Compilation of recent publications on Lipoedema

The number of publications on lipoedema has increased enormously. The following is a compilation of recent research, although not exhaustive, on this topic

Date range: January 2024 to June 2024

Title: Quality of life following liposuction for lipoedema: a prospective outcome study

Authors: Klöppel, M., Römich, D., Machens, H.-G., & Papadopulos, N. A.

Publication: Journal of Plastic, Reconstructive & Aesthetic Surgery, 2024, 91, 70–78.

Abstract & Key Findings


The study examines, for the first time, the impact on quality of life after liposuction for lipoedema. The influence of aesthetic plastic interventions and their effects on treatment outcomes has been a major focus of our research group over the past 20 years.


A total of 35 patients were invited to participate in our prospective study, with 30 responding to both the pre- and postoperative questionnaires. The patients received the questionnaires pre-operatively, and 6 months after the liposuction. Our questionnaire set included a self-developed, indication-specific part, along with standardised and validated questionnaires such as the Questions on Life Satisfaction (FLZM), Patient Health Questionnaire (PHQ-4), Rosenberg Self-Esteem Scale (RSES) and the Freiburg personality inventory-revised (FPI-R).


Our self-developed questionnaire showed that our patients feel more balanced, more attractive and more self-confident after the treatment. The FLZM showed significant improvements in all three modules: the general satisfaction with life, the state of health and the outer appearance (body image). Using the PHQ-4, a significant improvement in the two subscales of anxiety and depression could be determined, as well as a reduction in overall mental stress. In addition, the RSES showed a significant improvement in self-esteem post-operatively. Furthermore, the FPI-R indicated a significant improvement in emotional stability.


Liposuction improves the quality of life in lipoedema patients. Post-operatively, our patients reported less pain and were more satisfied with their bodies and appearance. The hypothesis that liposuction in lipoedema improves the quality of life as a multidimensional construct could be confirmed.

Key Findings

  • Study Group and Response Rate: The study involved 30 patients, a larger sample size compared to other prospective lipedema studies. The response rate was high at 86%, which is significantly better than other studies with lower response rates (e.g., 57%)​​.
  • Use of Validated Test Instruments: Unlike previous research, this study employed four comprehensive validated questionnaires to assess the quality of life in its multidimensionality, allowing for better comparison with the norm population​​.
  • Uniformity in Surgical Procedure: Liposuction was consistently performed by the same surgical team, enhancing the comparability of the results​​.
  • Prospective Study Design: The study was designed as a prospective study with a uniform observation period of six months, making the results more objective and comparable across participants​​.
  • Quality of Life Improvement: The hypothesis that liposuction in lipedema improves the quality of life as a multidimensional construct was confirmed. Significant improvements were observed in several quality of life dimensions, including friends, hobbies, health, living conditions, family life, and partner relationships​​.
  • Emotional Stability: The Freiburg Personality Inventory (FPI-R) results indicated significant improvements in emotional stability post-operatively, with fewer patients classified as emotionally unstable six months after the surgery​​.
  • Recommendations for Further Research: The study suggests that further research is needed to fully understand the long-term impact of liposuction in lipedema patients. It recommends follow-up surveys one and two years post-operatively and consideration of other conservative therapies like manual lymphatic drainage and compression​​.
  • Encouragement for Health Insurance Support: The study encourages health insurance companies to support liposuctions for lipedema patients to improve their long-term well-being and to foster further research in this area​​.

Title: National survey of patient symptoms and therapies among 707 women with a lipedema phenotype in the United States

Authors: Aday, A. W., Donahue, P. M., Garza, M., Crain, V. N., Patel, N. J., Beasley, J. A., Herbst, K. L., Beckman, J. A., Taylor, S. L., Pridmore, M., Chen, S.-C., Donahue, M. J., & Crescenzi, R.

Publication: Vascular Medicine (London, England), 2024, 29(1), 36–41.

Full article available

Title: Diagnostic imaging in lipedema: A systematic review

Authors: Parra, R. F. D., Deconinck, C., & Krug, B

Publication: Obesity Reviews, 2024, 25(1), e13648-n/a.

Abstract & Key Findings

Background: Diagnosing lipedema remains a challenge due to its heterogeneous presentation, co-existing diseases, and the lack of objective diagnostic imaging.

Objective: This systematic review aims to outline the currently available diagnostic imaging methods to characterize lipedema in the legs along with their diagnostic performance.

Methods: PubMed, Embase, Google Scholar, Scopus, and Web of Science were searched. The quality assessment of diagnostic accuracy studies (QUADAS) tool was used for quality assessment.

Results: Thirty-two studies describing a total of 1154 patients with lipedema were included for final analysis. Features for lipedema have been defined using ultrasound (increased subcutaneous adipose tissue), lymphoscintigraphy (slowing of the lymphatic flow and a frequent asymmetry between the lower extremities), computed tomography (symmetrical bilateral soft tissue enlargement without either skin thickening or subcutaneous edema), magnetic resonance imaging (increased subcutaneous
adipose tissue), MR lymphangiography (enlarged lymphatic vessels up to a diameter of 2 mm), and dual-energy X-ray absorptiometry (fat mass in the legs adjusted for body mass index (BMI) ≥ 0.46 or fat mass in the legs adjusted for total fat mass
≥ 0.384).

