Lipoedema is a chronic, painful disorder which almost exclusively affects women. It is estimated that 10% of women are thought to have the condition. Despite this prevalence, many go ignored, undiagnosed and untreated for years. This Blog explores some of the key facts around this devastating illness.
Nurses and midwives are in a powerful position to spot early warning signs of lesser-known conditions, such as lipoedema, a chronic condition that almost exclusively affects women, causing an abnormal build-up of fat and a myriad of symptoms which can often be misunderstood, misdiagnosed, and overlooked in education.
Lipoedema is a chronic condition causes an abnormal build-up of adipose tissue, typically hips, thighs and legs and sometimes arms are affected, while the waist and upper body remains relatively slimmer and unaffected. These affected areas may appear large, heavy and painful and out of proportion to the upper body. This abnormal fat is resistant to diet and exercise and many women are told by clinicians and healthcare practitioners, that have mistaken the condition as obesity, to “simply eat less and move more,” compounding both physical and psychological distress.
Left undiagnosed, lipoedema can lead to a range of complications:
- gait or joint problems and reduced mobility
- anxiety, depression, and loss of confidence
- earlier-than-expected exit from the workforce
- challenges in family life and personal relationships
- obesity or secondary lymphoedema.
The physical impact is significant but so too is the emotional toll of living with a condition that's misunderstood or dismissed.
There is no single diagnostic test for lipoedema – differential diagnosis is through clinical examination and comprehensive assessment.
A greater awareness of the condition amongst nurses and a holistic approach can make a huge difference. Look out for:
- disproportionate body shape – larger lower body vs. slimmer waist and upper body
- pain, heaviness or tenderness in legs or arms and fatigue
- Sometimes varicosities are visible over the legs as well as bruising
- no foot or hand swelling (unlike lymphoedema)
- a history of weight gain around hormonal events such as in puberty, pregnancy, menopause
- multiple dress sizes difference between top and bottom halves
- a pad of fat medially on knees and ‘cuffing’ at the ankles or sometimes wrists
- uneven appearance to subcutaneous tissues – especially over the thighs or hips and sometime small nodules can be felt under the skin on palpation.
The onset of lipoedema is usually around puberty, pregnancy, or menopause, and quite often runs in families, with mother, grandmother or aunt having similar symptoms.
I recently met a young patient in her 20s with mild lipoedema with concerns that her legs would worsen and “turn into my mothers”. She went on to have specialist liposuction in Germany and was delighted with the outcome and improved symptoms. Many may consider that extreme in such a mild case, however, I met her mother a few months later who had not been diagnosed, she explained her symptoms had worsened over the years and she was now struggling with pain, joint and mobility issues and to keep on working.
Whether in primary care, community nursing, school health, weight management, or midwifery, you may be the first professional to recognise lipoedema.
Recognise and refer
Early recognition is key. If you suspect lipoedema, refer patients to their GP or local Lymphoedema, vascular, or dermatology services. Referral pathways vary - some services may not accept lipoedema patients, so advocacy with policy makers or commissioners is often needed.
Educate and empower
Help patients understand: “This is a medical condition, not a lifestyle failure.”
Point them toward trusted resources like charity Lipoedema UK and consider referral to psychological support if needed.
Compression and therapy
- Flat-knit, made-to-measure compression garments can help relieve symptoms. For some with milder symptoms - lighter supportive or support wear may be helpful.
- Adjunct therapies like Manual Lymphatic Drainage, Deep Oscillation Therapy, Intermittent Pneumatic Compression Therapy.
- Exercise, such as swimming, walking, strength training and light weights or even gentle movement can be helpful.
- The abnormal buildup of adipose tissue is not that respondent to normal weight management programmes and BMI can be misleading – however weight management is relevant and avoiding further weight gain is important. Although more research is needed there is some evidence that avoiding processed foods and anti-inflammatory diets can be helpful with symptoms. In some instances, a referral to weight management may be helpful.
These Conservative therapies can help manage symptoms, but do not reduce the volume of abnormal adipose tissue. Specialist liposuction does however and much of the evidence on specialist Liposuction has come from Germany and is the only treatment shown to reduce lipoedema fat, as well as improving symptoms and improving quality of life for those living with the condition. While NICE interventional guidance currently restricts this procedure to ‘research-only’ settings, a large multi centre, randomised controlled trial in Germany (due late 2026-27) may change this guidance in future.
There is some anecdotal evidence that GLP-1 receptor agonists medication may help with symptoms of lipoedema but further research and evidence is needed.
The psychological impact
Many women suffer in silence for years, feeling embarrassed, frustrated, or broken. The stigma of being told to “try harder” or “just lose weight” is frustrating. Being seen, heard, and believed can be transformative and offer a much-needed lift, both emotionally and psychologically.
Advocacy and education: A call to action
Despite the growing recognition of women’s health issues, lipoedema is still a “Cinderella” condition—underserved, under-researched, and underfunded.
At Lipoedema UK, we see firsthand how many nurses discover the condition not only in their patients but in themselves, colleagues or their loved ones. We need:
- greater inclusion of lipoedema in nursing and midwifery education
- improved referral pathways and equitable access to care
- acknowledgement of lipoedema as a key issue in women’s health.
Key resources
- . Support, education, and advocacy
- . Free online CPD
If we want to improve health outcomes for women, we must stop ignoring lipoedema. Nurses and midwives are perfectly placed to lead this change through earlier identification, compassionate care, and confident referral. Consider Lipoedema UK membership for both patients and clinicians. Membership offers advice, support, and education as well as regular access to webinars with expert international speakers and research as well as online support.
Let’s bring lipoedema into the spotlight together.
Author: Mary Warrilow is Director of Strategic Partnerships at Lipoedema UK and a member of the 国内精品伊人久久久久妇 Women’s Health Forum. She is also an Independent Clinical Nurse Specialist and Queens Nurse. She works closely with healthcare professionals to improve awareness, diagnosis, care pathways, and education around lipoedema.
