# Lipedema and obesity: A narrative review and treatment protocol

## TL;DR

This paper reviews lipedema and obesity, highlighting the challenges of misdiagnosis and proposing a treatment protocol for patients with both conditions.

## Contribution

The paper proposes a treatment protocol for patients with both lipedema and obesity based on current literature.

## Key findings

- Lipedema is often misdiagnosed as obesity or lymphedema, leading to ineffective treatments.
- A combination of conservative and surgical approaches is beneficial for treating patients with both lipedema and obesity.
- Early recognition of lipedema in patients with obesity can improve treatment outcomes.

## Abstract

Lipedema is a chronic condition characterized by abnormal fat accumulation, primarily in the lower extremities, affecting mostly women. Despite improvements in diagnosis and treatment, lipedema is often misdiagnosed as obesity or lymphedema. Patients with obesity and lipedema propose a distinct clinical challenge in treating both diseases. Improved recognition and understanding are necessary to enhance diagnosis and treatment outcomes.

Lipedema is thought to be hormonally driven, often manifesting during puberty, pregnancy, or menopause. It presents as disproportionate fat accumulation in the lower body, often with microvascular changes. Misdiagnosis as obesity or lymphedema leads to ineffective treatments like weight loss programs and bariatric surgery. Effective management involves both conservative and surgical approaches, as well as a tailored strategy for patients with both lipedema and obesity. The focus of this review is to summarize the current literature addressing adequate treatment regimens for patients with both diseases and based on the literature we propose a treatment protocol.

Patients with concurrent lipedema and obesity propose a distinct clinical challenge, in which early recognition can benefit adequate treatment. A combination of conservative measures and surgical options, particularly liposuction and/or bariatric and metabolic surgery, can be beneficial in treating patients with both diseases. However future research is needed to assess the effect of different treat regimens.