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PURPOSE: Individuals with lipoedema may experience negative impacts that are not often identified through current quality-of-life measures. The aim of this study was to explore the experiences of individuals living with pre-existing lipoedema and their perceptions of how these experiences influence quality of life. METHODS: Participants with a prior diagnosis of lipoedema participated in a single semi-structured interview or focus group. These interviews/focus groups were transcribed verbatim, allowing for an inductive thematic analysis to be conducted. RESULTS: Sixteen participants were included and four main themes were identified. These included: the ongoing work of living with lipoedema, living with a restrictive and overwhelming condition, caught between self-acceptance and social judgement, and forced to navigate lipoedema alone. Across the four themes, 21 sub-themes emerged to convey the quality-of-life concerns experienced by individuals with lipoedema. CONCLUSIONS: Individuals living with lipoedema experience impacts on their quality-of-life across physical, psychological, and social aspects of life. This study highlights how the ongoing burden of physical symptoms, social perceptions, and healthcare-related challenges contributes to reduced quality-of-life for individuals living with lipoedema. Increased knowledge and awareness amongst healthcare providers is needed to improve care received by individuals living with this condition.

OBJECTIVE: To compare the efficacies of extracorporeal shock wave therapy (ESWT) and complex decongestive therapy (CDT) in patients with lipedema. DESIGN: This randomized-controlled-study included 33 patients with lipedema, with 11 patients in each of the three groups. The first group received ESWT alone, the second group received CDT alone, and the third group received ESWT followed by CDT within the session for six treatment sessions. Assessments were performed at baseline and two weeks after treatment completion. Outcome measures included total and lower extremity fat mass assessed using dual-energy X-ray absorptiometry, lower extremity volume, body mass index, pain intensity, pressure pain threshold, and quality of life. RESULTS: Total and lower extremity fat mass decreased significantly only in the ESWT and ESWT+CDT groups (P<0.05), although the magnitude of improvement was small and not superior to that of CDT alone (P>0.05). Additionally, all three groups showed significant improvements in lower extremity volume, pain intensity, pressure pain threshold, and quality of life (P<0.05), with no significant differences between the groups (P>0.05). CONCLUSION: All three treatment approaches are safe and feasible options for the management of lipedema. Considering its low cost, accessibility, and ease of application, ESWT may be preferred over the other treatment modalities.

BackgroundLipedema is a frequently misdiagnosed chronic condition that significantly impacts patients' quality of life. As artificial intelligence (AI)-based large language models (LLMs) become increasingly integrated into healthcare communication, their accuracy and consistency in providing patient-centered information require thorough evaluation, especially in rare diseases like lipedema. Therefore, this study aimed to evaluate the accuracy and reproducibility of responses generated by ChatGPT, DeepSeek, and Gemini to questions frequently asked by patients with lipedema.MethodsThis cross-sectional study assessed the accuracy and reproducibility of responses generated by ChatGPT, DeepSeek, and Gemini to 25 commonly asked lipedema-related questions. Each model was queried twice in separate sessions, and answers were evaluated by three independent experts using a four-point rating scale. To ensure the objectivity and consistency of expert evaluations, inter-rater agreement was assessed using Cohen's kappa coefficient.ResultsDeepSeek achieved the highest proportion of comprehensive and correct responses (72%), followed by Gemini (64%) and ChatGPT (56%). Accuracy varied across content categories, with notable limitations particularly in treatment, follow-up, and maintenance questions. Reproducibility analysis revealed that DeepSeek produced the most consistent responses across sessions, while ChatGPT and Gemini showed more variability, particularly in treatment and quality-of-life questions. Cohen's kappa values indicated high inter-rater agreement overall, with perfect agreement in some categories for ChatGPT and DeepSeek.ConclusionsLLMs can provide generally accurate and consistent responses to patient-centered questions about lipedema, particularly in areas related to general information and diagnosis. However, reduced accuracy and reproducibility in complex clinical domains suggest that expert oversight is essential when using these tools for patient education.

