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Lipoedema and obesity: What's the difference?

Lipoedema is often misunderstood or mistaken for obesity. Although the diseases have different characteristics, they often occur together.

Lipoedema is often confused with lymphoedema or obesity. The World Health Organization defines obesity based on Body Mass Index (BMI), which you calculate by dividing your body weight in kilograms by the square of your height in meters. A BMI over 30 kg/m2 indicates obesity, while a BMI over 25 kg/m2 signals overweight. However, for diagnosing lipoedema, the Waist-to-Height (WtH) ratio is a more crucial indicator than BMI, as it helps identify the shape disproportions characteristic of lipoedema.

In obese patients, the presence of excessive fat is associated with significant risks to their health: Overweight and obesity can lead to chronic diseases of the heart and the cardiovascular system, diabetes, osteoarthritis, and also an increase the risk for some cancer types.

Characteristics of lipedema vs. obesity

Gender

  • Lipoedema: Almost exclusively occurs in women.
  • Obesity: Occurs in both men and women.

Onset

  • Lipoedema: Often associated with hormonal changes, like puberty, birth control pills, pregnancy, menopause, and phases of weight gain.
  • Obesity: Obesity can develop in early childhood, but it is not limited to a certain age group.

Family history

  • Lipoedema: Many lipoedema patients report similar signs and symptoms in other female family members.
  • Obesity: Family history is often a contributing factor.

Affected areas

  • Lipoedema: Typically affects both legs symmetrically, or less frequently, the arms. The hands or feet are not affected. Enlargement of the legs often results in shape disproportion – a narrow waist and larger hips and thighs.
  • Obesity: Affects the whole body, usually symmetrically.

Common signs

  • Lipoedema: The affected limbs are often tender, sensitive, or painful.
  • Obesity: No specific signs, especially no pain.

Consequences

  • Lipoedema: Overweight, limited social life, mental distress (incl. chronic stress, depression, and anxiety), joint problems, failed diets.
  • Obesity: Significant health risks: chronic diseases of the cardiovascular system, heart, diabetes, degenerative disorders of the joints.

Although lipoedema and obesity are two different diseases, they often occur together. Experts report that up to 85% of lipoedema patients are obese. Obesity in lipoedema patients also increases the risk of developing lymphoedema. Diagnosing lipoedema and distinguishing it from lymphoedema or obesity can be challenging, especially when two or more conditions coexist.

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