Lipoedema

What is lipoedema?

Lipoedema is a long-term condition in which fatty tissue is distributed in an abnormal way under the skin, most often in the legs, hips and buttocks, and sometimes the arms, out of proportion to the rest of the body. The changes usually affect both sides of the body symmetrically. The build-up typically stops abruptly at the ankles and wrists, sparing the feet and hands and leaving a visible "cuff sign". Unlike normal body fat, lipoedema tissue is often painful or sensitive to touch, and can feel soft in the early stages and lumpy or nodular over time.

Although lipoedema cannot be cured, it can be managed well. With the right care, symptoms can be eased, many people stay active and live well, and it does not always get worse. It is not caused by being overweight, and people of any body size can have it, although the two often occur together. Losing extra weight reduces ordinary fat, but the lipoedema fat itself is harder to change, so the out-of-proportion shape usually stays.

Lipoedema is not the same as lymphoedema, a separate condition where fluid (lymph) builds up in a limb. The two are sometimes confused, and can also occur together, which is sometimes called lipo-lymphoedema. If you are unsure which you have, ask a doctor or a therapist experienced in lipoedema.

Who gets lipoedema

Lipoedema affects almost only women. It often appears or worsens at times of hormonal change, such as puberty, pregnancy or menopause, and sometimes after starting the contraceptive pill or during periods of stress. It tends to run in families, so other women in the family may have the same body shape or symptoms.

No one knows exactly how common lipoedema is. Estimates vary widely, partly because the condition is under-recognised and often missed, and it is probably more common than generally appreciated.

Signs to watch for

Lipoedema usually develops gradually. Tell a doctor or therapist if you notice:

• A build-up of fat that affects both legs (and sometimes both arms) evenly, out of proportion to the rest of the body
• A clear cut-off at the ankles or wrists, with the feet and hands staying a normal size
• Tenderness or pain when the area is pressed, and sometimes pain even with light touch
• Skin that bruises easily
• Skin that feels cool to the touch
• Tissue that feels lumpy or nodular under the skin rather than smooth
• A heavy or aching feeling in the affected limbs

Lipoedema fat does not shrink easily with dieting or exercise the way ordinary fat does, even when the rest of the body becomes slimmer. Symptoms are often worse in hot weather and later in the day, and some people also notice fatigue.

Unlike the swelling of lymphoedema, lipoedema tissue does not usually leave a lasting dent when pressed with a thumb (called pitting). If new pitting or one-sided swelling appears, mention it to your doctor; it may point to a different or additional problem.

Getting a diagnosis

There is no blood test or scan that confirms lipoedema. The diagnosis is clinical, which means a doctor or therapist makes it by taking your history and examining you. They will look at how the fat is distributed, whether both sides are affected evenly, whether the feet and hands are spared, and whether the tissue is tender or lumpy. Most of the time careful examination is enough. Part of the assessment is working out what else could explain the changes.

Diagnosis is often delayed, and many people suspect lipoedema themselves before a clinician confirms it. However, lipoedema is now recognised as a health condition in its own right and it is now included in ICD-11, the World Health Organization reference of diseases and health conditions (ICD-11). Your GP can examine you and refer you to a specialist or a lymphoedema therapist experienced in lipoedema.

Treatment and self-care

There is no cure for lipoedema and no medication that removes the fat. The aim of treatment is to ease symptoms, protect the limbs, and support overall health and quality of life. Most care combines daily self-management with support from a multidisciplinary team: a GP or specialist for medical oversight, a lipoedema therapist for conservative treatment and compression, and where relevant a dietitian, exercise physiologist, or psychologist.

Compression

Compression garments support the tissue, can ease pain and heaviness, and help protect against secondary fluid swelling. Compression does not remove the lipoedema fat. Garments are usually custom flat-knit; off-the-shelf stockings are often not firm or shaped enough.

Compression is not suitable for everyone. People with significant circulation problems in the legs, some heart conditions, or reduced sensation may need a different approach. For this reason, a proper assessment always comes first and compression should not be started without professional advice. Stop wearing a garment that feels too tight, painful, or causes skin damage, and check with the therapist before wearing it again.

Movement and exercise

Movement helps with comfort, mobility and general health. Low-impact activity is best: walking, cycling, Pilates and yoga all help, and exercise in water (swimming or aquatic classes) is especially well suited to lipoedema because the water supports the limbs. Build up gradually, and wear a compression garment during exercise if one has been prescribed. Ask a physiotherapist or exercise physiologist about a plan that suits you.

