Lipedema therapy

Unfortunately, lipedema cannot be cured as its causes are unknown. For this reason, the treatment options mainly serve to alleviate the symptoms. However, it is possible to reduce the circumference of the legs or arms. In the first stage, treatment is not usually necessary because the accumulation of fat in the connective tissue is still painless and invisible. Therefore, the treatment of lipedema usually begins from stage 2.

It is important to try to decongest the affected tissue from the accumulation of water. Diuretics (diuretic drugs) are not effective in this case, they have a kind of “boomerang” effect: Initially, they reduce water retention, but this disappears again after therapy, which is why diuretic tablets are not recommended.
Drainage is achieved by means of so-called “complex physical decongestion therapy”, which consists of manual lymphatic drainage, compression therapy, exercise therapy and skin care.

Decongestive therapy is carried out for the rest of the patient’s life, otherwise the water retention will return.

Manual lymphatic drainage

Manual lymphatic drainage should be performed once or twice a week. A medical masseuse or masseur gently strokes the skin along the lymph channels with their fingers. This shifts fluids between the cells in the direction of the lymph channels and stimulates decongestion. This treatment activates the lymph channels to better drain even non-displaced fluid. This also has a calming and pain-relieving effect for those affected, but is time-consuming. After manual lymphatic drainage, a compression bandage is applied to maintain the result (reduction in circumference).

Compression bandages for lipedema

Compression therapy should be carried out with bandages in the initial decongestion phase and with compression stockings in the maintenance phase, especially if a reduction in circumference is expected under decongestive measures. In the majority of cases, the shape of the extremity and the nature of the tissue mean that compression stockings need to be made to measure (so-called flat-knit stockings). Compression stockings from stock (circular knit materials) are only suitable for mild lipedema.

Liposuction (liposuction)

Liposuction is used for the surgical reduction of abnormal subcutaneous fatty tissue on the legs and arms. It is particularly indicated if symptoms persist despite consistent conservative treatment or if the findings (subcutaneous fat volume) and/or symptoms (pain, edema) worsen.

Liposuction is performed under local anesthesia using tumescent local anesthesia (TLA), i.e. the wet technique with blunt microprobes. Supporting techniques such as vibration or water jets can be used. The procedure can be performed on an outpatient or inpatient basis.

It is debated how sustainable this treatment actually is, as the body tends to produce the lost fat again. Possible complications of the procedure include swelling, post-operative bleeding, circulatory problems and bruising. Liposuction rarely leads to infections, wrinkles, dents and numbness. Allergic reactions (itching, nausea and skin rashes) to the solution injected for local anesthesia and fat loosening can also occur.

What you can do yourself: Diet and exercise


Although lipedema does not respond to weight loss, it is important to maintain a normal and stable weight. If you are of normal weight and continue to eat a varied and healthy diet, you should try to maintain your weight. If you are overweight, it makes sense to lose weight. A diet with fewer carbohydrates and sufficient protein has proven effective for lipedema.


Among sporting activities, those in water appear to be particularly effective (swimming, aqua jogging, aqua aerobics, aqua cycling), as the buoyancy relieves the joints, the water pressure causes lymphatic drainage and calories are burned through movement against the water resistance. