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Unpacking Lipedema: What Is It and How to Improve It

Lipedema is a condition that predominantly affects women. In fact, it affects up to 11% of the female population. It is a condition that you may not have heard of, however, you may have seen it in individuals or seen it in your body. Here's what it is and how you can improve it.

What Is Lipedema?

An image of legs with Lipedema and varicose veinsLipedema is a condition that results in a buildup of fat cells in the lower part of the body including the buttocks, thighs, and calves. Over time, it can also affect the upper arms. The fat cells distribute themselves irregularly and this results in the fat cells appearing nodular and feeling like rice.

Lipedema may sound similar to the condition lymphedema. However, these two conditions are different. Lymph fluid is a fluid produced by your body that removes bacteria, viruses, and waste products. Lymphedema is when the lymph fluid cannot drain properly leading to a buildup of lymph fluid.  Whilst these two conditions are different there is a link between them. With lipedema, the build-up in fat cells can over time block the blood vessels. This results in the lymph fluid not being able to drain adequately, causing lymphedema.

Lipedema is classified into four different stages, with stage one being the early stage of the condition and stage four being the late stage of the condition.

Stage One of Lipedema

The individual's skin is smooth to the touch. However, a healthcare professional can feel nodules of enlarged fat during an examination. There may be some pain and bruising.

Stage Two of Lipedema

The surface of the skin becomes uneven, and the skin develops dimples, indentations, and develops a pattern that is similar to the pattern of a mattress. The amount of fat in stage two increases from stage one.

Stage Three of Lipedema

The fat tissue starts to thicken, and due to the thickening as well as inflammation, the individual starts to develop large extensions of skin and fat that make the legs look like columns. These extensions start to put pressure on the individual's joints and can affect mobility. The thickening of the tissues causes a reduction in the blood and lymph flow out of the fatty tissue. This causes the protrusion to continue to grow.

Stage Four of Lipedema

The reduction in lymph flow causes lymphedema and the two occur simultaneously.

What Causes Lipedema?

The cause of lipedema is unknown. However, there are theories as to why lipedema occurs.

Doctors suspect genetics increase the risk, as 60% of individuals with the condition have a family member who had the condition.

Hormones also are thought to play a role. During puberty, pregnancy, and menopause there are fluctuations in the hormones estrogen and progesterone. This fluctuation, especially the fluctuation of estrogen, is thought to increase the risk of lipedema occurring. In males with lipedema, it was found that testosterone levels were low whilst estrogen levels were high.

What Can You Do About Lipedema?

Many remedies can be used to relieve symptoms of lipedema and delay the progression.


When you think of massage, you may be thinking of the relaxing massage in a day spa. This form of massage however is slightly different. This form of massage is a form of manual lymphatic drainage and aims to increase the movement of lymph fluid in your body.

The pressure is light to medium, and the massage therapist will apply long strokes to the skin to help increase the movement of the lymph fluid. This can help to reduce the lymph fluid from building up in your tissue and can help reduce swelling that can occur during lipedema.

Lymphatic drainage massage can be practiced by yourself. However, for optimal results, it is best to receive this form of massage from a certified practitioner.


An image of a person putting compression stockings onCompression works in a similar way to massage and works to prevent the build-up of lymph fluid. Not only does compression therapy reduce the build-up of lymph fluid but it also helps to:

  • Improve distorted shapes of limbs
  • Improves mobility
  • Reduce inflammation and pain

Compression garments include socks, stockings, and shorts that cover the mid-thigh. These garments apply pressure to the part of the body it is applied to. Compression garments can be made from different types of materials and can apply different amounts of pressure. For a garment to be medical grade, it needs to apply a specific amount of pressure. These garments are recommended by healthcare practitioners.

These garments can be worn continuously or, depending on the individual and the stage of lipedema they are experiencing, can be worn at night. Compression garments designed to be worn at night are thicker than garments designed to be worn during the day and have extra padding to help to break up thickened tissue. As they are thicker and padded, it can take time for the wearer to get used to wearing the garment.

Using compression garments can take some trial and error whilst trying out different pressures and different forms of garments. It is recommended that you use a lower pressure garment in the beginning, and then increase to a higher pressure as you get used to it.

Pneumatic Compression Pump

A pneumatic compression pump is another form of compression therapy that can provide relief to lipedema. It consists of sleeves that cover your legs. These sleeves then inflate with air. Once the sleeves inflate, it causes the pressure to increase, and it gently massages your legs. This pressure encourages the movement of the lymph fluid. This pump can be used daily and can provide relief from pain. It is beneficial, especially, for individuals experiencing lipedema with lymphedema.


