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For the millions of women living with lipedema worldwide, finding effective treatment options has been a long and frustrating journey. However, recent research is shedding light on a potential new avenue for treatment: GLP-1 receptor agonists, particularly tirzepatide. What is Lipedema? Lipedema is a chronic medical condition characterized by the abnormal accumulation of fat cells,

Liposuction in lipedema is a safe and effective treatment, but there currently are no studies analyzing the individual complications of water-jet-assisted liposuction in lipedema or the impact of the cannula’s design.To answer the question which WAL cannula is the safest in lipedema patients, and providing practitioners with the data they need to make an informed decision about the cannula they choose.We retrospectively analyzed complications and their underlying risk factors in 117 patients across 243 cases. Groups were formed by diameter (Ø) and number of ports of the used cannulas. Unpaired t-Tests, Fisher’s exact tests and chi-squared tests were used to analyze the patients’ characteristics for the complication rates across the cannulas.Cannulas with 8 ports showed statistically significantly higher hemoglobin loss (p = 0.011), shorter incision-to-suture time (p = 0.023), and higher volume of aspirated fat (p < 0.001). The same results occurred when comparing the Ø 3.8mm cannulas that differ in the number of ports (4 versus 8 ports). The Ø 4.8mm group showed a significantly increased rate of wound healing disorders compared to the Ø 3.8mm group (p = 0.041) and a statistically significantly higher aspirated fat volume (p = 0.014).No specific cannula showed superior safety in terms of complication rates. However, 8 port cannulas facilitated a faster aspiration of large volumes and reduced the incision-to-suture time compared to 4 port cannulas. This benefit was accompanied by a grater loss of hemoglobin. In contrast, cannula diameter played a less significant role in aspiration speed and did not increase the hemoglobin loss.

Background: Lipedema, a chronic condition affecting mostly women, involves painful bilateral increase of subcutaneous adipose tissue. The societal impact of this disease is still poorly understood. This study aimed to validate the Lymphedema Quality-of-Life Questionnaire (LYMQOL) for lipedema patients in Germany, assessing its feasibility, reliability, and validity.Methods and Results: A total of 81 German-speaking stage II lipedema patients were asked to complete both the LYMQOL (arm and leg versions) and the Short Form Health Survey (SF-36) questionnaires twice, and this was 2 weeks apart. Feasibility was evaluated through response rates, scale structure via factor analysis, validity through SF-36 correlations, and reliability through internal consistency and test-retest reliability analysis. A valid 68% response rate was achieved. Both arm and leg versions demonstrated construct validity with significant correlations to SF-36 subscales. Internal consistency for the leg version was acceptable to excellent, and good to excellent for the arm version. Test-retest reliability was very good for both versions.Conclusions: This study validates the LYMQOL as a robust tool for assessing lipedema patients’ quality of life, and also validates the German translation contained in this article. We hope to fill a critical research gap and support future clinical studies aiming at enhancing patient care.

Background Lipedema is a chronic, progressive condition characterized by symmetrical accumulation of adipose tissue, predominantly in women's lower extremities. It is frequently associated with pain, reduced mobility, and psychological distress. Dietary interventions have become central to conservative management of the condition, yet their clinical efficacy remains unclear. Methods This systematic review included peer-reviewed studies assessing dietary strategies in individuals with clinically diagnosed lipedema. Searches were conducted in four databases in July 2025, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eligible studies applied dietary interventions and reported clinical or psychosocial outcomes, and the risk of bias was subsequently assessed. Results Nine studies involving 269 women met the inclusion criteria. The majority applied hypocaloric dietary protocols, particularly ketogenic, low-carbohydrate high-fat, or ketogenic modified Mediterranean diets. Across studies, weight loss and reduction in fat mass were consistently reported. Some studies also observed improvements in pain, inflammation, and quality of life, though these outcomes were not uniformly assessed. Few studies used advanced measures of body composition such as dual-energy X-ray absorptiometry or magnetic resonance imaging; most relied on bioelectrical impedance analysis. Only one study evaluated emotional dysregulation and only one assessed food addiction, but no study systematically measured eating behavior traits, or current or past eating disorders. Intervention durations ranged from four to twenty-eight weeks, and adherence strategies varied. The risk of bias was moderate to high in most studies. Two trials (conducted by Lundanes and Jeziorek et al.) were randomized controlled trials, whereas the remaining studies used non-randomized designs despite including control and intervention groups. Due to the high heterogeneity in study design, outcomes, and measurement tools, combined with the small sample sizes and risk of bias, it was not possible to conduct a meta-analysis. Conclusion The effects of dietary approaches on lipedema remain unclear. Future studies should adopt robust methodological designs, include larger and stratified samples based on disease stage, use accurate assessments of body composition (including muscle mass and strength), evaluate mental health and eating behaviors, and investigate the long-term sustainability of interventions. The literature lacks standardized methodologies and comprehensive evaluation of psychosocial and eating behavior, highlighting the need for stronger evidence to inform clinical practice.

