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Lipedema is a painful disorder of fat distribution, a women’s disease that usually affects the arms and legs first and leads to a disproportionate body shape. The condition is often not recognized as such, causing many affected individuals to endure a long journey of physical, psychological, and aesthetic suffering, frequently facing a lack of understanding from their surroundings and prejudices such as “just overweight” and “unathletic.”
The suffering of women is often not taken seriously by those around them and even by doctors. It is important to note:
Lipedema is a disease that cannot be resolved through exercise or dietary changes. Unlike healthy fat cells, the diseased lipedema fat cannot be eliminated with diets and sports. The condition is NOT self-inflicted; emphasizing this is very important to our specialists.
We, the expert team at LIPOCURA®, support you from the initial diagnosis through the development of a treatment plan tailored to you personally, including both conservative therapies and liposuction for lipedema, i.e., the surgical removal of the diseased fat. We are there for you before, during, and after your treatment, always offering a listening ear and helpful tips and advice.
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Reviewed by author
Dr Katrin Lossagk is a highly specialised lipoedema expert and founding member and medical director of LIPOCURA®. Research into the clinical picture and a holistic treatment approach are particularly close to her heart.
Dr. med. Katrin Lossagk
Medical director Specialist for plastic and aesthetic surgery
Table of contents
Does lipedema arise from being overweight? The answer is a clear No. The disease does not result from inactivity or poor diet, but from an uncontrolled change in adipose tissue. Coexisting obesity (adiposity) can, however, negatively affect the course of the disease.
The exact causes of lipedema are not yet fully understood, but various factors can promote the onset and/or worsening of the condition. Comorbidities such as postural issues, strain on joints and muscles, or inflammation in hanging skin folds are also known.
A genetic predisposition that is inherited within families is frequently observed. If lipedema occurs in the mother and/or grandmother, daughters or granddaughters may also be affected. Inheritance can also occur on the paternal side.
Largely, women are affected; therefore, lipedema is often associated with estrogen-related changes.
Lymphatic vessels, which transport lymph, waste products, blood cells, and nutrients, have impaired permeability in lipedema patients, leading to increased fluid release into the connective tissue. The subcutaneous fat cells absorb this fluid and exert increased pressure on the vascular system. This creates a vicious cycle, and even more fluid is released from the blood vessels. Due to compression of the lymphatic vessels, less fluid can be removed. The result is a buildup of water in the tissue, a so-called edema.
A key distinguishing feature of lipedema compared to other conditions is the symmetrical occurrence of the fat distribution disorder—usually in both legs or arms. Other typical signs include pressure-sensitive pain, feelings of tightness, and a clearly visible disproportion between the affected limbs and the rest of the body.
Detailed information on these and other symptoms can be found on our Lipedema Symptoms page.
If you are unsure whether lipedema is present, we would like to offer support. With our specially developed self-test — the first of its kind in Germany — you can make a preliminary assessment of whether there are signs of lipedema. These insights can not only serve as an initial indication, but also provide a solid basis for the consultation with our specialists.
Take a few minutes and complete the lipedema test.
Medically, lipedema is classified as a chronic disorder of fat distribution and is generally divided into three stages. This classification is based on the extent of volume increase in the arms, legs, and hips, as well as structural changes in the skin and subcutaneous fat tissue.
Important to know: Pain perception is not tied to the stage. Even in the early stage—despite still slender extremities—many patients report intense pain and feelings of tightness.
Further information:
Lipedema Stage I – Symptoms & early signs
Lipedema Stage II – typical complaints
Lipedema Stage III – progressive limitations
The body areas affected by lipedema vary individually but typically involve the lower and/or upper limbs symmetrically.
Fat distribution in the legs and arms differs from person to person. Some are primarily affected in the thighs or forearms, while in others the entire leg or entire arm is involved. However, the disorder of fat distribution is always symmetrical. Painful fat distribution disorders or increases in volume—even if it is empirically proven not yet to be lipedema—can affect various body regions:
In contrast to staging, classification focuses on the specifically affected body areas.
Type 01
Here, the subcutaneous fat tissue in the buttocks and hips is predominantly pronounced, leading to the characteristic saddle bags.
Type 02
In this type, lipedema extends to the knees, with increased fat accumulation on the inner sides of the knees.
Type 03
In this manifestation, the condition extends from the hips to the ankles. The disease now ranges from the hips down to the ankle joints.
Type 04
Here, the fat tissue of the arms is additionally affected, while the wrists are spared.
Important to know! This classification does not fit every patient. There are cases in which patients perceive symptoms typical of lipedema across the entire body. Whether you are affected by this condition can be determined through a comprehensive examination by a specialist during an individual initial consultation.
We would like to emphasize that our assessments below are based on many years of experience in treating and cooperating with individuals affected by lipedema. A definitive diagnosis of lipedema cannot be made solely based on specific cellular features. Therefore, we consider the common definition—and the rather restrictive view that lipedema affects only the extremities—to be outdated; see the S1 Guideline on Lipedema.
Diagnosis begins with a detailed medical history, recording typical complaints such as pain, feelings of tightness, and a family predisposition. This is followed by a physical examination to assess noticeable fat distribution patterns— first from a distance, then in the skin and soft tissue areas.
Further details on the process and methods of diagnosis can be found on our Lipedema Diagnosis page.
At the first signs of lipedema, early medical evaluation by a specialized physician should be sought.
After a confirmed diagnosis, two therapeutic approaches are usually considered: conservative measures such as compression therapy, manual lymphatic drainage, and joint-friendly exercise, as well as the surgical removal of the pathologically altered adipose tissue (liposuction).
Additionally, a healthy lifestyle with a balanced diet and regular physical activity can improve well-being and sustainably alleviate symptoms.
Detailed information can be found on our Lipedema Treatment page.
Coverage for conservative measures such as compression garments and manual lymphatic drainage is generally provided by basic insurance—depending on medical indication and approval.
For detailed information on treatment procedures and the organizational process related to treatment costs, please refer to our information page: Liposuction Costs and Service Package
Although lipedema is commonly regarded as a condition that primarily affects women—partly due to differences in the structure of adipose tissue between men and women—men can also develop lipedema. This is extremely rare—only a few cases are known—and may be caused by hormonal therapies, severe liver disease, or hormonal disorders. Therapeutic measures are independent of gender.
Lipedema is currently considered incurable, as conservative measures can alleviate the condition but cannot halt or reverse it. However, complaints can be significantly reduced if conservative therapy is applied consistently and continuously.
In many cases, surgical therapy through liposuction is an effective addition to sustainably reduce pain, feelings of tightness, and movement restrictions. Many affected individuals report a noticeable improvement in quality of life and everyday functioning after the procedure.
In lipedema, the adipose tissue under the skin is pathologically altered. Impaired function of the lymphatic vessels leads to poorer fluid drainage and fluid accumulation in the tissue—resulting in edema.
At the same time, there is an increase and hardening of fat cells as well as the formation of palpable nodules in the tissue. The condition often occurs during phases of hormonal changes, such as puberty, pregnancy, or menopause. Hormonal contraceptives or persistent stress can also have an influence.
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