Lipedema is a symmetrical proliferation of fat that usually occurs on the legs, buttocks and arms and usually only affects women. The distribution of fat in the body is disturbed by this disease and not, as long assumed, a consequence of overweight. In addition to water retention, massive tension pains occur, which in many cases are accompanied by increased bruising and pressure pains in the affected areas. The leg becomes evenly thick and heavy, usually from the hip to the ankle. Lipedema can also manifest on the upper arms, whereas the upper body, hands and feet usually remain slim.
Definition of the clinical picture:
According to the S1 guideline on lipedema, this is a chronic and progressive disease. Progressive means that the disease progresses and the clinical picture or the course of the disease worsens. Lipedema is a so-called fat distribution disorder. This results in a symmetrical distribution of fat on arms and legs, while the trunk initially remains slim. This disproportionate distribution of body fat cannot be influenced by sport or nutrition and must be differentiated from obesity. Lipedema is caused by the proliferation of subcutaneous fatty tissue in the arms and legs. The subcutis connects the upper skin layers (dermis and epidermis) with fascia, tendons and bones. The subcutis consists of connective tissue and fatty tissue. Excess fat is stored and accumulated here. In lipedema patients, this fat increases disproportionately at the extremities. This can be explained by hypertrophy (abnormal growth of individual cells) and hyperplasia (proliferation of tissue) of the fat cells as well as by an increase in volume caused by water accumulation.
Lioedema is therefore caused by 2 factors:
- The proliferation of fat cells in the subcutis, forming firm, nodular structures
- Water retention in the fat cells caused by disturbance of capillary permeability of the blood vessels