Dercum disease and lipedema commonly present with joint hypermobility, yet the relationship between these adipose disorders (AD) and hypermobile Ehlers-Danlos syndrome (hEDS) remains insufficiently understood. To date, no research has simultaneously examined hEDS and adipose disorders, leaving a critical gap in understanding their interplay. This investigation seeks to address diagnostic challenges and provide insights to inform more effective management strategies for these complex, overlapping conditions.

Lipedema is a chronic, often misdiagnosed disease characterized by painful, disproportionate fat accumulation in the extremities. Commonly mistaken for obesity or lymphedema, lipedema primarily affects women and has long been thought to be resistant to dietary intervention, a belief originating from its initial description by Allen and Hines at the Mayo Clinic in 1940. However, emerging research challenges this notion, revealing that individuals with lipedema often respond positively to therapeutic carbohydrate (CHO) reduction, particularly ketogenic diets (KD). Effective management of lipedema requires a comprehensive, holistic approach. Nutritional strategies should not only target symptom relief but also support overall health by considering physical comorbidities, mental and emotional well-being, and individual cultural and social factors. In this paper, we present an updated perspective on CHO-reduced dietary interventions for lipedema and propose a patient-centered framework to personalize nutrition plans for sustained success and improved quality of life.

Introduction:Lipedema is a progressive chronic condition that mainly affects women, and is characterized by disproportionate subcutaneous fat accumulation in the extremities, causing pain, edema, and impaired quality of life.Objective:This study evaluated the outcomes of the lipedema definition technique (LDT) for the treatment of lipedema, focusing on clinical efficacy, quality of life improvement, and patient satisfaction.Methods:A retrospective study was conducted with 67 women who underwent the LDT to treat lipedema (types II to V and stages 1 to 4). Analyzed variables included weight, body mass index, body fat percentage, total body water, InBody score, ideal weight, fat-free mass, basal metabolic rate, waist-to-hip ratio, visceral fat level, and percentage of obesity. The Lipedema Symptoms Assessment Questionnaire and complementary questionnaire were applied to assess satisfaction and clinical outcomes. Study assessments were conducted preoperatively, 90 days after surgery, and completed 2 years later.Results:A total of 34 patients (mean age of 40 years) were included; most had stage 2 lipedema (50.7%) and type IV (49.2%). After 90 days of the LDT, significant reductions were observed in weight (−2.5 kg, P = .001), body mass index (−0.9 kg/m2, P = .001), body fat percentage (−3.1%, P = .001), visceral fat (−1.8 points, P = .001), and percentage of obesity (−4.3%, P = .001). Moreover, fat levels in the upper and lower quadrants were significantly reduced, and bioimpedance analysis showed changes in all 5 body segments after LDT. Improvements in quality of life (89.4%) and pain reduction (87.2%) were reported. High satisfaction rates (91.5%) were observed, with 81.0% of patients reporting positive outcomes and 75.0% maintaining results in the long term.Conclusion:Lipedema definition technique was effective in reducing fat, improving quality of life, and achieving high patient satisfaction. This study reinforces the role of surgery as an intervention for lipedema, promoting important clinical and aesthetic benefits.

