Lipedema – a neglected fat disorderOn May 17, 2022 by themediafiles
Lipedema – a neglected fat disorder
Lipedema is a medical condition, poorly understood and commonly misdiagnosed as obesity,
cellulite or lymphedema which is seen almost exclusively in wom
en with an occurrence rate of
between 10-15% across the globe. It appears that there is a genetic predisposition as it is
commonly seen families and has a hormonal influence as puberty, pregnancy and menopause
are found to trigger the onset of the disease. Lipedema is like a lifestyle disease which can be
controlled and restricted from progressing.
Lipedema was first identified by Allen & Hines in 1940 in Germany but for reasons unknown was
not accepted and entered in the international classification of diseases by WHO until 2019 and
was not taught in medical colleges.
Lipedema is also known as “the painful fat syndrome”. It is characterised by abnormal deposition
of fat around the hips, buttocks, thighs, legs and sometimes in the arms symmetrically while the
waist is generally slim. The feet and hands are spared and maybe associated with an ankle or
wrist cuff. It is associated with spider veins and varicose veins as the disease progresses and
edema and heaviness of the limbs due to lymphatic weakness. There could be ea
sy bruising with
little or hardly known trauma. As the disease progresses the condition proceeds from lipedema
to lipolymphedema to frank lymphedema. Early identification and intervention helps in delaying
or slowing progression of the disease.
Due to the shape of the individual and the abnormal growth of certain parts of the body
lipedema was wrongly included as a type of obesity and classified as “pear shaped obesity”.
Unfortunately regular dieting, exercises or even bariatric surgery have little impact in the
treatment of lipedema.
Commonly also mistaken to be lymphedema various treatments for the same are tried like
compression bandages and compression stockings but with little or no benefit.
Lipedema is also mistaken for cellulite due to the dimpling of the skin and the rice grain or
nodular irregularities seen in the fat in the buttocks and thighs (orange peel appearance). Some
patients due to the pain, heaviness, change in gait, arthritis, easy bruising and gross change in
body shape can lead to irritability and depression.
There are 5 types and 4 stages of lipedema and earlier the diagnosis and initiation of treatment
the better the long term result and comfortable life they can lead. Depending on the stage of the
disease and the rapidity at which the progress takes place one has to be put in a combination of
therapies like decompressive therapy, medical management or surgery which could range from
lymph sparing water assisted liposuction to treatment of spider veins and/or varicose veins to
management of pain and treatment of stasis ulcers.
Lipedema is a team approach consisting of plastic surgeon, vascular surgeon, physiotherapist,
psychologist and dietician.
Dr. Srinagesh Vadrevu is an experienced plastic surgeon trained in Germany and is educating
and treating patients. He is a pioneer in the treatment of lipedema in India and one of the few
doctors knowledgeable in the management of lipedema across the globe. (Story: Lipedema – a neglected fat disorder)
Dr. V.K. Srinagesh
Consultant Plastic & Cosmetic Surgeon,
Apollo Hospitals, Jubilee Hills.
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