Has your body always felt different?  Have you always struggled to lose weight?  Do you suffer pain (usually in the legs)?  Have you repeatedly been told by Health Professionals to "go away and lose weight"?  It may be that you have a condition called Lipoedema. 

 

Lipoedema is a chronic condition that affects women (men rarely) and involves the body producing an abnormal amount of adipocyte (fat) cells which settle under the skin - . usually around the hips, buttocks and thighs.  It is a metabolic and connective tissue disorder also with links to HSD (Hypermobility Spectrum Disorders) and onset is linked with stages of hormonal imbalances; namely puberty, starting on contraception, pregnancy and permi-menopause.  There are 4 stages and 5 types of Lipoedema although staging is becoming increasingly seen as outdated and is being used less and less.  

 

Thankfully, a great deal of research is now going on into the condition since it's discovery in the 1940s. 

 

Sadly, many people have suffered for years (sometimes decades) with this condition and, as a result, weight gain has occurred.  Lipoedema is becoming known as the Hidden Condition - due to it being hidden behind obesity.  In the USA, 80% of Lipoedema patients also have obesity, but many also have pain and traditional fat is NOT painful!  Can it also be present in those without excess body fat?  Yes it can, it is just much harder to assess for!  The earlier someone can be assessed for it and lifelong management can be integrated into daily life, the better!

​

Historical thinking has been that Lipoedema is a progressive condition. However, the latest research, and many leading experts globally, now conclude that there is no evidence that Lipoedema is progressive.  It is weight-gain, particularly in the truncal region, that is biggest factor in progression of the condition.  Therefore, the main focus has shifted to that of "stabilise weight and move" being of the utmost importance.  If non-lipoedema fat can be kept as low as possible, there is little evidence that the condition will progress.  ​​

 

It has always been thought that Lipoedema will progress and become Lymphoedema or a condition called Lipo-Lymphoedema.  However again, there is no evidence to support it.  There is evidence though that it is the obesity that puts extra pressure on the Lymphatic System and therefore, it is the obesity that  causes Secondary Lymphoedema.  As a Lymphoedema Therapist, it is well known that one of the causes of Lymphoedema is obesity. 

​

Although it doesn't seem it, this is good news!  If non-Lipoedema fat can be reduced, this will reduce the risk of the condition progressing and/or also leading to Lymphoedema.   You do have power over the condition!  This is new thinking, but how empowering when so many women think there's nothing they can do. Guidance is also now recommending that obesity, Lipoedema and Lymphoedema should all be equally as separate conditions and recognised in the care, support and management of those with Lipoedema.  That is the care we offer at Trayah - always in line with the latest research and evidence.  

​

So what are the symptoms?

• Disproportionate body shape – lower body (hips, thighs, legs) much larger than upper body.

• Fat that is resistant to diet and exercise – areas affected do not improve in appearance or reduce in size as much as other areas of the body 

• Symmetrical swelling – both legs (or both arms) are usually equally affected

• Fat pads around knees, thighs, or ankles – creating a “cuffing” or “bracelet” effect.

• Soft, doughy, nodular fat texture – feels different from normal fat.

• Tenderness or pain in the affected areas – may be constant, intermittent or triggered by pressure or touch (hypersensitive)

• Easy bruising – especially on the legs, often without clear injury.

• Cold limbs – skin on legs or arms may feel cold to the touch.

• Restricted mobility – especially in more advanced stages due to heaviness or joint pressure.  This includes gait changes.

• Emotional distress or body image issues – due to changes in body shape and chronic symptoms.

 

​​Treatment options:

These are gone through at the initial assessment appointment but can include:

• Compression garments to support the inflamed tissue, reducing pain and feelings of heaviness.  Medical grade garments are not always required

• Skin care

• Diet/Nutrition advice (within our scope of practice) - there are many thoughts out there but due to there being a larger amount of inflammation in the body with Lipoedema, an anti-inflammatory diet is recommended.  The Keto diet, low-carb and Mediterranean Diet are all recommended.  Reducing/eliminating sugar, ultra processed foods and alcohol is key to minimise blood sugar spikes

• Movement

• Clinical Manual Lymphatic Drainage (MLD) - to reduce the pain and feeling of heaviness of the limbs  and can also reduce any oedema (fluid) that may be present in obesity-related Lymphoedema

• Decongestive Lymphatic Therapy (where appropriate)

• Remedial myofascial massage including gua sha, cupping, LLLT and ultrasound

• Intermittent pneumatic compression (compression pump therapy)

• Liposuction which is only available privately and care should be taken to ensure your chosen surgeon is experienced with Lipoedema

​

With the exception of surgery (you'll be pleased to know!), Trayah is your "one stop shop" for support with all of these treatment options. 

​​​

​

If you feel this is something you've been battling, we can help. 

​

 

 

The Trayah Way...

 

At the initial  assessment we take a full health history and carry out a range of assessments to ascertain whether (or not) you have Lipoedema.  We listen to you about how you are and have been affected - physically, mentally and emotionally.  We find out your goals for treatment and from these recommend a personalised treatment plan to support you based on our findings.  This includes evidence-based options to continue with at home in-between appointments which are emailed to you as a management plan.  These goals are then used to check the progress of treatment in the future, adjusting if needed.  

 

In line with the latest research, we work holistically with long-term support.  It is normal to have slightly more frequent appointments in the beginning but the aim is to reduce these as much as possible.  We are ALWAYS at the end of a telephone however!  These following appointments may include compression measuring/ordering, Manual Lymphatic Drainage, Intermittent Pneumatic Compression Pump, LLLT, DOT Therapy, Cupping, Myofascial massage etc.  

 

We do need to make you aware that medical grade compression is not always necessary for the management of Lipoedema and we will know this following our assessment.  However, if they are, measurement and ordering can take place at an appointment with us. 

​

During this process of support, we will also write to your GP.

​

Due to the fact the latest research shows how important ongoing support and community is for those living with Lipoedema, we have also started a private Whatsapp group that you are welcome to be a part of.  It is for past/current patients at Trayah and, although newly set up, is fast becoming a beautiful space of supportive ladies!

​

​

​

​​

​

​

​