IntroductionAfter unification of diagnostic criteria for lipedema through guidelines and consensus documents as a fat-disproportion between abdomen and extremities with pain in the affected area, reduced by compression, expensive treatment options like liposuction should be reserved to affected women. Whilst the diagnosis of lipedema is obviously clinic, technical investigations or clear cut-offs shall help avoiding misuse of resources. The aim of this study was to find differentiation criteria between lipedema (LIP) controls (CO).MethodsInvestigator initiated exploratory investigation of 20 women per group, with interim analysis after completion of investigation of 10 women per group. 14 LIP and 12 CO were investigated with QOL-questionnaires (CIVIQ and Lymph), Wunstorf-Vein-Office anamnesis questionnaire, Visual Analogue Scale (VAS) of spontaneous pain, Pain under manual investigation, pain under compression cuffs, ultrasound of skin and subcutaneous fat tissue, share-wave-elastography, water content of skin (LymphScanner) and stiffness of skin (FibroScanner).ResultsStatistical evaluation between LIP and CO presented significant differences for all parameters excepting share-wave-elastography, water content and stiffness of the skin. Differences between controls and Lipedema were achieved with p < .0001 for the Wunstorf-Vein-Questionnaire, with p < .001 for CIVIQ (cut-off >40 Points for LIP), compression cuff (cut-off <60mmHG), with p < .01 Skin thickness (skin lateral thigh >2.1 mm in LIP), fat tissue thickness (ankle >18 mm).ConclusionThis first analysis could establish a series of clear cut-off values between lipedema and controls for medical history parameters (existence of pain and compliance with compression garments), pain sensitivity to palpation and pressure, and the results of at least one quality-of-life questionnaire (CIVIQ better than Lymph-QOL) and promising cut-offs for objective, technically measurable parameters, such as skin and subcutaneous fat thickness. The possibility to discriminate between lipedema and lipohypertrophy will be assessed in the second part of the investigation.

BACKGROUND: Lipedema is a chronic adipose tissue disorder that may involve the upper extremities, particularly in advanced disease stages, leading to pain, heaviness, and functional complaints. While liposuction is an established treatment for symptom relief and volume reduction, its impact on objective upper-limb function-especially shoulder mobility-has not been systematically evaluated. METHODS: A prospective observational cohort study was conducted in female patients with upper-extremity lipedema undergoing circumferential arm liposuction. Active shoulder range of motion (ROM), including abduction, flexion, and external rotation, was assessed preoperatively and at 1, 3, 6, and 12 months postoperatively using standardized digital goniometry. Upper-limb disability (QuickDASH), pain, perceived heaviness, and upper-arm circumference were also recorded. Outcomes were analyzed over time and stratified by lipedema stage. RESULTS: Sixty-eight patients completed the 6-month primary follow-up. Mean active shoulder abduction improved significantly from 132.4° ± 13.8° at baseline to 154.7° ± 11.5° at 6 months and remained stable at 12 months (p < 0.001). Composite shoulder ROM demonstrated a similar progressive improvement. Patients with Stage II and III lipedema exhibited greater absolute functional gains, achieving postoperative ROM values comparable to those observed in earlier stages. QuickDASH scores, pain, and perceived heaviness decreased significantly over time (p < 0.001). Upper-arm circumference reduction correlated moderately with improvements in shoulder abduction (r = 0.42, p < 0.01). Measurement reliability was excellent (ICC ≥ 0.93). CONCLUSIONS: Upper-extremity liposuction for lipedema is associated with significant and durable improvements in shoulder mobility and upper-limb function. Beyond symptom relief and contour improvement, surgical debulking appears to restore functional movement, supporting the concept of upper-extremity lipedema as a functional disorder. Objective assessment of shoulder mobility should be considered an important outcome measure in the surgical evaluation of lipedema. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

ObjectiveThis study aimed to investigate central sensitization (CS) in individuals with lipedema using pressure pain threshold measurements and to examine its relationship with clinical features, sonographic findings, body composition, and Central Sensitization Inventory (CSI) scores.MethodsA total of 61 female patients with lipedema and 20 healthy controls were included in this cross-sectional study. Pressure pain threshold (PPT) was assessed at the thigh, pretibial region, and forearm using a manual algometer. Sonographic subcutaneous fat thickness was evaluated, and body composition parameters were assessed using bioelectrical impedance analysis. Clinical outcomes related to CS-including the CSI, Visual Analog Scale (VAS), Lower Extremity Functional Scale (LEFS), Short Form-12 (SF-12), and the Extended Nordic Musculoskeletal Questionnaire (NMQ-E)-were recorded. Linear mixed-effects models were used to compare PPT across groups, anatomical sites, and disease stages. Associations between PPT, CSI scores, body composition parameters, sonographic findings, and clinical measures were evaluated using Pearson correlation analyses.ResultsPatients with lipedema exhibited significantly lower PPT values across all anatomical regions, including the forearm, and significantly higher CSI scores compared with healthy controls (p < .001). Sonographic assessment confirmed increased subcutaneous fat thickness in the lower extremities of lipedema patients. Lipedema stage was not associated with overall PPT levels. However, lower forearm PPT and LEFS scores were observed in more advanced stages. Forearm PPT showed significant negative correlations with lean body mass, body fat mass, and total body water (p < .05), while no other significant associations were identified.ConclusionIndividuals with lipedema demonstrate features consistent with CS, characterized by reduced PPTs in both affected and non-affected regions together with elevated CSI scores. These findings suggest that altered pain processing may contribute to the widespread pain and functional limitations observed in lipedema, highlighting the importance of comprehensive assessment of CS in this population.

