Lipoedema is a condition close to my heart. When I first learned of the condition, I immediately recognised it in some of my extended family members. Over time, I've come to realise that I also experience this condition, though my symptoms of pain and inflammation are well managed through the interventions I advocate. 

Lipoedema is a poorly recognized condition that is often confused with obesity, although the condition can show up in those of normal weight, or even in those who are underweight. Research suggests it can impact up to 11% of women and probably has a hormonal component.

Lipoedema is a connective tissue disorder that affects the adipose (fat) cells, resulting in disproportionate fat accumulation in the lower limbs, especially around the hips, thighs, and buttocks. The lower limbs can also be impacted, leading to the appearance of ankle cuffs. The feet are typically spared until later stages of the condition. Impacted areas also experience pain, swelling and frequent, unexplained bruising.

Lipoedema has many presentations

Lipoedema is diagnosed by both stages and types. The types describe where a person experiences lipoedema. Is it only in their upper legs? Their arms and legs? Just lower legs?  The stage is determined by the degree of progression of the condition. In later stages, lymphoedema can occur along with lipoedema, leading to a condition known as lipo-lymphoedema.

What leads to the development of lipoedema?

Research into contributing factors for the development of lipoedema is ongoing, with the amount of research increasing at an exponential rate. I’m excited for what the next 10 years will bring for those with this condition in terms of us understanding the drivers and providing validated treatment recommendations. Research is looking into genetic links with a few target genes already identified.

Our current understanding suggests leaky capillaries may be involved, leading to excess fluid in and around the fat cells with compromised lymphatics leading to slowed removal of this fluid. This excess fluid contains cellular waste and toxins, which potentially invokes an immune system response. Viewed through a microscope, the fluid around the fat cells in lipoedema tissue contains an over expression of highly aggressive immune cells. This process may be what is contributing to the development of fibrosis (scarring) in the fat tissue. The immune over activation in and around the cells likely contributes to the pain many experience with lipoedema.

The scar tissue contributes to the nodules and lobules of fat tissue sufferers experience.  In the earlier stages, this appears as a grainy texture to the skin, like little grains of rice.  As the condition progresses, it can develop into chickpea size nodules, and even bigger.

Does diet help?

Lipoedema doesn’t readily respond to the traditional calories in/calories out paradigm, leading to a great deal of frustration for those experiencing it. More recent anecdotal experience suggests that carbohydrates are playing a role in the development of lipoedema tissue. Many are finding success for the first time with a very low carbohydrate (ketogenic) way of eating.