Weight Gain In Older Women May Not Be From Overeating

By Jennifer Wider, MD

An obesity epidemic continues to sweep the country and efforts are increasing to fight the growing number of people affected. Health care providers have consistently endorsed healthy eating and regular exercise as a way to combat obesity and weight gain. But for a significant number of women across the country, dieting and exercise will not make a difference. That is because they are not suffering from obesity. They have a lymphatic and metabolic disorder called lipedema.

Lipedema involves the extra deposit and expansion of fat cells in a distinct pattern on the body, usually from just below the waist to right above the ankles. In some cases, the arms and torso can be affected. A person with lipedema can appear quite skinny from the waist up, but obese from the waist down. The fat distribution occurs on both sides of the body in a similar fashion.

Lipedema predominantly affects women. It can be inherited and can occur in women of any size.

“It is most likely a hormonal disturbance because men don’t typically suffer from lipedema,” said Guenter Klose, a pioneering therapist who helped establish treatments in the United States for lymphatic diseases, especially lymphedema.

Lymphedema is a swelling of a body part and the result of abnormal accumulation of lymph fluid. The condition can develop in untreated lipedema patients, and at that point the disease is known as lipo-lymphedema. Based in Red Bank, N.J., Klose is a National Lipedema Association scientific advisory board member.

Lipedema typically manifests at puberty, but it can show up or worsen after a pregnancy, after gynecological surgery, or at the start of menopause. As the disease progresses, patients with lipedema can experience a host of problems. Patients can experience painful swelling, bruising, infections, and fibrosis, which is the formation of scarlike tissue.

Recognizing lipedema is not easy in the early stages, especially when patients are not obese. As the disease progresses and patients become larger, they are often labeled obese, going years without a proper diagnosis.

“I found out I had lipedema in much the same way that many lipedema patients do,” said Rebecca Morris, founder and president of the National Lipedema Association in Arlington, Mass.  “I recognized the symptoms of lymphedema in my legs. In 2002, for the third time and at my insistence, I was referred for lymphedema therapy.”

It was the therapist treating Morris’s lymphedema who concluded she had had lipedema, an opinion later confirmed by physician specialist. Neither Morris nor her primary care physician knew what lipedema was.

Unlike the fat associated with obesity, lipedemic fat cannot be exercised away. In addition, this fat tissue does not respond or reduce with diet, Klose said. As a result, undiagnosed patients end up frustrated and confused.

There is currently no cure for lipedema and the limited treatments available focus on alleviating symptoms.

“Compression garments and manual lymphatic drainage can help reduce pressure sensitivity,” Klose said. “The results are gradual and it requires a lot of patience and dedication to the program by the patient.”

The National Lipedema Association is working to improve care for the condition by promoting research, as well as better recognition of the condition by both health care professionals and patients.

This report was provided through the Society for Women’s Health Research.