OBJECTIVE: To evaluate ultrasonographic changes in lower extremity tendons and plantar fascia of patients with chronic edema and their relationship with edema volume, pain, function, and quality of life. DESIGN: This observational case-control study included 53 patients with chronic lower extremity edema and 55 age- and sex-matched controls. Ultrasonography assessed the Achilles, tibialis posterior, peroneal, and patellar tendons and plantar fascia. Edema volume was calculated from limb circumferences. Outcomes included the Lower Extremity Functional Scale (LEFS), Lymphedema Quality of Life Questionnaire-Leg (LYMQOL-Leg), and Visual Analogue Scale (VAS). RESULTS: All tendons (except the patellar tendon) and plantar fascia were thicker in the edema group than controls ( P <0.05). Differences in Achilles tendon and plantar fascia thickness remained significant after BMI adjustment (all P <0.01) and correlated positively with edema volume ( P <0.05). Plantar fasciitis (50.9%) and Achilles tendinopathy (22.6%) were more frequent in the edema group ( P <0.05). Patients had lower LEFS and higher LYMQOL-Leg and VAS scores (all P <0.01). CONCLUSION: Chronic lower extremity edema was associated with alterations in tendon and fascial morphology, particularly the Achilles tendon and plantar fascia. Musculoskeletal ultrasonography may complement clinical evaluation by providing information regarding tendon and fascial involvement.

BACKGROUND: Lipedema is a chronic adipose tissue disorder primarily affecting women, characterized by abnormal fat accumulation, pain, and reduced mobility. Its impact on sexual function remains underexplored. This study aimed to evaluate sexual function in women with lipedema and examine its associations with anxiety, depression, lower extremity function, and quality of life. METHODS: In this cross-sectional study, 100 sexually active women were recruited: 50 with lipedema and 50 age- and Body Mass Index-matched healthy controls. Sexual function was assessed with the Female Sexual Function Index (FSFI); anxiety and depression with the Hospital Anxiety and Depression Scale (HADS-A and HADS-D); quality of life with the EuroQOL 5-Dimensional 5-Level (EQ-5D-5L) instrument; lower extremity function with the Lower Extremity Functional Scale (LEFS); and pain intensity with the Visual Analog Scale (VAS). Multiple linear regression analysis was conducted to identify the factors associated with the total FSFI score. RESULTS: Women with lipedema had significantly lower total FSFI scores compared to controls (21.58 ± 3.99 vs. 25.86 ± 3.21, P < .001), with 76% having FSFI scores below the cut-off (≤ 26.55) compared to 36% of controls. All FSFI domain scores were significantly lower in the lipedema group (all P < .05). In the lipedema group, there was a significant correlation between total FSFI scores and age (P = .002), pain intensity (VAS; P = .022), depression (HADS-D; P = .010), quality of life (EQ-5D-5L index; P = .027), and lower extremity function (LEFS; P < .001). Multiple linear regression analysis identified depression (HADS-D; P = .047), perceived health status (EQ-5D-5L VAS; P = .033), and lower extremity function (LEFS; P = .011) as independent variables that had a significant relationship with the total FSFI score. DISCUSSION: Lower sexual function is common among women with lipedema and is associated with anxiety and depressive symptoms, lower extremity function, and pain intensity. These findings highlight the importance of incorporating sexual function assessment into the routine evaluation of patients with lipedema and support the need for comprehensive multidisciplinary treatment approaches addressing physical, psychological, and sexual health aspects of care.

