WHAT IS LIPOEDEMA?Lipoedema(Lipoedema) is the medical term for a condition in which excessive fat is stored in the legs, and sometimes also in the arms. Fat is not stored, or is stored much less, in other areas of the body, such as the abdomen, breasts, and face. The cause of this is unknown. It occurs almost exclusively in women, and usually begins during or shortly after puberty. It can run in families. Lipoedema can cause symptoms such as pain or a feeling of heaviness in the legs.HOW DOES LIPOEDEMA DEVELOP?The cause of lipedema is unknown. Sometimes it runs in families. In the Netherlands and other neighboring European countries, there are families in which all women develop thick legs later in life, as a result of lipedema. A person's build, whether they become overweight or thin, and their fat distribution are largely determined by genetic factors. Furthermore, there are significant differences in body shape and fat distribution between different population groups. Therefore, it should not be too hasty to conclude that having thick legs is an abnormality.
Because lipedema occurs almost exclusively in women, it is assumed that female hormones influence fat distribution. Lipedema can also develop during a period of rapid weight gain, for example, during pregnancy or after menopause, or with eating disorders that involve consuming large amounts of calories in a short period. Lipedema often occurs in conjunction with obesity. Fat that enters the body through food is stored in fat cells. The number of fat cells per person is fairly constant. When someone tries to lose weight, the amount of fat per fat cell decreases, but not the number of fat cells. When overweight women follow a diet or increase their physical activity, the size of their abdomen, buttocks, and legs decreases. However, with lipedema, the process is different: women with lipedema who follow a strict diet and exercise notice a decrease in waist circumference, but little to no change in leg circumference.WHAT DOES LIPOEDEMA LOOK LIKE?With lipedema, the legs and sometimes also the arms are swollen due to a buildup of fat. This can be unevenly distributed, giving the skin a bumpy appearance. Usually, only the legs are affected. Many people with lipedema have a difference of two or three clothing sizes between their upper and lower body. There are no swollen ankles or feet. Lipedema is actually a misnomer, because edema means fluid retention, which isn't the case. With edema due to fluid retention, a small indentation can be created in the skin by pressing a finger in one spot for a few seconds. This isn't possible with lipedema. Lipedema can be painful to the touch or pressure on the skin. Sometimes it causes continuous pain even without pressure. Bruising can also occur easily. Other symptoms may include fatigue, decreased general condition, and loss of strength in the arms and legs.
Swollen legs due to edema
Swollen legs can also be caused by fluid retention. This is called edema . The ankles (ankle edema) and feet also become swollen. Pressing on the skin can easily create an indentation. This indentation then disappears because the skin fills with fluid again. Edema in the lower leg can arise from several causes, such as varicose veins, thrombosis, reduced cardiac pumping function, and reduced kidney function. It can be treated by bandaging the leg or wearing an elastic compression stocking.
Swollen legs due to lymphedema
. Swollen legs can also be caused by lymphedema . In this case, the lymphatic vessels are damaged, blocked, or not properly formed. As a result, lymphatic fluid cannot drain properly. This lymphatic fluid is rich in protein, and the resulting lymphedema is not easy to remove. It is much more difficult to press an indentation in the skin. With lymphedema, the ankles, feet, and even the toes also become swollen. It can be treated with bandages and elastic stockings, but these must be much tighter than for normal edema.
Lipedema can occur simultaneously with normal edema (fluid in the legs) or with lymphedema. Sometimes additional testing is necessary to determine the cause of fluid in the legs. For example, testing with a duplex ultrasound device to check for varicose veins or damaged valves in the veins deep in the leg.HOW IS LIPODEMA DIAGNOSED?The diagnosis is based on the clinical picture and its appearance. The dermatologist can recognize lipedema by carefully examining the legs, observing the fat distribution, the slenderness of the feet and toes, and by pressing a small hole in the skin to assess the presence of fluid or lymphatic fluid. Sometimes additional testing is necessary to rule out varicose veins or lymphedema.CAN LIPOEDEMA BE TREATED?Unfortunately, lipedema cannot be treated. While there are some options for treating the symptoms it causes, these will not eliminate the lipedema itself. In extreme cases, liposuction, the removal of fat from the legs, is sometimes performed, but other treatment options are unavailable.
Liposuction is not a simple treatment. It is performed in specialized centers, under local or general anesthesia. Tubes are inserted into the leg through incisions in the skin at various points to extract the fat. Complications can occur, such as bleeding, infection, or damage to the skin and underlying tissue. The final result can be bumpy, and scarring may occur. Furthermore, the treatment is expensive and not covered by health insurance. Therefore, it is not often performed in practice.
Wearing elastic stockings helps with normal edema (fluid in the skin) and lymphedema, but not with lipedema. It will not reduce the circumference of the legs. It can even be counterproductive: elastic stockings that are too tight can cause pain due to pressure on the fatty tissue. If there is a combination of lipedema and regular edema or lymphedema, wearing elastic stockings can provide relief and reduce the heavy feeling in the legs.
Leg massage, connective tissue massage, and manual lymphatic drainage treatments are not effective for lipedema.
Losing weight if you are overweight is always wise, but lipedema responds little or not at all to weight loss. The circumference of the legs does not decrease, but the circumference of the rest of the body does. A healthy lifestyle, not eating too much or too much fat, and getting enough exercise can prevent lipedema from worsening. People who know they have a predisposition to lipedema, for example, because it runs in the family, can prevent it by paying attention to their weight. Also try to avoid temporary weight gain and fluctuations. Sometimes a visit to a dietitian can be helpful for advice on nutrition and lifestyle.
Additional symptoms such as pain, sometimes even chronic pain, can be managed with painkillers. If necessary, an appointment can be made with pain management specialists, often anesthesiologists working in a pain clinic. Symptoms of fatigue and muscle weakness can be managed by moving or exercising as much as possible. This will also improve your overall condition.
Mental or psychological help, such as guidance from a psychologist or medical psychologist, can be helpful. Having lipedema hinders daily life. It can cause chronic pain. Furthermore, having swollen legs can be cosmetically unsightly and disruptive. And it's very frustrating that there are no treatment options. All of this can cause psychological distress. |
