If you’ve struggled to get rid of dimply fat in your legs, hips, or arms — despite rigorous dieting and exercise — you may be dealing with more than just stubborn weight. It could be lipedema.
Similarly, women on GLP-1 medications have found that, despite losing a significant amount of weight, their legs (and sometimes even arms) may continue to look the same. If this sounds like you, it’s possible you may have lipedema, a chronic condition that causes fat cells to accumulate in your lower body, especially the legs.
“Lipedema is underdiagnosed, and many patients are told their symptoms are due to obesity or lifestyle choices,” says Dr. Thomas Su, a lipedema liposuction specialist and cosmetic surgeon. “This misinformation leads to delayed care and unnecessary suffering.”
Understanding what causes lipedema — and how to treat it — can improve your self-confidence and quality of life.
[READ: How to Gain Muscle and Lose Fat at the Same Time]
What Is Lipedema and How Does It Progress?
Lipedema is a chronic fat disorder that primarily affects women. It causes an asymmetrical buildup of fat, most often in the legs, hips, butt, thighs and calves.
Lipedema progresses over time. The stages of lipedema are:
— Stage 1. The skin on your legs looks normal, but underlying fat feels thicker and slightly rubbery. This may appear as bumps directly under the skin. It may also be painful to touch and skin may bruise more easily.
— Stage 2. The skin begins to grow unevenly around the subcutaneous fat, which is what creates the classic dimpled appearance and lumpy skin texture.
— Stage 3. In addition to noticeable indentations in the skin, legs begin to look swollen or inflated at this stage. Larger fat masses develop around the thighs and knees, which can impair mobility, making it more challenging to walk normally. It can also contribute to joint pain.
— Stage 4 (also known as lipolymphedema). This stage often involves a secondary lymphedema diagnosis, characterized by excess fluid buildup — in addition to the fat buildup. It’s when the lymphatic system (a group of organs, vessels and tissues that play a role in your immune and circulatory systems) becomes compromised. This causes significant swelling in the legs that impairs movement to an even greater degree than stage 3 lipedema. Secondary lymphedema is extremely difficult to treat through conservative approaches.
[READ: Factors That Contribute to Weight Loss and Weight Gain]
Common Lipedema Symptoms and Signs
Common symptoms of lipedema include:
— Disproportionate fat accumulation in the lower body
— Bumpy fat buildup
— Tenderness
— Swelling
— Pain from pressure applied to affected areas
— Bruising easily
— Difficulty losing weight from diet and exercise modifications
— Fatigue
Not everyone will experience the same symptoms with lipedema. In fact, some may have lipedema in their upper body, primarily the upper portion of the arms, though it’s not as common.
Lipedema vs. cellulite
Lipedema can often be mistaken for cellulite, a very common (and harmless) skin condition that affects up to 90% of females, primarily around the thighs, butts and hips. While it also leads to dimples and depressions in the skin, it’s very different from lipedema.
While lipedema causes swelling and is often painful, cellulite doesn’t cause any symptoms — it’s more of an aesthetic concern for folks.
The treatments for each are also very different. For instance, the most effective treatment for lipedema is liposuction. But for cellulite removal, liposuction can worsen dimpling from cellulite. Instead, it often becomes less noticeable with more conservative treatments, like weight loss, increased muscle mass from exercise and even certain creams and lotions.
[READ MORE: Health Questions to Ask Your Doctor]
What Causes Lipedema? Genetic and Hormonal Influences
While the exact cause is not fully understood, lipedema appears to have a strong link to:
— Puberty
— Genetics
[Read: Calf Stretches to Relieve Muscle Pain.]
Lipedema Risk Factors
Since the exact cause of lipedema isn’t fully understood, its risk factors are also somewhat uncertain.
However, there are certain known risk factors, including:
— Having a family history of lipedema
— Being born female
— Experiencing hormonal fluctuations
— Having a body mass index (BMI) of 35 or above
[READ: What Is Bariatric Surgery?]
Complications of Untreated Lipedema (Lymphedema Risk)
Lipedema isn’t just a cosmetic issue — it can pose real health risks. These include:
— Mobility issues, such as difficulty walking
— Increased risk of vascular disease
— Flattened foot arches
— Strained joints
— Increased risk of infection
— Anxiety and depression
— Secondary lymphedema, which can lead to lymph (fluid) buildup
[SEE: Questions to Ask Before a Cosmetic Procedure]
How Doctors Diagnose Lipedema: Physical Exam and Imaging
There is no one specific test for lipedema.