Lipedema is a chronic progressive disease characterized by disproportionate and symmetric adipose tissue accumulation, predominantly affecting women, with upper extremity involvement (Type IV) in approximately 30% of cases. This study aimed to evaluate ultrasound measurements of subcutaneous tissue thickness in the upper extremities of women with lipedema compared with matched controls and to establish diagnostic cutoff values for this region.MethodsCross-sectional case-control study including 102 women (51 with clinically diagnosed lipedema and 51 age- and BMI-matched controls). Bilateral ultrasound measurements were obtained at six standardized anatomical points on the upper extremities, and subcutaneous thickness was measured from the dermal-epidermal junction to the deep fascia. Receiver Operating Characteristic (ROC) curves were used to derive diagnostic cutoff values.ResultsSubcutaneous thickness was significantly greater in the lipedema group at all sites, independent of BMI (p < .05). The mid-arm region (10 cm distal to the axillary line) showed the best diagnostic performance (AUC 0.74; sensitivity 82.4%; specificity 51.9%; cutoff >11.4 mm), and four of the six points demonstrated good accuracy (AUC 0.73-0.74).ConclusionUltrasound using standardized anatomical points and defined cutoff values provides good discriminatory capacity for diagnosing upper extremity lipedema and represents an accessible and reproducible adjunct to clinical assessment.

We read with great interest the article on Tranexamic acid use in Liposuction for Lipedema by Bruno and Foti [1]. Evaluating how tranexamic acid affected surgical results and expected blood loss in patients undergoing liposuction for lipedema. The authors provide valuable insights into incidence, prevalence, survival, and diagnostic timelines. However, several methodological considerations merit further discussion. These shortcomings do not undermine the study, but they do suggest the stated treatment effect magnitude may be underestimated. Prospective designs, statistical adjustment for clustering, blinded outcome evaluation, and objective blood loss quantification would all be helpful for future research.No Level Assigned This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

ObjectivesThe aim of this study was to compare metabolic status and biochemical indices associated with cardiovascular risk, including the triglyceride-glucose (TyG) index, triglyceride-glucose-body mass index (TyG-BMI), and atherogenic lipid indices, between obese individuals with and without lipedema, and to evaluate the potential effect of lipedema on these parameters.Materials and MethodsThis cross-sectional study included 70 obese patients diagnosed with lipedema and 70 obese control individuals without lipedema. Fasting glucose, total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglyceride levels were recorded. Based on these parameters, the TyG index, TyG-BMI, atherogenic index of plasma (AIP), atherogenic coefficient (AC), and Castelli risk indices I (CRI-I) and II (CRI-II) were calculated.ResultsNo significant differences were observed between the lipedema and control groups in fasting glucose, total cholesterol, HDL-cholesterol, triglyceride levels, TyG, TyG-BMI, or atherogenic lipid indices (all p > .05). LDL-cholesterol levels were significantly lower in the lipedema group compared with the control group (p = .008). In the lipedema group, TyG-BMI showed a positive correlation with age and BMI, whereas no significant associations were found with symptom duration or pain severity.ConclusionAlthough LDL-cholesterol levels were lower in obese individuals with lipedema, this difference was not reflected in biochemical indices associated with metabolic status and cardiovascular risk. Importantly, metabolic parameters in patients with lipedema accompanied by obesity were comparable to those observed in individuals with obesity alone, suggesting that obesity rather than lipedema may be a more important determinant of metabolic risk in this population. Therefore, metabolic evaluation should not be overlooked in patients with lipedema, and the management of obesity should be considered in treatment planning.