Conclusion: The diagnostic performance of currently available imaging modalities for assessing lipedema is limited. Prospective studies are needed to evaluate and compare the diagnostic performance of each imaging modality. Imaging techniques
focusing on the pathogenesis of the disease are needed.

Key Findings

  1. Study Selection and Characteristics:
    • A total of 32 studies involving 1154 patients with lipedema were included.
    • The imaging techniques evaluated were ultrasound, lymphoscintigraphy, CT scan, MRI/MR lymphangiography, dual-energy X-ray absorptiometry (DXA), and indocyanine green lymphography.
  2. Ultrasound:
    • Seven studies prospectively evaluated ultrasound findings, comparing lipedema patients with control populations (e.g., lymphedema and obesity patients, healthy controls).
    • Significant increases in cutis and subcutis thickness were observed in lipedema compared to healthy controls.
    • One study showed excellent performance of ultrasound in measuring pretibial subcutaneous fat thickness with high sensitivity and specificity.
  3. Lymphoscintigraphy:
    • Eleven studies evaluated lymphoscintigraphy, often including control populations like lymphedema patients or healthy controls.
    • Delayed lymphatic transport and asymmetry in lymph transport were commonly observed in lipedema patients.
  4. CT Scan:
    • Two studies reported increased subcutaneous fat characteristic of lipedema.
  5. MRI/MR Lymphangiography:
    • Eight studies reported on MRI findings, with MRI and MR lymphangiography showing dilated distal lymphatic vessels in about 40% of cases.
  6. DXA:
    • Two studies used DXA, presenting cutoff values for identifying lipedema based on leg fat mass ratios.
  7. Indocyanine Green Lymphography:
    • Four studies revealed significant changes in superficial lymph flow in lipedema, including slower lymph flow and higher fluorescent intensity in the skin.
  8. Diagnostic Accuracy:
    • Only three studies reported cutoff values for diagnosing lipedema, and five studies reported the diagnostic accuracy of imaging studies.
  9. Limitations and Challenges:
    • The review highlighted variability in clinical diagnosis criteria and biases in patient selection and reference standards.
    • The diagnostic value of imaging techniques in lipedema is not thoroughly evaluated, and none of the imaging patterns found are pathognomonic for lipedema.
  10. Conclusion:
    • Despite the availability of various imaging methods, no consensus exists on the best imaging technique to assess lipedema.
    • The study emphasizes the need for standardized diagnostic criteria and further research to validate imaging techniques for lipedema diagnosis.

These findings underscore the complexity and variability in diagnosing lipedema and the need for standardized approaches in clinical practice​​.

Title: Comparison of fluid and body composition measures in women with lipoedema, lymphoedema, and control participants

Authors: Stellmaker, R., Thompson, B., Mackie, H., & Koelmeyer, L

Publication: Clinical Obesity. 2024

Full article available

Title: Proposed Framework for Research Case Definitions of Lipedema.

Authors: Keith, L., Seo, C., Wahi, M. M., Huggins, S., Carmody, M., Faerber, G., Forner-Cordero, I., Michelini, S., Rapprich, S., & Rockson, S. G.

Publication:Lymphatic Research and Biology, 2024 22(2), 93–105.


Background: Our aim is to propose a framework for the development of a research case definition of lipedema, based on current available literature and those observations that can be applied to future lipedema research with the intent to standardize and strengthen the scientific evidence base.

Methods and Results: We conducted a narrative review of the literature, and identified consensus characteristics and disputed characteristics that could be included in a research case definition of lipedema. After considering the strength of the evidence and how each characteristic might be measured in a research study, we recommended an approach for the development of a research case definition of lipedema that would be based on consideration of five agreed-upon characteristics, and five disputed, or less substantiated, characteristics as additional evidence to enhance specificity.

Conclusions: We present a case definition framework for lipedema drawn from the scientific literature that can be applied to future studies on lipedema. Utilizing this framework should help to increase the sensitivity and specificity of case definition and provide an opportunity for meta-analysis of clinical studies and facilitate future research intercomparisons.

Title: Disability and emotional symptoms in women with lipedema: A comparison with overweight/obese women

Authors:Chachaj, A., Jeziorek, M., Dudka, I., Sowicz, M., Adaszyńska, A., Truszyński, A., Putek, J., Kuźnik, E., Małyszczak, K., Kujawa, K., & Szuba, A.

Publication: Advances in Clinical and Experimental Medicine : Official Organ Wroclaw Medical University. 2024

Full article available

Title: Health Implications of Lipedema: Analysis of Patient Questionnaires and Population-Based Matched Controls

Authors: Kempa, S., Gross, M., Oliinyk, D., Siegmund, A., Müller, M., Prantl, L., & Tews, H. C.

Publication: Life (Basel, Switzerland), 2024. 14(3), 295-.