Eating well

Eating changes in lipoedema are aimed at overall health and at any coexisting weight gain, not at the lipoedema fat itself, which does not respond to dieting. Two patterns are commonly used: a Mediterranean-style, anti-inflammatory way of eating, and lower-carbohydrate or ketogenic approaches. Research into lower-carbohydrate eating is growing and has influenced some treatment guidelines, but it does not suit everyone. A dietitian can help you decide what fits your health and preferences. Avoid extreme or crash dieting, which does not help and can do harm.

Skin care

Looking after the skin keeps it healthy and lowers the risk of infection. Wash gently, pat dry, and moisturise daily with a fragrance-free moisturiser. Treat cuts, scratches and cracked skin promptly. This matters most if lymphoedema is also present, when the risk of infection is higher.

Lymphatic drainage

Manual lymphatic drainage (MLD) is a gentle, specialised form of massage given by a trained therapist. Simple lymphatic drainage (SLD) is a simplified version that the therapist can teach people with lipoedema, their family members or carers, to do at home. In lipoedema, these are sometimes used to help with pain and any fluid swelling.

Pain management

Pain is one of the most troubling parts of lipoedema for many people. Compression, movement and lymphatic drainage can all help. Talk to your GP or therapist about a pain plan if discomfort is limiting what you can do; the right combination differs for each person.

Surgery for lipoedema

For some people whose symptoms persist despite good conservative care, a specialised form of liposuction can reduce the volume of affected tissue and ease pain. It needs a surgeon experienced in lipoedema, techniques that spare the lymphatic vessels, careful preparation, and structured aftercare. Liposuction does not cure lipoedema, and it is not a cosmetic fix: the aim is less pain and bulk, not a guaranteed change in shape, and compression and self-care continue afterwards. The evidence has grown, including a randomised trial reporting less pain after surgery, though long-term data are limited and it is not funded in Australia. If you are considering it, ask a specialist whether it suits you, and be wary of quick procedures, particularly overseas, where the workup and follow-up can fall short.

Other options for certain cases

These are not first-line treatments, but they can help in particular situations. Ask a clinician whether any might suit you.

• Newer weight-loss medications can lower overall body weight and may ease symptoms linked to carrying extra weight, and they are being studied in lipoedema. They are not a proven treatment for the lipoedema fat itself, and would be considered only for a coexisting weight or metabolic problem, under medical supervision.
• A continuous glucose monitor, a small skin sensor worn for a couple of weeks, can show how your own body responds to particular foods and help fine-tune a lower-carbohydrate approach. It is a way to personalise eating rather than a treatment in itself, it is not subsidised for this purpose in Australia, and it works best with professional guidance, so that it supports steady eating rather than worry about food.

Living with lipoedema

Living with lipoedema can be wearing, and the path to a diagnosis is often long. Many people spend years being told their body shape is simply a matter of weight before lipoedema is recognised. The disproportion is part of the condition, not a failure of willpower, and it affects people across the whole weight range, including people who are slim.

Even so, living with a body that does not match expectations, and with pain that others cannot see, can affect body image and mood, and the risk of disordered eating is higher. If low mood, anxiety, or a difficult relationship with food is troubling you, a GP, psychologist or counsellor experienced in chronic illness or body-image work can help; ask for a referral.

Symptoms are often worse in heat and later in the day, so plan demanding activities for cooler mornings, and rest and elevate the limbs when you can. Lightweight clothing, garment-application aids, and regular gentle movement all make daily life easier. Many people find peer support one of the most useful things of all; talking to others who understand eases the sense of being alone with it.

Lipoedema does not always get worse. Many people remain stable for years. Lymphoedema can develop alongside it over time, which is one reason to stay in touch with your treating team.

Support and resources

Lipedema Foundation: lipedema.org. Resources for people with lipoedema and international research registry.

Lipoedema Australia: www.lipoedema.org.au. Information, advocacy, and peer support.

Australasian Lymphology Association (ALA): lymphoedema.org.au. The National Lymphoedema Practitioners Register lists registered practitioners across Australia, including those who care for people with lymphoedema and lipoedema.

healthdirect: healthdirect.gov.au/lipoedema, helpline 1800 022 222 (24 hours).

About this resource

This information sheet was prepared by Dr Kheng Soo, Consultant Physician (FRACP). Dr Soo's clinical practice includes the medical assessment and management of lipoedema, lymphoedema, and chronic oedema. Consultation and referral information: www.drkhengsoo.com

If you are living with lipoedema, seek advice from your doctor or a therapist experienced in lipoedema about an appropriate management plan.

Last reviewed: June 2026. Next review: June 2028.