Lipedema

Lipedema (alternately, lipoedema) is a chronic fat and connective tissue disorder that affects women almost exclusively.  Symptoms include painful, symmetrical fat distribution on the hips, legs, and sometimes arms; and a distinct change in tissue structure.   Unless obesity is also present, the fat deposits do not generally affect the torso above the hips, and the torso may appear slender in comparison to the hips and legs. 

Clinically, lipedema may be associated with microvascular fragility, or structural weakness of small blood vessels within the fat tissue. This weakness may cause some tiny vessels (capillaries and venules) to break and leak fluid, which needs to be picked up by the lymphatic system. At later stages, this fluid accumulation may lead to chronic lymphedema. At earlier stages, this fluid may be bound up in interstitial structural components called proteoglycans.  Some patients may also have hypermobile joints.  

It is indeed possible to have both lipedema and lymphedema.

Patients with lipedema may develop secondary lymphedema due to lipedema tissue effects on capillary leakage, mechanical disruption of lymphatic drainage, or other causes.  Chronic venous insufficiency may also be aggravated by the fat deposits, leading to development of secondary phlebolymphedema. Lymphedema appearing together with lipedema is referred to by some clinicians as lipo-lymphedema.


Lipedema patients may have normal weight or may become overweight. A medical diagnosis is needed to differentiate between obesity and lipedema occurring with obesity or on its own.  A diagnostic differentiator between lipedema fat and obesity is that lipedema tissue is painful and obesity fat is not.

Conservative therapeutic treatments for lipedema include compression garments, pneumatic compression therapy systems, exercise, and skin care.  Manual lymph drainage may be recommended in patients who have lymphedema as well as lipedema. 

Other treatments include diet and lifestyle modification, and surgical procedures such as specialized liposuction performed by a surgeon trained in the special requirements of this procedure for cases of lipedema. 

Lipedema and cellulite can look similar, but they are very different. Cellulite is a common cosmetic change that causes dimpled or uneven skin and is usually painless. Lipedema is a chronic condition involving abnormal adipose and connective tissue, most often affecting the legs and sometimes the arms in a symmetrical pattern. Unlike cellulite, lipedema may be associated with pain, tenderness, easy bruising, heaviness, and swelling, while the feet are typically spared. Because appearance alone cannot confirm lipedema, persistent pain, disproportionate limb enlargement, or easy bruising should be discussed with a healthcare professional.

Lipedema care is individualized and may include exercise, compression, manual therapy, lifestyle support, and, for some patients, lipedema reduction surgery. Surgery can reduce affected adipose tissue and may help relieve symptoms, but it is an invasive treatment and is not appropriate or necessary for every person with lipedema. Pneumatic compression therapy offers a non-invasive option for ongoing symptom management. Clinical research with Lympha Press® has demonstrated improvements in fluid accumulation, leg volume, swelling, tenderness and pain, supporting its role as part of a comprehensive lipedema management plan. For patients who do undergo surgery, compression may also remain part of pre- and post-operative care according to the treating specialist’s recommendations.

Lipedema is commonly described in three stages based mainly on changes in the skin and underlying fatty and connective tissue. In Stage 1, the skin usually appears smooth, although the tissue beneath it may already feel thickened or nodular. Stage 2 is characterized by more noticeable irregularity of the skin and larger nodules within the tissue. In Stage 3, tissue changes become more pronounced and larger folds or lobules may develop. Importantly, lipedema stage does not necessarily reflect symptom severity. Someone with earlier-stage lipedema may still experience significant pain, tenderness, heaviness, swelling, or limitations in daily life.

Lipedema management should be guided by the person’s symptoms, functional needs and clinical assessment, not by stage alone. Compression is an established part of conservative lipedema care and may help manage pain, swelling and feelings of heaviness. Lympha Press® provides sequential pneumatic compression that can be incorporated into an individualized treatment plan to support fluid movement and symptom management. In a 2025 clinical study of women with predominantly Stage 2 lipedema, adding at-home Lympha Press® Optimal Plus therapy to compression leggings was associated with reductions in leg volume and tissue fluid, together with improvements in pain, swelling, heaviness and quality of life.

Living with lipedema is different for every person. The visible stage tells only part of the story, which is why treatment should focus on the symptoms that affect you and your everyday life.