INTRODUCTION: Recent research suggests that body contouring surgeries may reduce benzodiazepine (BNZ) use in patients with anxiety or depressive disorders. This study explores whether similar benefits occur in women with lipedema-a chronic adipose disorder causing pain, limited mobility, and psychological distress-who are often prescribed BNZ. MATERIALS AND METHODS: We conducted a retrospective observational study on 100 adult female patients with Stage I-III lipedema undergoing tumescent or water-assisted liposuction between 2019 and 2024. All participants were on stable BNZ therapy for at least six months before surgery. The primary outcome was BNZ usage at six months postoperatively. Secondary outcomes included anxiety (GAD-7), pain (VAS), sleep quality (PSQI), and body image (BODY-Q) and assessed pre- and post-surgery using validated instruments. DISCUSSION: At six months, 77% of patients reduced or discontinued BNZ (32% stopped entirely), with average daily dosage decreasing from 3.2 ± 1.1 to 1.4 ± 1.2 mg (p < 0.001). Statistically significant improvements were also observed in anxiety, pain, sleep quality, and body image (all p < 0.001). Reductions in BNZ use correlated with improvements in pain (r = 0.56), anxiety (r = 0.47), and body image (r = - 0.52). Only minor complications occurred (8%), and no major adverse events were reported. CONCLUSION: Liposuction for lipedema not only improves physical symptoms but also supports psychological recovery, reducing dependence on benzodiazepines. These findings highlight the potential of surgical treatment as part of an integrated approach to managing chronic conditions with both somatic and mental health components. Further research is needed to confirm long-term effects and underlying mechanisms. LEVEL OF EVIDENCE I: Level I, therapeutic study using a properly randomized controlled trial. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Lipedema is a chronic disorder characterized by disproportionate subcutaneous fat accumulation and pain, with an incompletely understood inflammatory component. It remains unclear whether this inflammatory profile is disease-specific or primarily driven by coexisting adiposity. This study aimed to evaluate systemic inflammatory markers in women with lipedema compared with women with obesity and normal-weight controls. This retrospective study included 229 women aged 30-65 years: 78 with lipedema, 76 with obesity without lipedema, and 75 normal-weight controls. Demographic and laboratory data were obtained from medical records. Inflammatory indices, including the neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic immune-inflammation index, C-reactive protein-to-albumin ratio, and C-reactive protein-albumin-lymphocyte index, were calculated. Group comparisons were performed using one-way analysis of variance with appropriate post hoc tests. Age was similar across groups, whereas body mass index was significantly higher in the lipedema and obesity groups than in controls (p<0.001). The erythrocyte sedimentation rate, C-reactive protein level, and CAR were significantly higher in both the lipedema and obesity groups compared with controls, whereas no significant differences were observed between lipedema and obesity groups. The neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic immune-inflammation index, and C-reactive protein-albumin-lymphocyte index did not differ significantly among groups. Inflammatory indices were generally comparable across lipedema grades. These findings suggest that lipedema is associated with low-grade systemic inflammation; however, its inflammatory profile largely overlaps with obesity, indicating shared inflammatory mechanisms rather than a distinct systemic inflammatory phenotype. Among the evaluated markers, C-reactive protein-based parameters, particularly the C-reactive protein-to-albumin ratio, appeared to better reflect inflammatory burden than hematological composite indices.

BACKGROUND: Liposuction is a standard treatment for advanced-stage lipedema, often involving large volumes of tumescent fluid infiltration and aspiration. These shifts raise concerns about postoperative electrolyte imbalances, though systematic data are limited. METHODS: This retrospective single-center study analyzed 116 women with stage 2 or 3 lipedema who underwent liposuction between 2019 and 2023. Pre- and postoperative (within 24 hours) laboratory values including hemoglobin, hematocrit, leukocytes, and electrolytes were compared using paired t-tests, and correlations with clinical variables were assessed. RESULTS: Postoperatively, lower hemoglobin (13.6 ± 0.9 to 11.8 ± 1.2 g/dL, p < .0001) and hematocrit (40.9 ± 2.5 to 35.1 ± 3.5%, p < .0001) levels were observed, alongside higher leukocyte counts (7.6 ± 3.1 to 13.1 ± 5.9 × 109/L, p < .0001). Electrolyte shifts included higher chloride (104.7 ± 2.2 to 106.0 ± 1.9 mmol/L, p < .0001) and slightly lower calcium (2.3 ± 0.1 to 2.2 ± 0.1 mmol/L, p < .0001), sodium (140.8 ± 2.1 to 140.2 ± 2.1 mmol/L, p = .01), and potassium (4.1 ± 0.35 to 4.0 ± 0.4 mmol/L, p = .02). All parameters remained within physiological ranges and were not associated with adverse outcomes. Calcium correlated with hemoglobin (r = 0.49) and hematocrit (r = 0.51) and inversely with aspirate volume (r = -0.41, p = 0.001). CONCLUSIONS: Post-liposuction electrolyte and hematologic changes are mild and clinically insignificant, reflecting predictable hemodilution rather than metabolic disturbance. Routine postoperative testing appears unnecessary for most patients, supporting selective monitoring in those with abnormal baseline values, high aspirate volumes, or relevant comorbidities. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

