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Lipedema
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- 2. IS THIS PICTUREFAMILIAR TO YOU ? ▸ It’s one of the diseases that unrecognized or misdiagnosed; despite an estimated prevalence of 10% in the overall female population.
- 3. WHAT IS LIPEDEMA? Lipedemais a chronic medical condition characterized by a symmetric buildup of adipose tissue (fat) in the legs and arms. A common but under recognized disorder.
- 4. SYMPTOMS OF LIPOEDEMA ▸your legs appear symmetrically swollen – swelling can occur from the hips down to the ankles and your legs appear column-like; the feet are not usually affected ▸ affected areas feel 'spongy' and cool and the skin is generally soft and subtle ▸ you bruise easily in the affected areas ▸ you may have small varicose or spider veins in the affected areas ▸ your legs and other affected areas are sensitive to touch ▸ your legs and other affected areas hurt and feel uncomfortable – swelling may become worse in the afternoon, evening, after activity or in hot weather.
- 5. SYMPTOMS OF LIPOEDEMA ▸People with lipoedema may fi nd it dif fi cult to walk or to participate in physical activities, exercise and other aspects of everyday life. Restrictions in mobility may contribute to people with lipoedema developing low self-esteem and other problems such as anxiety, as well as restricting their social life. Buying clothes is often dif fi cult for people with lipoedema, as their upper and lower body are very different in size.
- 6. DIAGNOSIS OF LIPEDEMA ▸Lipedema is dif fi cult to evaluate and diagnose and is sometimes even misdiagnosed. So, it must be done by an expert medical professional. Imaging studies like Ultrasound, MRI, Lymphoscintigraphy and Lymphanodiogram may be bene fi cial in diagnosing Lipedema. ▸ Many healthcare providers are not familiar with lipedema. If you suspect you have lipedema but have not been diagnosed, you may want to consider seeing a vascular specialist. Vascular providers are typically well-informed about the most common causes of leg pain and they can help rule-out other causes or contributors to your symptoms. ▸ However, it must be known that the test results may appear normal in the early stages of Lipedema.
- 7. CAUSES OF LIPEDEMA ▸The exact cause of lipedema is unknown. But the condition runs in families and may be inherited. The condition occurs almost exclusively in women, and usually starts or gets worse at the time of puberty, pregnancy or menopause. Because of this, there is likely a connection to hormones.Lipedema is not caused by obesity but more than half of patients with this condition are overweight or obese. Dieting can cause you to lose weight in your upper body without changing the areas affected by lipedema.
- 8. IS IT OBESITY? ▸No. Obese fat occurs throughout the body. ▸ In lipedema, the fat occurs in the limbs, sparing the hands and feet. People with early- stage lipedema typically do not have diabetes, high cholesterol, or high blood pressure.
- 9. IS IT LYMPHEDEMA? ▸No. The swelling in lymphedema often affects only one side of the body, and includes the hands and feet. ▸ Furthermore, lymphedema can be diagnosed with imaging or genetic tests..
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- 11. STAGES OF LIPEDEMA ▸Lipedema is divided into four stages, which describe the structure of the tissue and the texture of the skin. In this common form of stage classi fi cation, a very important parameter of lipedema, pain, is not taken into account. Even in stage I, when the skin surface still seems very smooth, patients can suffer from massive pain in the extremities, which makes long walking and standing impossible. Findings such as this must be treated differently from a patient in stage I who has little or no pain.
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- 13. STAGES OF LIPEDEMA ▸In this early stage, it may be dif fi cult to distinguish lipedema from excess fat on the lower body. Instead, providers look for certain characteristics, including: ▸ Extra fat in the buttocks, thighs, and calves, but not in the ankles or feet ▸ Pain resulting from fi rm pressure on the affected area ▸ Skin and tissue that do not indent (pit) when a fi nger is pressed into the area STAGE 1
- 14. STAGES OF LIPEDEMA ▸Without treatment, lipedema will progress to the next stage. Signs of stage 2 include: ▸ Fat deposits or nodules under the skin ▸ Discoloration and an uneven or bumpy appearance of the skin STAGE 2
- 15. STAGES OF LIPEDEMA ▸Fat continues to accumulate on the lower body and can make mobility dif fi cult. Other signs of this stage include: ▸ Excess fat from buttocks to ankles ▸ Large fat deposits around the knees ▸ Folds of skin and large masses of fat give the appearance of a deformity STAGE 3
- 16. STAGES OF LIPEDEMA ▸This advanced stage is also known as lipo-lymphedema. It may take many years (more than 10) for the condition to advance to this stage. Eventually, fat deposits from lipedema may block or damage lymph nodes, preventing lymphatic fl uid from draining properly. At this point, you may experience: ▸ Swelling over the entire lower body, including previously unaffected areas such as the ankles and feet ▸ Uneven distribution of the abnormal fatty tissue in the legs, which can lead to dif fi culty moving ▸ Development of lipedema in the arms STAGE 4
- 17. COMPLICATIONS OF LIPOEDEMA ▸Over time, fat cells block the vessels of your lymphatic system, which normally helps balance body fl uid levels and protect against infection. This blockage prevents the proper drainage of lymph fl uid, leading to a buildup of fl uid called lymphedema. ▸ If not treated, lymphedema can lead to problems such as infections, delayed wound healing, development of scar-like tissue called fi brosis, and hardened skin in the legs.
