Lipedema is classified into one of the following five types, based on the location of the fat deposits in the body (1): Type 1 – buttocks, hips, and pelvis. Type 2 – buttock to the knees. Type 3 – buttocks to the ankles. Type 4 – includes upper arms as well. Type 5 – only the lower legs. Currently, there are no particular lab tests or imaging exams to confirm the diagnosis of lipedema. It is usually done based on the woman’s medical and family history and physical examination of the symptoms of lipedema, as discussed below.

Symptoms Of Lipedema

Most women with lipedema would have uneven fat deposits in their lower bodies. There are some other common symptoms that might accompany lipedema, but not all women must have them. As per the Genetic And Rare Diseases Information Centre (GARD), these symptoms may include (1), (2)

 Painful Fat: The fat build-up in the hips and legs might become painful and tender to touch and any sort of pressure.  Easy Bruising: The affected parts of your body might bruise easily. Tiny spider veins that run close to the skin surface might contribute to this bruising.  Upper Arm Fat: About a third of women affected with lipedema might also have excess fat build-up in their upper arms.  Hard Nodules: Pea-sized hard nodules or lumps of fat can be felt under the skin when massaged.  Cuffing At Wrist Or Ankle: Since lipedema does not affect the hands and feet, the swollen legs and arms might look cuffed, especially in later stages of the disease.  Cold Skin: The skin of the affected area of the hips and legs might seem cooler to touch than the rest of the body.  Immobility: With the worsening of the condition, the increase in leg size, heaviness, and the associated pain might lead to joint damage and changes in your gait, making it difficult to walk at all.  Fibrosis: Chronic inflammation in lipedema might also lead to fibrosis or the formation of scar tissue in the fat deposits, further hindering lymph circulation.  Lymphedema: With the progress of the condition, lymphedema (swelling due to lymph fluid blockage) might also occur in the lower limbs and hip area (3).

Apart from the above symptoms, women with lipedema have been found to be more vulnerable to higher rates of migraines, hypothyroidism, depression as well (4). But, strangely enough, they may have lower risks of high blood pressure, type 2 diabetes and metabolic syndrome since most of the fat is deposited in the legs and hips, and not around the visceral organs (5). Lipedema, with its life-altering symptoms, might take a toll on your physical and mental well-being. However, with proper treatment, exercise, and diet changes, the above symptoms of lipedema can be managed to a certain extent. So, what kind of diet can help reduce fat deposits, pain, and fluid retention without affecting their metabolism?

What Is The Best Diet For Lipedema?

While you may not see an immediate improvement in your condition, there are a few food products that might cause lipedema to worsen. You should avoid the consumption of:

 Pasteurized dairy products (milk, cheese, yogurt)

 High-fat animal meat (bacon, red meat, sausage)  Simple sugars and carbohydrates (white rice, pasta, potatoes, honey, or cereals)  Highly processed and salty foods ( beef jerky, smoked meat, canned meat)  Processed or refined flour products (white tortillas or bread)

Apart from these basic dietary changes, many women with lipedema have found considerable improvement in their symptoms on following the ketogenic diet (6). A ketogenic diet restricts the dietary intake of any form of carbohydrates such as sugar, rice, pasta, bread, potatoes, and most fruits. This results in a metabolic state called ketosis, wherein fat becomes the primary source of your body’s energy instead of glucose. But how does a ketogenic diet help improve the symptoms of lipedema? Is it really beneficial in dealing with stubborn fat, its associated pain, and fluid retention? Let’s find out.

Benefits Of The Lipedema Diet

While direct evidence is scanty, a few small studies, clinical trials, and anecdotal evidence suggest that a ketogenic diet may help reduce the fat buildup, pain, and discomfort associated with lipedema (6). Some of the research pieces of evidence that state the beneficial effects of the ketogenic diet for lipedema are mentioned below.

 Helps Lose Weight

When women with lipedema shift to a ketogenic diet, there is a resultant change in their metabolism. Their bodies are forced to metabolize fats instead of glucose to produce energy. This may lead to the burning up of some of the excess accumulated body fat. Many studies confirm that when people cut back on carbs completely and fill up on proteins and fats instead, they tend to eat less and lose weight (7), (8).