Lipedema is a chronic, progressive adipose connective tissue disorder characterized by symmetrical, disproportionate fat accumulation, typically affecting the lower extremities and arms, accompanied by pain, swelling, and a sensation of heaviness. This study introduces intermediate Stages 1.5 and 2.5 to the established lipedema classification (Stages 1, 2 and 3), and other affected areas, based on physical examination, a questionnaire, and photographic documentation. Bioelectrical Impedance Spectroscopy (BIS) was employed to quantify total body water (TBW) across stages. A significant and linear increase in BMI was observed from Stage 1 to 3, correlating with increased reported pain and heaviness in the thighs, calves, and upper arms. Systemic symptoms of brain fog, debilitating fatigue, and hypothermia were significantly prevalent. TBW demonstrated a significant, stage-dependent increase in the lower extremities. Adipose tissue accumulation over the knees and feet significantly increased with lipedema stage. In contrast, shin involvement was evident in early stages and remained consistently elevated throughout later stages. Skeletal Muscle Mass (SMM) exhibited a significant increase across lipedema stages, positively correlating with fat mass (FM) in Stage 3. This study elucidates previously underrecognized clinical features and distribution patterns of lipedema, offering a refined staging system to improve understanding of its progression and burden.

Estrogen-dependent conditions, such as endometriosis, adenomyosis, lipedema, polycystic ovary syndrome, and breast cancer, are intimately involved with hormonal changes related to estrogen and their receptors. These conditions can be expressed mainly during hormonal changes such as pregnancy, puberty, and menopause. They are associated with alterations in estrogen function and inflammatory mechanisms, leading to significant discomfort and a marked decrease in self-esteem in women. Resveratrol has been studied in the treatment of inflammatory diseases like obesity, metabolic syndrome, and endometriosis. The research suggests potential pathways through which resveratrol may also be beneficial in treating metabolic and estrogen-dependent conditions. We reviewed 63 articles from 2000 to 2025, prioritizing systematic reviews, meta-analyses, and randomized controlled trials in the PubMed, ScienceDirect, and SciELO databases. Our results suggest that resveratrol may benefit metabolic and estrogen-dependent conditions by modulating anti-inflammatory factors that regulate estrogen receptor activity, increasing lipolysis, decreasing insulin resistance, and mitigating oxidative stress. Future research should evaluate the long-term safety and potential therapeutic effects of resveratrol in metabolic conditions.

Background/Objectives: Lipedema is a chronic and progressive adipose tissue disorder characterized by the abnormal accumulation of subcutaneous fat, predominantly in the legs and occasionally in the arms. The symptom that most signi cantly affects the quality of life is pain. Ultrasound elastography is an imaging technology that allows for measuring tissue stiffness quantitatively. This study aims to evaluate the relationship between accompanying pain in patients with lipedema and tissue elasticity measured using shear-wave elastography (SWE). Methods: Our study was designed as an observational, analytical and cross-sectional study. The visual analog scale (VAS) was used to assess pain, while the PainDetect questionnaire was utilized to evaluate neuropathic pain. The evaluation of tissue elasticity and brosis was conducted using the SWE method. Results: This research assessed thirty- ve patients, revealing an average age of 45.2 years and an average VKI of 33.6 kg/m². 60% of the patients had a lipedema diagnosis in their family history. Both age (p<0.01) and BMI (p<0.001) values were moderately correlated with all subcutaneous adipose tissue measurements, while no correlation was observed in SWE measurements. Only the level of the thigh in the SWE-Elasticity (SWE-E) values was related to VAS (p=0.03). Additionally, PainDetect data revealed correlations with SWE-Velocity (SWE-V) and SWE-E in both the right and left thighs. Conclusions: While SWE measurements were not correlated with skin adipose tissue, SWE measurements were correlated with pain and neuropathic pain in patients with lipedema. This nding highlights a potentially important relationship between tissue elasticity and pain, which may warrant further exploration.