Exercise has multiple benefits for individuals currently experiencing lipedema. Some of these benefits include:

  • Improves the movement of lymph fluid around the body
  • Increases blood flow
  • Increases the amount of oxygen to muscles
  • Reduces inflammation
  • Weight management
  • Stimulates the release of brain hormones, enhancing mental health

Aerobic and strength training are two forms of exercise that can help to relieve symptoms of lipedema. Aerobic exercises focus on heart health and general fitness whilst strength training focuses on increasing your muscle mass. Both forms of exercise help to improve the movement of lymph in your body and are recommended. If you are unsure of how to start exercising, a healthcare professional specializing in exercise can help design a training program for you.

Note that if you have certain health conditions, like advanced adrenal fatigue, it is important to start very gently with exercise to avoid causing a cortisol spike and overworking your body.

Weight Loss

Having a heavier weight increases the risk of developing lipedema. It was found that 85% of lipedema patients were obese. Lipedema is an abnormal accumulation of fat cells. If the weight is higher, the chances of more fat cells are higher, and more symptoms such as inflammation can occur. By managing your weight, you can manage the number of fat cells, therefore, reducing the progression of the condition.

Nutrition is an important component in managing your weight and can help in reducing additional fat cells. Nutrition focusing on drinking water every day, including more fruits and vegetables, reducing processed foods and saturated fats, and increasing your consumption of unsaturated fats, specifically fish oils, can help in reducing inflammation. Certain spices such as turmeric and garlic are known to have anti-inflammatory properties and including them in your diet can potentially help reduce inflammation as well.

Skin Care

An image of a woman in the shower washing her legsIn lipedema, the skin affected can become stretched and thin, or on the opposite end, it can feel thicker. These changes in the skin increase the risk of the skin becoming infected. To prevent this from happening, it’s important to practice good skin care. Skin care includes cleaning, checking, and moisturizing.


Cleaning your skin helps to remove bacteria that can cause infection. When you clean the part of your body experiencing lipedema, be careful and pay attention to skin folds and the skin between the toes. Once cleaned, dry the area gently.


After cleaning, it is important to check the skin and check for signs of infection. These signs include redness, scratches, and bites. If the skin becomes damaged, clean and apply appropriate care to the area. If the area is red and shows signs of infection, contact your healthcare provider.


After checking the skin for signs of infection, moisturizing the skin can help to hydrate the skin and can prevent the skin from cracking. When you moisturize, apply it gently, being aware of the skin folds and the skin between the toes.


One of the final remedies used in lipedema is the use of liposuction. It involves the surgical removal of inflamed fat cells. This procedure can help individuals experiencing lipedema, especially in the advanced stages of lipedema, experience relief from the pain and inflammation caused by the fat cells.

Lipedema and Adrenal Fatigue Syndrome (AFS)

Adrenal Fatigue Syndrome (AFS) is a group of symptoms individuals experience as a result of chronic stress. When you experience stress, your adrenal glands, two glands that sit above your kidneys, release stress hormones. These stress hormones help your body to respond and adapt to the stress.

During times of chronic stress, the adrenal glands become depleted and the amount of stress hormone released reduces. This then results in the individual experiencing symptoms such as weight gain, sleep problems, and mental health disturbances.

The NeuroEndoMetabolic (NEM) stress response supports your adrenal glands. Six circuits of related organ systems make up this NEM system, and one circuit is the inflammation circuit. The immune system, gastrointestinal tract, and gut microbiome make up this circuit.

During AFS, the inflammation circuit can become imbalanced and can cause an increase in mast cells. These cells are part of the immune system, and an increase in these cells can cause bumps in the skin, pain, and an increase in inflammation. This can exacerbate lipedema.

Not only does AFS affect lipedema but lipedema can also affect AFS. An increase in fat can increase the amount of hormones the adrenal glands produce. Since lipedema is an accumulation of fat cells, lipedema can increase the number of hormones produced. This increase in hormones increases the chances of the adrenal glands becoming depleted and therefore increases the risk of AFS developing.

Cautions With Lipedema and AFS

If you are currently experiencing lipedema as well as AFS, it is important to exercise caution when choosing remedies. During AFS, your body can become sensitive to external products. This includes the material of compression garments and pumps.

An image of a woman exercisingDoing high-intensity exercise can also increase cortisol levels and may cause an adrenal crash, so only gentle exercises are recommended with AFS.

If you are currently experiencing lipedema with AFS, it is important to chat with your healthcare provider. Your healthcare provider can help design a plan for you that can provide relief from AFS and lipedema without your body experiencing severe reactions.

Final Thoughts

There are multiple remedies that can help to provide relief from lipedema. These remedies are best when used together and can slow the progression of lipedema as well reduce the pain and inflammation.

If you are experiencing lipedema and need help finding ways to manage it that support your overall health, you can chat with our team at +1 (626) 571-1234 or click here.

© Copyright 2023 Michael Lam, M.D. All Rights Reserved.

Dr. Lam’s Key Question

Whilst being overweight or obese increases the risk of lipedema, it is only a risk factor. Lipedema can occur in individuals of normal weight. Another risk factor for lipedema is fluctuating hormones. This risk factor can result in individuals of a normal weight experiencing lipedema.

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