 May Help Reduce Fluid Retention

Progression of lipedema may result in lymphedema over time. As per a study, the ketogenic diet can be potentially helpful in reducing lymph fluid retention and swelling of the limbs (9).

 May Help Reduce Pain And Inflammation

The pain associated with lipedema fat could be due to inflammation and allodynia (nerve pain) (10). A number of studies have shown that a ketogenic diet reduces inflammatory and chronic pain associated with weight and obesity (11). Few animal studies also suggest the beneficial effect of the ketogenic diet in reducing allodynia and inflammation (12), (13).

 Helps Remove Excess Fluid

Women with lipedema may benefit from the loss of water from their tissues that may help reduce water retention and the corresponding swelling of the limbs. The ketogenic diet has a diuretic effect initiating loss of water weight in the first few days followed by fat-weight loss (14). As per a study on people with obesity and lymphedema, a ketogenic diet was found effective in reducing the amount of lymph fluid retention in their affected limbs (15).

 May Help Remove Excess Salt

Women with lipedema tend to have higher sodium concentrations in the accumulated fat tissue of their legs and hips (16), (17). A ketogenic diet, by lowering insulin and releasing water weight, also helps remove salt from your body (18), (19).

 May Help Improve Mental Health

Women diagnosed with lipedema have been found to feel low, demotivated, and depressed. Pain and lack of mobility affect their mental well-being as well (19), (20). The ketogenic diet has been found to help improve mental health conditions like depression and anxiety (21). This could help improve the quality of life for women suffering from the cumulative health effects of lipedema. While a change in diet is needed to help facilitate metabolic changes from within, it needs to be supplemented with some amount of exercise to help mobilize the fluid and fat accumulated in lipedema. Let’s delve deeper into what forms of exercise are possible and best suited at different stages of lipedema.

What Is The Best Exercise For Lipedema?

While the painful build-up of fat might prevent you from performing any heavy exercise, maintaining a moderately active lifestyle is key to helping reduce the pain and symptoms. Even gentle walking and leg movements can help mobilize the fat deposits and lymph fluid, reducing the inflammation and pain thereof (22). In the initial stages of lipedema, women should try and maintain an active lifestyle. Even light walking for 45 minutes, 4 to 5 times a week may be helpful. However, women diagnosed with lipedema in the later stages might find it difficult to move due to the pain associated with the fat buildup in the lower half of their bodies. In such cases, light aquatic exercises like walking in water or low-impact water aerobics might help provide some relief. Water helps provide buoyancy to help move the body and some amount of compression as well to channelize the lymph circulation. Few women also use rebounders (small trampolines) or exercise on the vibration plates for lipedema (23). Other treatments that might help improve the symptoms of lipedema include liposuction (surgical removal of subcutaneous fat), massage therapy, compression (with or without vibration therapy), and manual lymph drainage (24), (25). Regular low-impact exercise and following the lipedema diet might help reduce some symptoms and manage this condition better. Can exercise make lipedema worse? Yes. High intensity or vigorous exercises may exacerbate lipedema. Can you lose weight in your legs with lipedema? No, you cannot lose weight in your legs with lipedema. However, in certain lipedema types, fat accumulation occurs only in particular body parts. If there is fat accumulation in the abdomen, hips, pelvis, and thighs, it can make your legs look smaller. Is oatmeal good for lipedema? Yes, whole grains like oats are good for lipedema. Does fasting help lipedema? Not really. You should eat a healthy diet (like a ketogenic diet). Your body needs nutrition to survive and be active. Eat foods that have a good amount of fiber and protein and also consume fruits and vegetables. What happens if lipedema is left untreated? Lipedema, if left untreated, can elevate the risk of hypertension, diabetes, heart failure, and certain eating disorders (27). Is turmeric good for lipedema? Yes. Turmeric functions as an antioxidant and may aid in lowering inflammation, enhancing blood vessels, and eliminating free radicals (28). How does Mucinex help lipedema? Mucinex is believed to reduce pain or thin out the extracellular proteins in lipedema tissue and act as an expectorant. However, there is not enough research supporting these beliefs. What hormone causes lipedema? Estrogen is the hormone that leads to the development of lipedema (29). What is the pinch test for lipedema? You can frequently identify if you have lipedema with a quick pinch test. Lightly pinch the skin in the potentially affected areas of the body to do this. If you have excessive pain, you might have lipedema.

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