Lipedema is a chronic and progressive condition characterized by the disproportionate accumulation of subcutaneous adipose tissue predominantly in the upper and lower limbs, sparing the trunk, hands, and feet. It affects approximately 12.3% of the female population in Brazil. Clinically diagnosed, its most common symptoms include tenderness upon palpation and spontaneous bruising. During the development of a qualitative ultrasonographic classification for lipedema, termed Lipedema Dermis and Hypodermis Classification (LDHC), an echogenic nodule was identified in the superficial hypodermis. This nodule was painful upon superficial palpation and lacked ultrasonographic features of a lipoma. The patient presented with a nodule in the distal posterior region of the right thigh and another on the distal posterior of the right arm. Given the possible differential diagnoses, including neoplasia and angiodysplasia, an ultrasound-guided biopsy was performed. Macroscopic analysis revealed an oval-shaped, reddish nodule, suggestive of blood content. Histological analysis revealed areas of steatonecrosis, hemorrhagic foci, and neoangiogenesis with irregular architecture and fragile vessel walls. Complementary analysis of the resistance index (RI) of superficial hypodermal arteries demonstrated an increased RI in the lipedema patient compared to the control. All these findings suggest that the tissue is hypoxic and characterized by chronic inflammation, supporting the hypothesis of increased subcutaneous compartment pressure in lipedema. This case report elucidates the ultrasonographic findings of nodules classified by LDHC through microscopic anatomical correlation and aids in understanding the pathophysiological mechanisms underlying lipedema.

To determine the frequency of neuropathic pain in patients with lipedema and to assess the impact of neuropathic pain on quality of life and its correlation with clinical variables.

Objectives To identify research priorities related to the diagnosis, treatment and management of lipoedema. Design This was a research question priority-setting that ensured the involvement of patients, relatives and healthcare professionals in all parts. It consisted of the following steps: identifying research questions through an open survey, seeking input from patients, patient relatives and healthcare professionals. Prioritisation, including a Delphi exercise and a final priority-setting meeting. Setting Swedish healthcare and community. Participants A total of 255 participants submitted research questions. 130 participated in the prioritisation of the submitted questions. Of these, 89 were patients, 10 were relatives, 19 were healthcare professionals and 12 were representatives of patient organisations. Results 1314 potential research questions were submitted; 62 unique questions remained after analysis. 130 and 123 people answered the first and second Delphi surveys, respectively. 20 questions were discussed by 13 participants at the final priority-setting meeting. The following five research questions were selected as a top priority: (1) what criteria should apply for a diagnosis of lipoedema? (2) What outcomes are important in lipoedema research? (3) What effect does manual treatment, such as manual lymphatic drainage have on lipoedema? (4) What effect does liposuction have on lipoedema? (5) What are the effects of hormonal treatment on lipoedema? Conclusions We found a consensus between patients and healthcare professionals on topics that warrant priority in future research into lipoedema. The questions reflect both the diagnosis of the condition and research on treatment effects. We hope the results will inform researchers and research funders, and direct future studies towards important research questions. Data are available upon reasonable request.

Lipedema is a chronic adipose tissue disorder traditionally considered to affect almost exclusively women, with recent estimates suggesting approximately 0.2% prevalence in men worldwide; the condition remains underdiagnosed in males due to limited awareness and scarce literature. This retrospective case series from the Amato Institute of Advanced Medicine in São Paulo, Brazil, describes clinical characteristics, diagnostic findings, and treatment outcomes of five male patients diagnosed with lipedema between January 2022 and December 2024. The patients, aged 31-58 years (mean, 42.6 ± 9.7), with a BMI of 29-42.4 kg/m², all presented bilateral, symmetrical lower extremity fat accumulation, sparing the feet, with endocrine comorbidities present in 80% of cases and one participant testing positive for HLA-DQ2/DQ8. Diagnosis was based on clinical criteria requiring bilateral symmetrical fat accumulation, disproportionate fat distribution, negative Stemmer’s sign, sparing of feet, and at least two minor criteria. Conservative management, including dietary interventions over four to eight weeks, resulted in mean weight reduction of 7.0 ± 2.2 kg and lower limb volume reduction of 2.5 ± 1.1 L. These findings demonstrate that lipedema occurs in men with classical phenotypic features, and the presence of HLA-DQ2/DQ8 markers in some cases suggests potential autoimmune components and opportunities for targeted dietary interventions. Conservative management yields significant short-term improvements, warranting larger prospective studies to establish prevalence, investigate HLA associations, and optimize management strategies for male lipedema.

