Lymphedema and Lipedema: What are the differences?

Explaining the differences between Lymphedema and Lipedema .

Lymphedema and Lipedema (sometimes spelled lipidema or lipoedema)can easily be confused with each other, but they present in very different ways with different pathologies or reasons why they may occur in a patient. 

Lipedema is a chronic disorder of fat metabolism and distribution which usually manifests as a disproportionate amount of fat being stored in the lower half of the body. While lipedema can affect both men and women, it’s most commonly seen in people assigned female at birth. 

Lipedema is a chronic disorder of fat metabolism and distribution.

According to The Lipedema Project: “Lipedema is a relatively common fat disorder that is often mistaken for simple obesity. Its clinical diagnosis is an adipose tissue disorder or a lipid metabolism disorder. A typical lipedema patient is a woman who struggles with large hips and legs, usually out of proportion to the rest of her body. Lipedema also appears in the upper arms. One of the hallmarks of the disease is that lipedema fat is relatively unresponsive to diet and exercise. These measures may lead to weight loss in other areas, but the size of the hips and legs remains disproportionately large.”

Lipedema sufferers will present with a disproportionate amount of fat stored in the outer thighs, inner thighs, lower legs and ankles, and sometimes the upper arms. In severe cases, the fatty collections can be quite disfiguring, leading to problems with joints and mobility. The cause of lipedema is unknown however experts believe it’s linked to hormonal imbalances, particularly in people assigned female at birth as many symptoms develop or worsen during times of extreme hormonal changes such as puberty, pregnancy, or menopause. 

Those suffering from lipedema generally experience hormonal disturbances, frequent bruising of the skin, and develop tissue that feels rubbery to touch or as if there are bumps under the skin. Lipedema can be a progressive disease and may worsen with age. It progresses with big changes in weight, hormones or stress.  Additionally, studies have shown that lipedema may run in families.

Lymphedema, on the other hand, is an excess build-up of fluid in the arms or lower legs. Lymphedema occurs because of a blockage in your lymphatic system which is part of your immune system. Where lipedema is primarily a condition that is characterized by increased fatty tissue in the affected areas, lymphedema is essentially a build-up of lymph fluid in these tissues. This blockage prevents your lymph fluid from draining properly and the build-up of excess fluid causes symmetrical swelling. 

Lymphedema is an excess build-up of fluid in the arms or lower legs

The causes of lymphedema can be divided into primary and secondary. Primary lymphedema is a rare genetic condition and can develop in infancy, during puberty or pregnancy, or in some cases after the age of 35. 

Secondary lymphedema occurs as a result of another disease or condition. Secondary lymphedema can be caused by injury or removal of lymph nodes during surgery, exposure to radiation treatments for cancer, or due to an infection of the lymph nodes.

Interestingly, lymphedema can also occur secondary to lipedema. The reason for this is that the increased fatty tissue in lipedema can congest the very delicate lymphatic tracts/vessels and impede the flow of lymph fluid resulting in a build-up of lymphatic fluid – aka lymphedema. 

Those suffering from lymphedema experience different symptoms than those with lipedema. Lymphedema sufferer’s skin tends to be more tolerant and not painful to touch. They also don’t bruise as easily and do not suffer from hormonal disturbance. People with secondary lymphedema often describe a feeling of heaviness in the affected limb(s) and the area of swelling is most commonly asymmetrical.

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