Full article available

Title: Efficacy of Liposuction in the Treatment of Lipedema: A Meta-Analysis.

Authors: Amato, A. C., Amato, J. L., & Benitti, D.

Publication: Curēus (Palo Alto, CA), 2024, 16(2), e55260–e55260.

Full article available

Title: Effect of a low‐carbohydrate diet on pain and quality of life in female patients with lipedema: a randomized controlled trial.

Authors: Lundanes, J., Sandnes, F., Gjeilo, K. H., Hansson, P., Salater, S., Martins, C., & Nymo, S

Publication: Obesity (Silver Spring, Md.), 2024, 32(6), 1071–1082.

Full article available

Title: An uncertain uphill battle–experiences and consequences of living with lipedema

Authors: Dahlberg, J., Nylander, E., Persson, M., & Shayesteh, A.

Publication: International Journal of Qualitative Studies on Health and Well-Being, 2024, 19(1), 2300152–2300152.

Full article available

Title: A Family-Based Study of Inherited Genetic Risk in Lipedema.

Authors: Morgan, S., Reid, I., Bendon, C., Ishaq, M., Shayan, R., Pope, B., Park, D., & Karnezis, T.

Publication: Lymphatic Research and Biology, 2024, 22(2), 106–111.

Full article available

Title: Development of New Predictive Equations for the Resting Metabolic Rate (RMR) of Women with Lipedema.

Authors: Jeziorek, M., Wronowicz, J., Janek, Ł., Kujawa, K., & Szuba, A.

Publication: Metabolites, 2024, 14(4), 235-.

Full article available

Title: Lymphedema and lipedema: More than a swollen limb?

Authors: Carroll, B. J.

Publication: Vascular Medicine (London, England), 2024, 29(1), 48–49.

Full article available

Title: Integrating AI in Lipedema Management: Assessing the Efficacy of GPT-4 as a Consultation Assistant.

Authors: Leypold, T., Lingens, L. F., Beier, J. P., & Boos, A. M.

Publication: Life (Basel, Switzerland), 2024, 14(5), 646-.

Full article available

Title: Prevalence of Fibromyalgia Syndrome in Women with Lipedema and Its Effect on Anxiety, Depression, and Quality of Life.

Authors: Turk, A. C., Erden, E., Buyuksireci, D. E., Umaroglu, M., & Borman, P.

Publication: Lymphatic Research and Biology, 2024, 22(1), 2–7.


Background/Aim: The aim of this study was to determine the frequency of fibromyalgia syndrome (FMS) in patients with lipedema and to evaluate the effects of FMS on anxiety, depression, and quality of life (QoL) in this patient group.

Methods: Patients with lipedema were invited to participate in a Survey-Monkey questionnaire (according to inclusion and exclusion criteria) that was announced on the facebook page of the lipedema patient community. The demographic and clinical properties, including age, body mass index (BMI), education, marital status, and types and stage of lipedema, were collected. Presence of fibromyalgia was assessed by the questions based on American College of Rheumatology 2016 FMS diagnostic criteria. The Hospital Anxiety and Depression Scale and Short Form-12 (SF-12) were used to assess the anxiety and depression, and QoL respectively. The demographic and clinical characteristics, as well as anxiety/depression level and QoL of lipedema patients were evaluated in regard to the presence (Group 1) and absence (Group 2) of FMS.

Results: A total of 354 participants with a mean age of 43.18–9.53 years and BMI of 30.61–6.86 were included. The majority of them were married and had university education. Most of the patients had types 1, 2 and commonly stages 1 and 2 lipedema. One hundred twenty-four patients (35%) satisfied FMS criteria. The demographic characteristics except pain intensity were similar between the groups. The mean anxiety and depression scores of Group 1 were significantly higher compared with Group 2 (13.11–4.2 vs. 9.87–4.65, 10.23–3.79 vs. 8.26–4.15, respectively, p<0.001). The mental and physical subgroup scores of SF-12 (35.37–8.59 vs. 42.55–10.15, 35.27–8.49 vs. 40.38–11.36, respectively) were significantly lower in Group 1 than in Group 2 (p<0.001). Conclusion: More than every 3 lipedema patient may have FMS. This comorbidity may increase depression and anxiety, and impair QoL. Therefore, FMS must be kept in mind especially in the assessment of painful lipedema patients to decrease anxiety/depression and enhance the QoL of them.

Title: Non-obese lipedema patients show a distinctly altered quantitative sensory testing profile with high diagnostic potential

Authors: Dinnendahl, R., Tschimmel, D., Löw, V., Cornely, M., & Hucho, T.

Publication: Pain Reports, 2024, 9(3), E1155-e1155.

Full article available

Title: Assessment Modalities for Lower Extremity Edema, Lymphedema, and Lipedema: A Scoping Review.

Authors: Markarian, B., Toro, C., Moreira, K., Polam, S., Mathew, N., & Mayrovitz, H. N

Publication: Curēus (Palo Alto, CA), 2024, 16(3), e55906–e55906.

Full article available