Phlebologie 2018; 47(03): 120-126
DOI: 10.12687/phleb2418-3-2018
Übersichtsarbeiten – Reviews
Schattauer GmbH

Lipoedema – myths and facts Part 2

Article in several languages: deutsch | English
T. Bertsch
1  Földiklinik Hinterzarten – Europäisches Zentrum für Lymphologie
,
G. Erbacher
1  Földiklinik Hinterzarten – Europäisches Zentrum für Lymphologie
2  Dipl.-Psychologin, Psychologische Psychotherapeutin, Supervisorin (hsi)
› Author Affiliations
Further Information

Publication History

Eingereicht: 12 March 2018

Angenommen: 12 March 2018

Publication Date:
21 May 2018 (online)

Summary

Lipedema as a disease is associated with numerous myths. In this small overview of the myths surrounding lipedema, we throw a critical eye on popular statements regarding the disease; We have found that statements made in scientific publications decades ago have been repeated over and over again without criticism. These statements have become part of the general knowledge for lipedema patients and lipedema self-help groups. In the first part of our presentation we focussed on critically reviewing two popular myths about lipedema. We found that there were no scientific evidence for the following statements: “Lipedema is a progressive disease”, and “Lipedema negatively affects mental health”. In this our second contribution on the myths surrounding lipedema, we focussed on the edema aspect; i.e. on the so-called “edema in lipedema” and the subsequently recommended therapy – manual lymph drainage. Myth #3: Lipedema is primarily an “edema problem”, and manual lymph drainage is thus an essential standard form of therapy, which must be conducted regularly! This statement also contradicts our daily experiences with this specific subset of patients to a high degree. Simultaneously we also established through extensive literature research, that there is no evidence for this concept. There is actually no indication that any form of relevant edema is present in lipedema patients, i.e. edema in the sense of fluid retention. There is also no scientific evidence that this barely measureable (in most cases entirely absent) edema is reponsible for the complaints of lipedema patients. There is thus no basis for the prescription of long-term and regular manual lymph drainage for treating this “edema”. Lipedema is much more than just fat and painful legs! We must thus leave behind some of the old therapeutic methods, for which there is no scientific evidence and which furthermore directly contradict our clinical experiences. The comprehensive treatment of lipedema should thus consider all aspects of the disease, not only the immediately obvious such as observable changes and reported symptoms. Lipedema therapy must focus on the treatment of somatic complaints as well as on the psychosocial and sociological aspects of this complex disease, as outlined in our first contribution. The presentation of a comprehensive therapeutic concept for lipedema patients will be the subject of the last part of our short series on lipedema. We find new paths when we have the courage to walk down them – this is also true for the treatment of lipedema!