Background Lipedema often remains undiagnosed in patients with obesity, leading to mismanagement of treatment. Because of this, despite remarkable weight loss after bariatric surgery and decreases in hip and abdomen circumference, some patients show only small decreases in the circumference of the extremities and report persistent limb pain. We present the first scoping review to systematically explore the reported patient characteristics, clinical outcomes, and diagnostic challenges of lipedema in patients undergoing metabolic bariatric surgery, to identify gaps in current practice and promote earlier diagnosis and tailored treatment. Methods A search in PubMed, Embase, Medline, and Cochrane was conducted, from inception to December 19th, 2023. We consider as inclusion criteria original articles, case reports, and case series of lipedema after metabolic bariatric surgery. Results Among the included studies, a total of 49 patients were reported, and all were female. The mean age of cases was 42.43 (range 24–63) years old, and the mean BMI was 49.92 kg/m2. In the majority of the included patients, a sleeve gastrectomy was performed (25 patients, 51%), Roux-en-Y in 22 patients (45%), and One anastomosis Gastric Bypass in 2 (4%). Forty-eight patients had lipedema diagnosed after bariatric surgery. The mean excess weight loss was 70.93%, and the mean total weight loss was 36%. The mean pain score increased after surgery with 7.92 compared to 7.30 before surgery. Conclusion Recognizing the presence of lipedema in females experiencing extremity pain and disproportionate fat distribution is crucial. Bariatric surgery alone does not appear to significantly improve lipedema-related symptoms, based on currently available evidence, and even significant excess weight loss of more than 70% often fails to alleviate its associated pain.

Background: Lipedema is a chronic disease of subcutaneous adipose tissue that predominantly affects women and is frequently associated with endocrinopathies such as insulin resistance and obesity. Its pathogenesis is still unclear, and treatment, which requires a multi-disciplinary approach, is prolonged over time and is not always effective. There is currently no drug treatment available for this disease. Methods: Five different cases of women with lipedema and insulin resistance, treated with Glucagon-Like Peptide-1 Receptor Agonists (GLP-1 RAs) and once-weekly exenatide, in association or not with lifestyle changes (diet or physical activity) for 3 to 6 months are described. Changes in anthropometric parameters, symptoms, clinical findings and the thickness of superficial adipose tissue measured by ultrasound were evaluated. Results: Treatment with exenatide, whether combined with a change in diet or physical activity, resulted in a reduction in the characteristic symptoms of lipedema, in pain evoked by pinching the adipose tissue fold and in the thickness of subcutaneous adipose tissue at the levels of the lower limbs, abdomen and upper limbs. In four out of five cases, a reduction in body weight was observed, particularly during the first three months of treatment and in cases with greater metabolic impairment. Clinical, instrumental and subjective improvements were also observed in cases where there was no reduction in body weight and in patients who had previously undergone lower limb liposuction. Conclusions: The improvement in symptoms and clinical signs of lipedema, in addition to the reduction in adipose tissue in patients with lipedema and insulin resistance with exenatide, suggests a novel pharmacological approach to the disease, which can be combined with other conservative and surgical treatments to promote weight reduction. These results also highlight the association of this disease with metabolic alterations and the fundamental role of an accurate diagnosis followed by the treatment of comorbidities and excess weight in these patients.