ObjectivesThere is a deficiency in awareness and knowledge of lipedema disease among the general public and healthcare professionals. This situation may lead patients to waste time on getting the correct diagnosis and treatment. Currently, information regarding women's awareness and knowledge level of lipedema in Turkey is limited. This study aims to examine women's awareness, knowledge level, and desire for information concerning lipedema in Turkey.MethodsA total of 502 volunteer women participated in this online cross-sectional survey study. The survey, constructed by the authors of the study with the assistance of guidelines, systematic reviews, and current literature, consisted of sections aimed at determining demographic data, lipedema awareness, knowledge level, lipedema symptoms and suspicion, as well as individuals' health behavior and desire for information. The primary outcome of the study was lipedema awareness, which was defined by having previously heard the term lipedema.ResultsDespite 76.1% of participants reporting awareness of lipedema, the average knowledge score about the condition was a low-to-moderate level of knowledge. The vast majority of participants (71.3%) indicated that they were willing to learn more about lipedema, and their preferred source of information was healthcare professionals (80.3%). Yet, only 19 participants (3.8%) think that lipedema is sufficiently regarded within the healthcare system.ConclusionThis study reveals that, despite relatively high awareness of lipedema among women in Turkey, the level of knowledge remains limited. The strong willingness to receive further knowledge and the preference for healthcare professionals as the principal source of information garner attention. However, the low confidence in the recognition of lipedema within the healthcare system may suggest that healthcare professionals have insufficient knowledge or do not prioritize this issue. Improving awareness and knowledge of lipedema among the public and healthcare professionals might facilitate early identification and minimize treatment delays.

BACKGROUND: Lipedema is a prevalent chronic condition in women, characterized by a painful and symmetrical accumulation of adipose tissue primarily in the lower limbs. Its diagnosis is based on specific clinical characteristics; however, these characteristics lack robust scientific validation. Furthermore, lipedema is frequently misdiagnosed as obesity. This study aims to compare quality of life and physical and psychological characteristics between patients with obesity with and without lipedema. METHODS: This cross-sectional study included 30 patients with obesity and lipedema (Lip-Obes group) and 29 patients with only obesity (nonLip-Obes group). Quality of life, body composition (BMI, fat free mass, fat mass, waist-to-hip ratio, waist-to-height ratio, leg volume), pain (pain pattern, pressure pain thresholds, pain interference, pain distribution, symptoms of neuropathic pain), physical functioning (hand grip strength, quadriceps strength, functional exercise capacity, functional mobility and physical activity level), and psychosocial functioning (pain catastrophizing, depression, anxiety, and stress, body image dissatisfaction, self-efficacy, and eating difficulties) were assessed using clinical measurements and self-reported outcomes. Statistical analyses were performed using independent t-tests or Mann-Whitney U tests for continuous variables and Chi-square or Fisher's exact tests for categorical variables. A two-sided p-value of < 0.05 was considered statistically significant. RESULTS: Compared to the nonLip-Obes group, the Lip-Obes group showed greater impairments in quality of life (p < 0.05). Despite similar body composition variables, the Lip-Obes group had lower waist-to-hip, waist-to-height, upper leg-to-waist, and lower leg-to-waist ratios, as well as higher total limb volume than the nonLip-Obes group. Additionally, the Lip-Obes group reported higher pain intensity, lower pressure pain thresholds in the arms and legs, and greater pain interference than the nonLip-Obes group (p < 0.05). Although hand-grip strength and physical activity levels were comparable, the Lip-Obes group exhibited lower quadriceps strength, functional exercise capacity, and functional mobility (p < 0.05). Additionally, the Lip-Obes group reported higher pain catastrophizing, greater body image dissatisfaction, and more severe eating difficulties than the nonLip-Obes group (p < 0.05). No significant differences were found in depression, anxiety, stress, or self-efficacy between groups (p > 0.05). CONCLUSION: This cross-sectional study highlights the complex nature of lipedema, providing preliminary evidence of differences in quality of life and distinct body composition and physical and physiological characteristics between patients with obesity with and without lipedema. These results emphasize the need for further research to identify diagnostic biomarkers for lipedema through in-depth investigations. Future studies should also focus on developing and optimizing a multidisciplinary treatment approach tailored to the unique characteristics of patients with lipedema.