Pictures: Joyce Bosman, Bauerfeind
>>> Lipedema and adiposity
Greer (1974) pointed out that, although not
all lipedema patients are obese, some 50
percent of those affected are overweight.
Given the population increases within many
different ethnic and cultural groups, howev-
er, there are signs around the world of eat-
ing habits and preferences becoming highly
varied. This changing structure, together
with our faster pace of life, has played a part
in the incidence of overweight lipedema
patients increasing to an estimated 70
to 80 percent. This can make it difficult
when performing differential diagnoses to
distinguish overweight or obese patients. As
such, it has been suggested that pronounced
fat deposits on women’s legs may be ac-
counted for as follows: obesity (60 percent),
lipedema (20 percent), or a combination of
the two (20 percent).
Those with pure lipedema are often recom-
mended pointless forms of treatment like
weight reduction. It is not unusual for
patients to make numerous failed attempts
through diet or sporting activities to lose
excess fat from extremities affected by
lipedema. For many patients, the condition
is associated with feelings of shame, with
depression and low self-esteem often de-
veloping as well. Langendoen et al. showed
that a patient’s mobility can be restricted by
feelings of shame or by physical unease, as
well as by pain or mechanical impediments,
with obesity sometimes developing over
time as a result.
Targeted treatment, lower costs
It is particularly important to further improve
recognition and awareness of lipedema among
specialists, not to mention among politicians
and decision-makers within the public and
Joyce Bosman is a physiotherapist and
edema therapist at Medisch Centrum
Zuid in Groningen, the Netherlands. She
organizes the Dr. Vodder School in the
Netherlands in cooperation with the
Dr. Vodder Schule in Walchsee, Austria.
If you would like to be updated and con-
tribute to consensus about the manage-
ment of lipedema, or you have experience
with one of the above-mentioned topics
that you would like to share, please send
an e-mail to
1. Langendoen, SI; Habbema, L; Nijsten, TEC; Neumann, HAM. Lipedema: from clinical
presentation to therapy. A review of the literature. Br J of Dermatology 2009;161:
2. Schmeller, W; Meier-Vollrath, I. In Weissleder and Schuchhardt. Lymphedema. Diagnosis
and Therapy, 2007. Lipedema (Chapter 7).
3. Forner-Codero, I; Navarro-Monsoliu, R; Muñoz-Langa, J; Rel-Monzó, P. Early or late
diagnosis of Lymphedema in our lymphedema unit. Eur J of Lymphology 2006;49:19-23.
4. Herpertz, U. Lipedema. Z Lymphol 1995;19:1-11.
5. Földi, M; Kubik, S (Eds.): Textbook of Lymphology. Urban and Fischer, 2005.
6. Lymphoedema Framework. Best practice for the management of lymphoedema.
International Consensus. London: MEP Ltd, 2006.
7. Greer, KE. Lipedema of the legs. Cutis; 1974:14:89.
private health systems. The main thing is to
ensure that substantial work on new treat-
ment approaches continues unremittingly so
that care for patients with lipedema improves.
Lipedema is a chronic, progressive condi-
tion, which can sometimes be slowed down or
even controlled through early diagnosis and
a targeted approach to treatment. These also
offer scope for reducing health care system
spending by several millions.
Joyce Bosman, physiotherapist and edema therapist at Medisch Centrum Zuid in Groningen.