Lipoedema is finally getting the attention it deserves on social media and in the press, and that’s a good thing. For a long time, women with the condition were told to just eat less or move more, when in reality their legs, hips or arms were swelling and enlarging for reasons that had nothing to do with laziness or willpower.
“It’s great to see that it’s getting attention in social media and on the press, so people are understanding that it’s not just being lazy that’s causing your legs to swell up and get large and accumulate a lot of fat,” says Dr Glenn Murray of Absolute Cosmetic. “It’s inflamed fat. It gets bigger and inflamed.”
That distinction matters. Lipoedema isn’t ordinary body fat responding to lifestyle. It’s a chronic condition affecting the fat tissue itself, and understanding that difference is often the first step towards getting the right diagnosis and the right treatment.
What Causes Lipoedema?
The exact cause of lipoedema still isn’t fully understood, but hormones and genetics are both thought to play a significant role. The condition almost exclusively affects women, and oestrogen receptors in fat tissue are considered a major contributing factor. That’s why lipoedema often first appears, or worsens, at key hormonal turning points: puberty, pregnancy, and menopause.
Because of this hormonal link, lipoedema is sometimes mistaken for weight gain associated with these life stages. It can also run in families, suggesting a genetic component, though researchers haven’t yet pinned down a single cause.
Signs and Symptoms of Lipoedema
With lipoedema, fat becomes tender, lumpy, and inflamed rather than smooth and even. It can build up quite quickly, and one of the clearest signs is a mismatch between the top and bottom of the body: the upper body may look proportionate or even slim, while the legs look completely different in size and shape.
Common signs include:
- A disproportionate build-up of fat in the legs, hips or buttocks, with the upper body largely unaffected
- Tenderness or pain in the affected areas
- Fat that feels lumpy or nodular rather than smooth
- Easy bruising, due to fragile capillaries in the affected tissue
- Swelling that doesn’t respond to typical weight loss efforts
- Spread to the arms in some cases
While lipoedema most commonly affects the legs, Dr Murray notes it can spread to the arms as well, which is why an early, accurate diagnosis matters rather than assuming the pattern will stay confined to one area.
The Four Stages of Lipoedema
Lipoedema is generally classified into stages based on how the skin and underlying tissue have changed. Understanding where a patient sits on this scale helps guide diagnosis and treatment planning.
Stage 1 The skin surface remains smooth and even, but there’s already an uneven, disproportionate build-up of fat underneath. This is often the stage where lipoedema is most easily mistaken for ordinary weight gain, and where it’s easiest to overlook.
Stage 2 The skin surface starts to show indentations and unevenness, with larger, more noticeable mounds of fat forming beneath it.
Stage 3 Fat deposits become larger and more pronounced, with visible lobules or bulges, particularly around the thighs and knees. This can noticeably distort the shape of the limb.
Stage 4 Also known as lipo-lymphoedema, this is where lipoedema overlaps with lymphoedema. Ongoing fat accumulation begins to interfere with lymphatic drainage, leading to more significant swelling and, often, reduced mobility.
Lipoedema isn’t automatically progressive, meaning it won’t necessarily move through every stage for every person. But when it does progress, it tends to do so gradually over time, which is exactly why Dr Murray is firm on one point.
Why Early Treatment Matters
“The main thing that you must be aware of is don’t leave it too late to treat,” Dr Murray says. “Always get in early when it’s in stage one, and when you’ve noticed it’s starting to happen, quickly come in for a consult to diagnose whether you have it or not, and then treat it.”
Catching lipoedema in stage one gives you the most options and the best chance of managing it before it progresses to the point of affecting mobility or lymphatic function. Because early lipoedema can look a lot like ordinary weight gain, a proper clinical assessment is the only reliable way to tell the difference.
Why Skin Health Matters in Lipoedema Treatment
Skin is one of the most important factors to manage well when treating lipoedema. As fat accumulates and the affected area grows, the skin can become stretched over time. If that’s allowed to progress too far, patients may eventually need more extensive skin-lifting surgery to correct the excess skin left behind after fat is treated.
“The big thing about this is skin,” Dr Murray explains. “You must make sure that your skin doesn’t get too stretched, because you don’t want big lifting surgery.”
This is part of why early treatment is emphasised so strongly. Addressing lipoedema while the skin still has good elasticity generally means a simpler treatment pathway, with less need for separate skin-removal procedures later on.
How Lipoedema Is Treated
At Absolute Cosmetic, treatment is built around protecting the skin while addressing the underlying fat. Dr Murray uses a combination of three techniques:
- J-Plasma (renuvion), to treat and tighten the skin
- VASER liposuction (UAL VASER pro), an ultrasonic-assisted liposuction (UAL VASER pro) technique, to treat the fat itself
- A water jet effect, created by infusing fluid into the tissue, to assist the process
Using these together allows the fat to be treated while supporting the skin at the same time, rather than tackling the two separately.
It’s also worth being clear about what won’t fix lipoedema on its own. “Diet can help a little bit, but it’s very resistant fat,” Dr Murray says. Lipoedemic fat behaves differently to typical body fat and generally doesn’t respond to diet and exercise the way other fat does, which is exactly why so many women spend years being told to simply try harder before finally getting an accurate diagnosis.
The Bottom Line
Lipoedema is not caused by laziness, and it’s not something diet alone can fix. It’s a genuine medical condition, and the earlier it’s identified and treated, the more options are available and the better the likely outcome, particularly when it comes to protecting the skin.
If you’ve noticed a disproportionate build-up of fat in your legs, hips or arms that doesn’t respond to diet and exercise, it’s worth having it properly assessed rather than waiting to see if it changes on its own.
Frequently Asked Questions
Is lipoedema caused by being lazy or overweight? No. Lipoedema is a medical condition involving inflamed, abnormal fat tissue, not a result of lifestyle or inactivity.
What are the early signs of lipoedema? A common early sign is a disproportionate build-up of fat in the legs, hips or buttocks compared to the upper body, along with fat that feels tender, lumpy or swollen and bruises easily.
What causes lipoedema? The exact cause isn’t fully understood, but hormones and genetics both appear to play a role. It almost exclusively affects women and often appears or worsens during puberty, pregnancy or menopause.
Can lipoedema spread to other parts of the body? Yes. While it most often affects the legs, lipoedema can spread to the arms as well.
What are the stages of lipoedema? Lipoedema is generally classified into four stages, ranging from an even skin surface with disproportionate fat underneath in stage one, through to lipo-lymphoedema in stage four, where fat build-up begins to affect lymphatic drainage.
Can diet and exercise get rid of lipoedema? Diet can help a little, but lipoedemic fat is very resistant to typical weight loss methods, which is why medical treatment is often required.
Why is skin health important when treating lipoedema? If the skin becomes too stretched as fat accumulates, patients may eventually need more extensive skin-lifting surgery. Managing skin health early, alongside fat reduction, helps avoid this.
How is lipoedema treated? Treatment can involve a combination of J-Plasma (renuvion) for the skin, VASER liposuction (UAL VASER pro) for the fat, and a water jet effect from infused fluid, used together to treat the fat while supporting the skin.
When should I see someone about lipoedema? As early as possible. If you notice signs of lipoedema starting to develop, it’s best to book a consult while it’s still in stage one, rather than waiting until it progresses.
For more information or to book a consultation, visit our lipoedema treatment page or get in touch with our team.