There are often two key prongs of a physical examination.
1. Visual inspection:
— Even fat buildup on both sides of the body
— Notable size differences between the upper and lower body
— Fatty deposits that form small bulges around the hips, inner knees, ankles or above the elbows
— A distinctive fold or “cuff” of fat at the ankles or wrists
— Visible small or enlarged veins (spider veins or varicose veins)
2. Palpation
Your doctor will use their hands and fingers to assess your skin texture and its tenderness. They will also be looking for signs of fibrosis, or hardened, scar-like connective tissue that replaces normal tissue and fat in the affected areas.
Key signs of lipedema include:
— Lumpy, firm or uneven skin texture
— Tissue that feels different from surrounding tissue
— Pain or tenderness when applying light pressure to the affected area
— Unusual coolness around the affected skin (compared to surrounding tissue)
“However, it’s important to rule out other causes for lower extremity swelling, such as deep venous thrombosis or chronic venous insufficiency,” says Dr. William Shutze, a board-certified vascular and general surgeon at Texas Vascular Associates in Dallas.
If the ultrasound shows no signs of these vascular conditions, they can make a lipedema or secondary lymphedema diagnosis depending on the severity of your condition.
Effective Lipedema Treatment and Management Strategies
There is no cure for lipedema, but that doesn’t mean you can’t manage the condition or reduce its physically (and emotionally) debilitating effects. Making certain lifestyle modifications and doing a combination of medical and surgical interventions can help ease pain and even improve your self-image.
Lifestyle modifications
Research has identified an association between lipedema and inflammation in the body. Making the following modifications may help you manage the condition and improve inflammation levels. These include:
— Eating an anti-inflammatory diet, such as the Mediterranean diet or DASH diet
— Taking inflammation-fighting supplements, like omega-3 fatty acids and vitamin D
You can also explore alternative or adjunctive therapies to help reduce inflammation. The Lipedema Foundation recommends the following:
— Cupping
— Dry needling
— Dry brushing
— Using a massage gun on the affected areas
Medical treatments
These medical treatments can help tame lipedema symptoms and prevent the condition from worsening.
— Manual lymphatic drainage. Lymphatic drainage massage is a gentle, noninvasive massage technique designed to encourage lymph fluid movement and drainage. This can help reduce swelling and discomfort.
— Compression garments and accessories. Compressive tools — like stockings, bandages, wraps and inflatable devices — for your legs can all help manage inflammation, reduce fibrosis and improve lymphatic flow in your lower body.
— GLP-1 medications. If you’re overweight and you qualify for one of these powerful weight loss drugs, it can help reduce inflammation and even potentially remove lipedema nodules. It will also help reduce harmful types of fat, such visceral fat, though it won’t directly reduce subcutaneous fat associated with lipedema, the Lipedema Foundation suggests.
Surgical treatments
Despite the health benefits associated with complementary and medical treatments, surgical interventions are necessary to completely rid your body of lipedema fat.
“Liposuction is currently the only proven method for removing lipedema fat,” Su says. “For lipedema patients, this cosmetic improvement is especially important because of the deep psychological toll the condition can take.”
Apart from cosmetic improvements in both shape and proportion, patients also find significant relief in lipedema symptoms, such as a reduction in pain and heaviness in their legs.
Bariatric surgery may also be a part of the conversation you have with your doctor, especially if your body mass index exceeds 35.
FAQs About Lipedema
Can lipedema be cured?
No, there is currently no known cure for lipedema, but the condition can be effectively managed and treated through various therapies.
What type of doctor treats lipedema?Lipedema is often treated by specialists who have experience with the condition, such as specialized dermatologists, vascular surgeons or phlebologists (vein specialists).
Is lipedema genetic?
Yes, lipedema is believed to have a strong genetic component, often running in families.
Bottom Line
Lipedema isn’t just a cosmetic inconvenience; it can severely hinder your mobility and ability to engage in everyday activities. This chronic condition is often overlooked, so important you stay vigilant of the signs and know your family medical history. If you’re experiencing pain, fatigue and swelling, be sure to talk to your doctor. Often surgical interventions are the key to removing lipedema fat, though other medical and complementary treatments can help manage symptoms in the interim.
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What Is Lipedema? Symptoms, Stages, Causes and Effective Treatments originally appeared on usnews.com
Update 04/10/26: This story was previously published at an earlier date and has been updated with new information.
