Because it causes localized fat and sagging, lipedema is commonly seen as obesity or overweight. But we are talking about different conditions.

Lipedema is a chronic vascular disease much more common in women, which tends to appear at puberty, during pregnancy, or after menopause. In short, there is swelling and an accumulation of fat, especially in the lower limbs.

“The fat from lipedema is usually painful and concentrates on the hips, thighs, and calves. Some small nodules may also appear,” explains Andrea Ferri Catib, a nutritionist, sports medicine specialist, and member of the Brazilian Society for Physiology Studies (Sobraf). “The appearance of bruises, often without even trauma, is common,” she adds. The patient may also have hypersensitivity to touch, ligament laxity, and a lot of skin flaccidity.

Other symptoms include disproportion between the legs and torso, cellulite, a feeling of heaviness in the legs, and fatigue. Over time, there is a risk of deformities and mobility problems.

The fat from obesity, according to Catib, is distributed more uniformly throughout the body. And it is also eliminated with less difficulty through diet and physical activity, which does not happen in cases of lipedema. In fact, this condition is not always accompanied by excess weight.

“There is probably a connection with genetics, but no gene has yet been identified. There also seems to be a relationship with estrogen, since it affects practically only women and, normally, in phases when there is an increase in this hormone, such as puberty and pregnancy,” says Catib. “In men, the few cases reported in medical literature were of patients who had liver problems or testosterone deficiencies,” she adds.

Lipedema treatment requires a multidisciplinary team, comprised of an angiologist, vascular surgeon, nutritionist, physical therapist, and, in some cases, a psychologist. Tests are also performed to detect endocrinological diseases that could cause similar symptoms.

In the opinion of Fernando Amato, plastic surgeon and member of the Brazilian Society of Plastic Surgery (SBCP), surgery should be the last option: “Only after trying clinical treatment for some time should we indicate liposuction.”

In addition to multidisciplinary monitoring, it is recommended to avoid excessive consumption of foods such as pork and beef, processed meats, soft drinks, alcoholic beverages, and industrialized products, which can intensify the inflammation of lipedema. Exercise, on the other hand, is highly recommended.