What are the main causes of lipedema

Lipedema: which treatment is useful?

Status: 03/12/2021 6:39 p.m.

With lipedema, the legs or arms get thicker and thicker. Women in particular are affected by the uncontrolled growth of adipose tissue. Usually only an operation will help.

Lipedema is a disorder of fat distribution that occurs almost exclusively in women. This leads to an increase in fat, especially on the legs, hips, buttocks and in some cases on the arms. Around 3.8 million people in Germany suffer from lipedema. However, experts assume that the number of unreported cases is very high because many people affected believe that they are eating the wrong foods or exercising too little. Doctors don't always recognize the disease, either. It is often mistaken for lymphedema or obesity. Only in the past 20 years has lipedema become a little more conscious of the medical community.

Symptoms and causes of lipedema

A disproportionate relationship between the individual body parts is typical of lipedema. In extreme cases, affected women wear size XS on the upper body, but XXL on the thighs. There is also constant pain.

The exact causes of lipedema have not been clarified. Since the first symptoms usually occur during puberty or after pregnancy, experts suspect hormonal triggers. The tendency to lipedema appears to be hereditary.

Lumps and edema in adipose tissue

In lipedema, the fat cells multiply in an uncontrolled manner in the fatty tissue of the subcutaneous tissue. Hard knobs can be felt in the affected areas, while the ankles and wrists remain slim.

There is water retention between the fat cells - so-called edema. They press on the surrounding tissue, causing the legs to feel tight and heavy, especially in the evening, after standing for a long time and in warm temperatures. The affected areas are very sensitive to touch and pressure. Bruises occur even after small bumps.

Lipedema disease has three stages

With a mostly slim upper body, the legs appear disproportionately thick in lipedema. The disease has three stages:

  • in the Stage I. the subcutaneous layer is still evenly thickened.
  • in the Stage II it becomes knot-shaped and leads to bumps on the surface of the skin.
  • in the Stage III the tissue hardens increasingly, there are pronounced fat bulges, which can lead to an impediment to walking in the knee and thigh area.

Can lipedema be cured?

The accumulation of fat cannot be reduced by dieting or exercising. So far it has not been possible to treat the cause of lipedema. Therefore, only the symptoms can be treated. Often the symptoms can be alleviated through

  • a complex physical decongestive therapy
  • a combination of regular manual lymphatic drainage, physiotherapy and wearing compression stockings

Sucking off fat: surgery from stage II

In the case of lipedema, the affected areas are sensitive to touch and pressure.

From stage II onwards, targeted liposuction (vibration liposuction) has also proven itself. The diseased fat masses are sucked out under local anesthesia with a very thin, rounded and vibrating probe. In this way, normal body shapes can be restored and the symptoms permanently alleviated. In addition, an operation as early as possible can prevent the development of dangerous secondary diseases such as lymphedema or open legs.

After a confirmed diagnosis, experts recommend having the procedure performed in a specialized clinic, as the operation requires a lot of experience.

Stage III surgery is currently funded

Until recently, the statutory health insurance companies only covered the costs of several thousand euros per procedure in individual cases: The long-term effectiveness of the method was not sufficiently proven. Surgical liposuction for stage III lipedema has been a health insurance benefit since 2020. The takeover is limited to 2024. By then, findings from a test study initiated by the Federal Joint Committee (G-BA) should be available, which examines the effect of liposuction in all stages of lipedema.

Conservative treatment is often more expensive than surgery

Conservative treatment with compression stockings and lymphatic drainage is often significantly more expensive than surgery (as of 2019):

  • Conservative therapy: Depending on the health insurance company, four custom-made compression stockings for 700 to 1,200 euros each and ten prescriptions for ten lymphatic drainages (500 to 550 euros each) are paid for. After one year that is around 7,800 to 10,300 euros, after ten years it is 78,000 to 103,000 euros.
  • surgery: The one-time procedure for lipedema costs around 18,000 euros. The health insurances usually do not cover the costs because the item is not in the catalog of benefits of the statutory health insurance.

Gentle movement relieves pain

The lipedema cannot be "trained away". Regular exercise can prevent lipedema from developing into painful lymphedema (lipo-lymphedema). Targeted training helps to alleviate leg edema.

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The Movement Docs | 03/15/2021 | 9:00 p.m.