Lipedema is a chronic, estrogen-sensitive adipose tissue disorder characterized by disproportionate subcutaneous fat accumulation, fibrosis, inflammation, and resistance to fat mobilization. Despite its high prevalence, lipedema remains poorly understood and frequently misdiagnosed. This narrative review proposes a novel pathophysiological model in which menopause acts as a critical turning point in the progression of lipedema, driven by estrogen receptor imbalance (ERβ predominance over ERα), intracrine estrogen excess, and adipose tissue dysfunction. We demonstrate how menopauseinduced estrogen deficiency amplifies adipose tissue dysfunction by suppressing ERα signaling, enhancing ERβ activity, and disrupting mitochondrial function, insulin sensitivity, and lipid oxidation. Concurrently, the upregulation of aromatase and 17β-HSD1, combined with the suppression of 17β-HSD2, sustains localized estradiol excess, perpetuating inflammation, fibrosis, and immune dysregulation. The molecular signature observed in lipedema closely mirrors that of other estrogen-driven gynecological disorders, such as endometriosis, adenomyosis, and uterine fibroids. Understanding these molecular mechanisms highlights the pivotal role of menopause as a catalyst for disease progression and provides a rationale for targeted therapeutic strategies, including hormonal modulation and metabolic interventions. This review reframes lipedema as an estrogen receptor– driven gynecological disorder, offering a new perspective to improve clinical recognition, diagnosis, and management of this neglected condition.

Lipedema, a chronic and progressive adipose tissue disorder, is characterized by disproportionate fat accumulation, primarily in the lower extremities, often leading to pain, bruising, and mobility impairment. Despite its significant prevalence and impact on quality of life, diagnosis remains challenging, frequently relying on clinical examination and patient history. Ultrasonography holds promise as a non-invasive diagnostic tool, offering insights into subcutaneous tissue characteristics. However, developing a standardized qualitative ultrasonographic classification for lipedema presents considerable challenges due to the heterogeneous nature of fat tissue, variability in disease presentation, and the subjective interpretation inherent in qualitative assessments. This article reviews the current diagnostic landscape of lipedema, explores the potential and limitations of ultrasonography, and critically examines the complexities involved in establishing a robust qualitative ultrasonographic classification. By outlining these challenges, we aim to guide future research towards more objective and standardized imaging criteria, ultimately improving the accuracy and consistency of lipedema diagnosis.

This study investigates long-term volume reduction after microsurgical autologous lymphatic vessel transplantation (LVT) in patients with chronic lymphoedema. Lymphoedema is caused by inadequate lymphatic drainage and leads to swelling, pain, and a reduced quality of life. Conservative treatments often show only limited success, which is why surgical procedures such as LVT are increasingly gaining in importance. In a retrospective long-term analysis, patients who underwent LVT between 1988 and 2010 were examined on average 21.7 years after surgery. The examination included pre- and post-operative volume measurements, which were supplemented by modern 3D body scanner analyses and lymphoscintigraphy. The results show a significant volume reduction both in the short term (p < 0.01) and at the follow-up examination (p = 0.04). There was no significant difference between manual volumetry with circumferential measurements and 3D volumetry (p = 0.775). The improvement in lymph transport capacity was considerable (p = 0.078). This study provides valuable insights for the further development of lymphatic surgery. While preferred surgical methods change over time, this study demonstrates that LVT can make a decisive contribution to improving the quality of life of lymphedema patients.

Background/Objectives: Gender bias in healthcare remains a persistent challenge, partly due to gaps in gender-related knowledge among professionals. While existing instruments assess gender sensitivity and gender-role ideology, there is a lack of generalizable tools specifically designed to evaluate gender-related health knowledge. This study aimed to develop and validate the Gender Knowledge Scale in a sample of 591 nursing students from the University of the Basque Country (Spain). Methods: The 10-item multiple-choice instrument was created using the Nominal Group Technique with a multidisciplinary panel of experts. Results: Psychometric analyses supported a unidimensional structure with acceptable fit indices (CFI = 0.928, RMSEA = 0.025), and items displayed a diverse range of difficulty levels. Knowledge scores were moderately correlated with gender sensitivity but not with gender-role ideology, suggesting that knowledge may influence attitudes but is insufficient to challenge entrenched stereotypes. Knowledge differences emerged across academic years, though not by gender. Misconceptions, particularly regarding menstruation, cardiovascular risk, and pain, were prevalent. Conclusions: The Gender Knowledge Scale is a practical and psychometrically sound tool for assessing gender-related health knowledge among nursing students. While further validation is needed in other populations, the scale may support educational interventions aimed at reducing gender bias in clinical care.