- 18. COMPLICATIONS OF LIPOEDEMA ▸complications that are detrimental to mental health and life-threatening can occur. These complications include mental problems such as eating disorders and generalized complications including hypertension, diabetes, and heart failure. Furthermore, patients may develop pseudo-Bartter’s syndrome, which is characterized by hyperaldosteronism and hypokalemia due to the excessive use of diuretics, and joint problems in the spine or lower extremities due to excessive body weight.
- 19. TREATMENT OF LIPOEDEMA ▸1- Compression ▸ Compression garments help to force in fl ammatory products out of the legs and prevent them from building back up. ▸ Should be worn during the day and removed at night, prior to bedtime. ▸ Consistent use of well- fi tting compression garments can help reduce the remodeling and enlargement of affected limbs. ▸ Compression garments can sometimes be uncomfortable for lipedema patients so there can be some degree of trial-and-error.
- 20. ▸ 1-Compression ▸ Optionsinclude knee-high socks, thigh-high stockings, pantyhose, and leggings ▸ Compression leggings may be the most comfortable since there are no tight bands around the legs. ▸ Leggings should be avoided if there is swelling in the feet. ▸ Try starting with lighter compression (15-20 mmHg), and work up to tighter compression (20-30 mmHg). ▸ Some patients may also bene fi t from a device called a pneumatic compression pump which consists of sleeves for the legs that in fl ate with air, gently massaging the legs and encouraging the fl ow of lymphatic fl uid.
- 21. ▸ 2-diet ▸ Lipedemapatients may bene fi t from an anti-in fl ammatory diet. ▸ Avoid processed and pre-made foods and opt for whole-food, homemade options. ▸ Avoid saturated fats and meats and opt for a plant-based diet with occasional lean proteins. ▸ Eat more fruits and veggies. ▸ Drink plenty of water.
- 22. ▸ 2-diet ▸ Incorporatenatural anti-in fl ammatories, like garlic and turmeric, into your cooking or add a supplement. ▸ Weight management is important to slow disease progression. More fat = more opportunity for symptoms to develop or worsen. ▸ It is important that note that weight loss does not cure the discomfort associated with lipedema and is therefore an inappropriate stand-alone therapy.
- 23. ▸ 3-Exercise ▸ Regular,low-impact exercise can help to manually force in fl ammatory products in the tissues out of the legs. ▸ Exercise may also help to reduce the symptoms of hormonal fl uctuations.
- 24. ▸ 4-Liposuction ▸ Manypatients become discouraged when weight loss fails to alleviate their pain. It may not even signi fi cantly change the size of their legs. Lipedema patients can consider liposuction for better results. Removing the in fl amed fat cells appears to be very effective for many patients. ▸ Before considering liposuction for lipedema, seek out a plastic surgeon who specializes in the disease.
- 25. ▸ 5-Vascular Care ▸Some patients with lipedema may also have deep or super fi cial vein disease that is contributing to their symptoms. ▸ Not all vein disease is obvious but some signs and symptoms include: ▸ Spider and/or varicose veins ▸ Leg swelling ▸ Leg Discoloration - Darkening of the skin around the calves or ankles ▸ Heaviness or fatigue of the legs ▸ Itching or restlessness of the legs ▸ Treating vein disease can help to eliminate some leg symptoms like discomfort and swelling.
- 26. RESOURCES: ▸ American LymphedemaFramework Project www.alfp.org ▸ Canadian Lymphedema Framework www.canadalymph.ca ▸ Fat Disorders Research Society www.fatdisorders.org. ▸ International Lymphoedema Framework www.lympho.org ▸ Lipedema Foundation www.lipedema.org ▸ Lipoedema Australia www.lipoedemaaustralia.com.au ▸ Lipoedema UK www.lipoedema.co.uk ▸ Lymph Notes www.LymphNotes.com. Online resource directory, practical information, and books. ▸ Lymphatic Education & Research Network www.lymphaticnetwork.org ▸ National Lymphedema Network (NLN) www.lymphnet.org.