Lipoedema and Obesity - What's the Difference?

Lipoedema is a condition that is often misunderstood or mistaken for obesity or lymphoedema. According to the World Health Organisation (WHO), the definition of obesity is based on the Body Mass Index (BMI). You can calculate your BMI as follows: Bodyweight (kilogram) : (Body height)² . A BMI of more than 30 kg/m² means obesity, whereas a BMI of more than 25 kg/m² means overweight. For the diagnosis of lipoedema, the Waist-to-Height (WtH) ratio is more important than the BMI. The WtH ratio is beneficial to assess shape disproportions that are typical for lipoedema.

In obese patients, the presence of excessive fat is associated with significant risks to their health: being overweight and obesity can both lead to chronic medical conditions of the heart and the cardiovascular system, diabetes, osteoarthritis, and an increase the risk for some cancer types.

Lipoedema and obesity have different characteristics that are summarised here:

Gender

• Lipoedema: almost exclusively occurs in women
• Obesity: occurs in both men and women

Onset

• Lipoedema: often associated with hormonal changes: puberty, birth control pills, pregnancy, menopause, and phases of weight gain
• Obesity: obesity can already develop in early childhood, but it is not limited to a certain age group

Family history 

• Lipoedema: many lipoedema patients report similar signs and symptoms in other female family members
• Obesity: very common

Affected areas 

• Lipoedema: lipoedema usually symmetrically affects both legs or, less frequently, the arms. The hands or feet are not affected. Enlargement of the legs often results in shape disproportion – a narrow waist and larger hips and thighs
• Obesity: obesity affects the whole body, usually symmetrical

Common signs

• Lipoedema: the affected limbs are often tender, sensitive, or painful. The affected area feels different from normal body fat: it feels cooler, softer, and can appear dimpled like orange-peel
• Obesity: no specific signs, especially no pain

Complications and consequences

• Lipoedema: overweight, limited social life, mental distress (including chronic stress, depression, and anxiety), joint problems, failed diets 
• Obesity: Significant health risks: chronic diseases of the cardiovascular system, heart, diabetes, degenerative disorders of the joints

Although lipoedema and obesity are two different medical conditions, they often occur together. Experts report that up to 85% of lipoedema patients are obese. Obesity in lipoedema patients also increases the risk to the develop lymphoedema. It can be difficult to diagnose lipoedema, differentiate it from lymphoedema or obesity, or find out that two or more medical conditions occur together.

Learn more about how lipoedema is diagnosed