Signs and Symptoms of Lipoedema

Lipoedema is a long-term (or chronic) medical condition, that is the accumulation of abnormal fat (adipose tissue) and is unrelated to diet. It particularly affects the legs; however, it may also impact the arms. It appears to almost exclusively affect women but, a few cases of men with lipoedema have also been reported. Most women who have lipoedema report its onset around puberty, although it may also be reported at a time of hormonal change such as pregnancy, menopause and oral contraceptive use.

Signs and symptoms may include the following:

  • Tissue enlargement and changes. The development of fatty tissue enlargement for those with lipoedema is gradual and/or subtle. It affects both limbs, and they appear symmetrical in appearance. It mostly affects the legs, especially the thighs, hips and buttocks, but the feet are spared and appear normal. In some cases, the upper arms may also be affected but not the hands
  • Cuffing or braceleting. Tissue enlargement does not extend into the feet or hands. It stops abruptly at the ankles or wrists known as ‘cuffing or braceleting’
  • Affected area look and feel. The tissues in the affected areas may feel cooler than the rest of the body due to the insulating effect of the fat. They may also look pale and feel softer. Over time, the tissues lose their tone becoming very loose and ‘floppy’
  • Pain. The lipoedema limbs are often tender, sensitive or painful
  • Skin texture. Bulging areas of fat can lead to a ‘mattress effect’ on the skin, often described as orange peel or cellulite
  • Shape disparity. Those with lipoedema of the lower limbs often have shape disproportion, that is a narrow waist and large hips. Many experience difficulties in buying clothes to fit, as their upper body is often several sizes smaller than their lower body. Finding trousers, boots, sweaters and jackets that fit can be particularly frustrating. Many advise that they become increasingly self-conscious about their appearance. This can affect self-confidence and participation in social and sporting activities
  • Mobility and gait. Range of movement may be restricted and/or reduced for those with lipoedema. This is often due to the heaviness of the limbs, or tissue enlargement that causes the limbs to rub together (chaffing), especially at the inner-thigh area. Abnormal gait (walking position) may be a problem, especially if the legs are very bulky around the knees. Flat feet and knock-knees may also be troublesome for some with lipoedema
  • Joint pain. Knee and hip pain may be problematic if suffering from lipoedema. This can limit movement and may cause further general weight gain, as it may prevent exercise being effectively implemented. Some lipoedema sufferers also report hypermobility of the joints (joints that extend beyond the normal range). Muscle weakness may also be a feature of lipoedema
  • Diet and exercise. Many with lipoedema advise that their affected limbs do not respond to calorie-restricted diets and exercise. Only the unaffected areas reduce in shape and size, resulting in possibly more shape disproportion. However, a healthy balanced diet and movement and exercise is encouraged. 
  • Foot swelling. Some who are diagnosed with lipoedema describe foot swelling at the end of the day, during hot weather, after standing for prolonged periods of time or following long-haul flights. It is not uncommon for those who do not have lipoedema to experience these symptoms, therefore, this is not a clear indicator that lipoedema is present. However, if it is a co-existing feature, the symptoms of lipoedema can be exacerbated.

If you are experiencing any of the above signs and symptoms, or believe you may be suffering from lipoedema, make an appointment with your GP or healthcare professional to discuss this further.