearing a compression garment and mechanical lymphatic massage.Manual lymphatic massage requires special training, so choose a professional who is experienced in lymphatic massage.

Machine lymphatic massage

Machine lymphatic massage is used for lipedema in the same way as for lymphoedema. Read my previous article on this.  Mechanical massage requires a suitable "boot" consisting of several air chambers, which should be put on your feet. The machine inflates the air compartments of the boots one after the other and "squeezes" the oedema from the treated area. In addition to the machine treatment, continue to use the compression garment and include regular manual massage in your treatment as these are most effective together.

Lipoedema can be sensitive to pressure, so only buy a modern lymphatic massage machine with adjustable cuff pressure. With modern, multi-chambered systems, you can adjust the pressure so that it doesn't cause any complaints but improves symptoms.


A regular, dynamic exercise, preferably in compression - i.e. exercise while wearing compression stockings - is an important part of therapy! As your muscles alternately tighten and contract, the tights will also expand and contract elastically to 'pump' the oedema. Do 60 minutes of lymphatic exercises at least three times a week (you can learn them from a specialist and do them yourself at home).

In addition, you can do movements that don't put too much strain on the limb. Intense, vigorous running is not for you! Swimming, water gymnastics, walking and easy-paced cycling are for you.