Lipedema: how to understand that the hips are not just extra fat

What is lipedema

Lipedema is a condition in which fat accumulates predominantly on the thighs, shins, and ankles, and less frequently on the upper arms. This is more common in women.

Lipedema is not due to excess weight, although more than half of people with this disease have it. In thin girls, the contrast between a thin waist and a massive lower part is even more noticeable. At the same time, there is usually nothing unusual on the feet, so a kind of overhanging step is obtained above them.

At first, lipedema looks like a cosmetic problem, but over time it begins to cause pain and severe complications:

  • Lymphedema – swelling due to impaired lymph flow, while the skin becomes hard and cold.
  • Arthrosis of the hip and knee joints. Due to the increased load, they collapse. In order not to remain disabled, the joints will have to be changed.
  • Valgus deformity of the legs – curvature of the legs in the form of the letter X.
  • Varicose veins. Edema and impaired lymph flow increase pressure in the blood vessels, and inflammation in the tissues provokes inflammation of the veins. Curved thick bands are visible on the skin.
  • Gait disturbance. Due to arthrosis, pain and large leg volume, it is difficult for people to walk as usual.

Why does lipedema occur?

Researchers believe that fat cells become abnormally large in lipoedema. They cause the production of hyaluronic acid, which attracts water, so the legs feel heavy. In addition, inflammatory cells rush there, which secrete substances that injure the blood and lymphatic vessels. The body tries to cope with the damage, so bead-like scars form under the skin.

It is unknown why this happens. Most likely, the matter is in certain genes: lipedema is inherited. It is possible that in women with a predisposition it is provoked by hormonal changes, because it often occurs during pregnancy , puberty, menopause, or taking hormones. But so far this has not been confirmed by research.

What are the symptoms of lipedema

Lipedema is characterized by :

  • disproportionate distribution of fat on the legs and sometimes on the arms;
  • dimples and depressions on the skin;
  • pain when pressing on the skin;
  • bruises and hemorrhages;
  • varicose veins;
  • spider veins ;
  • fat sacs above and below the knees.

The severity of symptoms depends on the state of health and the stage of the disease. At the first stage, the legs look normal, but there is already altered fat. On the second, pits appear in the skin, so it becomes soft, cool and similar to a quilt or mattress. On the third, the hips and knees are deformed, lymphedema joins – they feel tight and hard to the touch.

Photo: Usty/Shutterstock

How to differentiate lipedema from other conditions

This is important because the causes of uneven distribution of fat and swelling of the extremities may differ. Therefore, the treatment will be different.

From cellulite

Its correct name is gynoid lipodystrophy . This is a normal condition for the female body. Cellulite ( do not confuse with inflammation of the subcutaneous fat of the same name) appears in 80–90% of women due to estrogens – sex hormones – and a different location of “bridges” from the connective tissue under the skin compared to men.

Cellulite and lipedema are very similar: the texture of the skin changes, becoming bumpy, similar to an orange peel. But unlike lipedema, cellulite is only a cosmetic problem: it does not affect health in any way.

From obesity

Lipedema also occurs in slender people, does not lead to high blood pressure, diabetes and an increase in the risk of heart attack and stroke, and does not go away if you just lose weight. And in obese people, as a rule, there is no pain and bruising when pressing on the skin.

From lymphedema

Lymphedema is swelling of any part of the body (but more often of the arms and legs) that occurs due to problems with the lymphatic vessels. For example, if the lipedema is very advanced and compresses the tissues, it leads to lymphedema.

With lymphedema, the skin is dense and tight to the touch, and with lipedema without lymphatic edema , it is soft.

How to treat lipedema

Since it is impossible to influence the cause, it remains to treat the symptoms and slow the progression of the disease.

Maintain a healthy weight

With lipedema, fat from the legs practically does not go away , even if you lose a lot of weight. But you still need to make sure that it does not become more. This will help delay complications associated with stress on the bones and joints.

Therefore, you need to try to eat right and add physical activity to your daily routine.

Wear compression stockings

Special stockings and bandages reduce pain and discomfort and prevent lymphedema. Such underwear can be recommended by a therapist.

Make an operation

Liposuction helps to remove abnormally enlarged cells – an intervention in which fat is destroyed and sucked off with a special tube. The plastic surgeon will select the appropriate option for the operation.

If lipedema is associated with obesity, it may be necessary to surgically reduce the volume of the stomach.

How to relieve the condition with lipedema

In addition to pain and the risk of complications, lipedema also causes other problems, such as mood and self-esteem.

Move more

Physical activity, especially swimming, brisk walking, and cycling, will help reduce the risk of swelling and obesity.

visit a psychologist

If it is difficult to cope with the symptoms and treatment yourself, you need to contact a psychologist. For example, cognitive behavioral therapy can help.

skin care

The skin can dry out, so you need to remember about moisturizers. Of course, this will not cure lipedema, but the sensations will be better.

Try physiotherapy

It has not been proven to be very helpful for lipedema. But this way you can improve the lymph flow and delay the development of lymphatic edema. Previously, manual lymphatic drainage massage was recommended for this, but recently it is considered less effective than pressotherapy or lymphatic drainage.

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