Lipoedema- The Fat Disease

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Lipoedema The Fat Disease

What is lipoedema?

Lipoedema was first identified in 1940, lipoedema has been a poorly understood, frequently misdiagnosed and rarely recognised condition, as it is rarely taught to medical students or GPs.

Lipoedema is a chronic, genetic fat disorder that, it seems, often affects more than one family member. It appears to be linked to the female hormone oestrogen and predominantly affects females—it is exceptionally rare in males.

A defining trait of lipoedema is that lipoedemous fat responds very poorly to diet and exercise, and weight loss may occur only in areas of the body not affected by lipoedema.

Presentation

Lipoedema presents as a bilateral symmetrical enlargement of the lower (and in some cases) the upper extremities, often resulting in a significant disproportion of the waist-to-hip ratio. In the early stages, the only obvious marker can be the disappearance of the concave spaces on both sides of the Achilles tendon.  The feet are rarely affected, often resulting in a fatty ‘cuff ’, sometimes described as a ‘bracelet’ or ‘elastic band’ at the ankles. Areas such as knees, hips, thighs and buttocks develop distinctive pads of fatty issue, which become noticeably bigger than the rest of the body

The excess adipose deposits are frequently tender and painful in nature and often respond poorly to diet and exercise. The affected skin may be pale and cool to the touch, and bruising can occur easily and spontaneously without apparent cause

Under-diagnosis

As lipoedema is frequently misdiagnosed as obesity or lymphoedema, patients often embark on an endless cycle of diet and exercise programmes that fail to help, and often lead to physical and psychological harm.

Treatment

Compression therapy

Manual lymphatic drainage

Dietary advice

Exercise

Referral for liposuction

Box 1. Five ways to spot lipoedema
  • Hips, buttocks and legs are out of proportion with the rest of the body. Upper arms may also be out of proportion
  • Symptoms usually appear at puberty, before which the body appeared normal. In rare cases, it can also appear at other times of hormonal change such as hormonal contraception, pregnancy or menopause
  •  Lipoedema fat often hurts when banged or scraped gently, and bruises easily. The lower limbs can feel frequently tender and painful to even the slightest touch
  • Lipoedema looks and feels different to normal body fat—it is softer and dimpled, like cellulite
  •  Obesity responds well to diet and exercise and weight loss is experienced from all areas of the body. With lipoedema, weight loss will occur from the upper body but minimal improvement will occur in affected areas below the waist
Source: Wise (2013)

 

If you have any symptoms or would like to talk to someone contact Sasha (MLD Therapist) at Wellbeing Techniques.

 

Full text available at: Early lipoedema diagnosis and the RCGP e-learning course by Amy Fetzer and Sharie Fetzer. Amy Fetzer, freelance journalist and consultant specialising in health and sustainability; Sharie Fetzer, Chair, Lipoedema UK.

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