Lipedema: It is not obesity, it is a condition of constant pain.

Lipedema: It is not obesity, it is a condition of constant pain.

Our Medical Director, Jorge Orduña, tells us today in his podcast Pirates of Pain the reality of a pathology that affects between 12% and 18% of women worldwide, but which remains a great unknown for many professionals and patients: Lipedema. To delve deeper into this topic, Dr. Orduña interviews Dr. Alexo Carballeira, a prestigious plastic surgeon and a reference in the treatment of this condition, who explains why lipedema is not an aesthetic or weight problem, but an inflammatory disease of the fatty tissue that causes real pain.

What is Lipedema and how to identify it?

Lipedema was recognized as a disease by the WHO in 2018. It is characterized by a disproportionate accumulation of fat, mainly in the extremities (legs and, in 70% of cases, also arms), which does not respond to conventional diets or exercise.

Signs of suspicion:

  • Pain on superficial pinching: If pinching the fat on the inside of the knee or thigh hurts intensely, it is a clear indicator of lipedema.

  • Physical disproportion: thin trunk versus bulky legs or arms.

  • Frequent bruising: Appearance of bruises with no apparent traumatic cause.

  • Feeling of heaviness: A constant tension that worsens at the end of the day.

The misdiagnosis: Lipedema or Fibromyalgia?

Dr. Carballeira points out that many patients go through more than three specialists before being correctly diagnosed. Often, due to a lack of knowledge, it is labeled as obesity or fibromyalgia (it is estimated that 30% of patients with lipedema have this prior diagnosis). It is essential that the physician knows how to differentiate mechanical joint pain from subcutaneous tissue pain.

The 360° Approach: Conservative Treatment First

Despite being a plastic surgeon, Dr. Carballeira is firm: surgery is not the first step. Treatment should be multidisciplinary and start with conservative measures:

  • Anti-inflammatory Diet: Fundamental to reduce pain and tissue inflammation.

  • Low-impact sports: Especially in water (swimming, aquagym) or Nordic walking.

  • Flat knit compression garments: Essential orthopedic tools to improve lymphatic drainage and reduce heaviness.

  • Psychological support: The emotional impact and social misunderstanding generate a burden of anxiety that must be treated.

Discharge Surgery: Recovering quality of life

When conservative treatment is insufficient, surgery comes into play. This is not a conventional aesthetic liposuction, but rather an unloading surgery.

  • Pain Improvement: The most powerful impact of surgery is functional; 90% of patients report dramatic improvement in pain and heaviness.

  • Cutting-edge technology: The use of radiofrequency helps to retract the skin after removing large volumes of fat, improving the aesthetic and functional result.

Patient Safety: The importance of qualification

A critical point of the talk is the warning about intrusiveness. Jorge and Alexo stress that these surgeries, which sometimes involve the removal of 5 to 8 liters of fat, must be performed by qualified plastic surgeons (via MIR) and in hospital environments with full guarantees (equipped operating rooms and presence of an anesthesiologist). On social networks you can see everything, but to enter the operating room you must have a plan A, a plan B and a plan C.

The final message to patients is one of hope: “You are not alone”. The diagnosis often brings immense relief with the realization that the volume in their legs was not their fault. Although lipedema is a chronic condition, with proper diagnosis and comprehensive treatment, it is possible to regain mobility and live without the burden of constant pain.