Standard of care for lipedema in the United States

Abstract

Background Lipedema is a loose connective tissue disease predominantly in women identified by increased nodular and fibrotic adipose tissue on the buttocks, hips and limbs that develops at times of hormone, weight and shape change including puberty, pregnancy, and menopause. Lipedema tissue may be very painful and can severely impair mobility. Non-lipedema obesity, lymphedema, venous disease, and hypermobile joints are comorbidities. Lipedema tissue is difficult to reduce by diet, exercise, or bariatric surgery. Methods This paper is a consensus guideline on lipedema written by a US committee following the Delphi Method. Consensus statements are rated for strength using the GRADE system. Results Eighty-five consensus statements outline lipedema pathophysiology, and medical, surgical, vascular, and other therapeutic recommendations. Future research topics are suggested. Conclusion These guidelines improve the understanding of the loose connective tissue disease, lipedema, to advance our understanding towards early diagnosis, treatments, and ultimately a cure for affected individuals.

Management of Lipedema with Ketogenic Diet: 22-Month Follow-Up

“…Today, special nutrition is not considered a treatment of lipedema. However, it should have an important place, because it could represent a way, in the long term, to manage the inflammation-mostly subclinical-that is almost always present [2] in this condition, which almost exclusively affects the female population, and so it is considerate gender-related [3,4]. There is undoubtedly a genetic component, as already hypothesized by Herbst et al [5], and partially confirmed by the study of Polacci et al [6], which highlighted the mutation of the gene AKR1C1.…”

Prevalência e fatores de risco para lipedema no Brasil

“…Sensitivity to touch was mentioned on the questionnaire by 35.5% of the Brazilian women, leg pains by 90.3%, swelling by 51.6%, and feelings of water retention in the legs by 64.5%, which are characteristics that fit the current diagnostic criteria. 35 …”

“…Observamos que a sensação de peso foi citada por 51,6% das brasileiras, com equimoses frequentes em 54,8%, apresentando correlação positiva, assim como a queimação nas pernas. A sensibilidade ao toque foi mencionada no questionário em 35,5% das brasileiras, dor nas pernas em 90,3%, inchaço em 51,6% e sensação de retenção de líquido nas pernas em 64,5%, características que preenchem os critérios diagnósticos atuais 35 .…”

Reply letter to the editor regarding ultrasound examination for en-suite measurements in lipedema

“…Another common problem is lipedema’s name, which sounds like lipidemia or lipemia, which would mean alteration of blood fats, increasing confusion even more. 2 Despite its unclear etiopathogenesis, 3 lipedema is currently considered a loose connective tissue and lymphatic disease, 4 not only a fatty tissue disease.…”

“…There are some similarities, but we believe progression in lipedema treatment knowledge is harmed when a clear distinction is not performed. Lipedema is an inflammatory disease with fat deposition and lymphedema as a consequence, 4 while lymphedema is a clinical manifestation of impaired lymphatic transport with inflammation as a consequence. 8 Partial improvement of lipedema symptoms doing a lymphedema treatment strategy could happen because of lymphatic vasculature dysfunction caused by lipedema inflammation.…”