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What is Lipedema? The Fat That’s Not Your Fault

Have you dieted and exercised only to lose weight in your torso but your legs, hips, and/or buttocks remain the same? Have you been told that you have your mom, grandma, or aunt’s big legs? Have you been questioned about your compliance with diet and exercise? Technically, you may be “overweight”, but you’ve noticed you aren’t proportional. You’ve tried to reduce the size of your body but it won’t cooperate. Or maybe people think you’re overreacting when your pet jumps in your lap and it’s so extremely tender and painful that you cannot tolerate it.

Does this sound familiar? You may have Lipedema (also known as Lipoedema).

Identifying Lipedema & Diagnosis challenges

Lipedema is a chronic medical condition, a fat disorder that is misunderstood and misdiagnosed. Often misdiagnosed as simple obesity, it is not unusual for women with lipedema to stop exercising and/or eating well when they don’t get the results they expect. As a result, they gain the “sedentary fat” that we all gain when we don’t eat well and keep active. This added weight begins masking the lipedema and can make lipedema worse.

Lipedema is a medical mystery, the exact cause is unknown and women that have it are left to suffer the judgment of physicians, family, friends, and even strangers. While believed to be “rare,” research has shown a prevalence of anywhere from 10-20% of the female population to have lipedema. Although there are no definitive diagnostic tests for Lipedema, medical professionals rely on the following key clinical features for diagnosis:

  • Buildup of adipose tissue (fat) in the hips, thighs, buttocks, and/or arms that is not proportionate to the torso; The Waist-to-Hip-Ratio is great

  • Easy Bruising

  • Pain with applied pressure or “painful fat”

  • Persistent swelling, even with elevation

  • Unusual texture within the fat that can feel like rice, peas or walnuts beneath the surface of the skin

  • Small spider or varicose veins - notably around the ankles

  • “Column/stove-pipe/tree-trunk legs” where the fat abruptly cuts off at the ankle with the feet spared, creating a “cuff” appearance. This “cuff” can also be present at the wrists.

  • The onset of symptoms often begins during puberty or young adulthood; progression can occur during pregnancy and/or menopause

Management & Treatment

Although there is no cure, there are measures you can take to help you along your journey. A Certified Lymphedema Therapist (CLT) can educate you on the diagnosis and help prevent worsening of the condition by:

  • Improving Lymphatic Flow

  • performing Manual Lymphatic Drainage (MLD) and teaching you a version you can perform at home (self-MLD). Wearing “appropriate” compression garments can be very beneficial in improving lymphatic flow and a CLT can help you find compression that works best for you

  • Reducing Inflammation

  • Despite the fact that lipedema fat cannot be lost by just reducing calories and exercising, providers who treat lipedema typically advise that daily light to moderate exercise can be very beneficial to decrease swelling and help prevent “sedentary fat” that occurs with a sedentary lifestyle. Lymphatic yoga, swimming or aquatic exercise, and rebounding have been shown to be beneficial. Your CLT can help you find what is best for you.

  • The Anti-Inflammatory style of eating is believed to be helpful in reducing inflammation in the body, which can help reduce pain and has other health benefits. (the research is on-going)

  • Finding Emotional Support- You are not alone

  • Many with lipedema have experienced some form of anti-fat bias, either from their family and/or their medical providers and this can greatly impact their mental health. Knowing you aren’t alone and having a sense of community can be comforting. Your CLT may be able to help you find a support group of others with lipedema.

A Message To Lipedema Warriors:

It is NOT YOUR FAULT! Now that you know what it is, learning how to manage your lipedema is the beginning of a better road ahead. Each body is different and your Certified Lymphedema Therapist can determine the best treatment or management plan that works for you. Also, be reassured that there is ongoing research being conducted on Lipedema.


Additional Resources:

Check out our other blogs to learn about Lymphedema and treatment options including lymphedema therapy in Central Arkansas.



Olivia McKee is our Certified Lymphedema Therapist (CLT) on the Advanced Physical Therapy team. She has several years of experience working with patients with lipedema. Olivia treats patients in the Little Rock area and actually sees patients from all over the state. See how Olivia can help! If you have any questions or would like to book an appointment with Olivia McKee, call our Advanced Physical Therapy office: 501-224-5454.

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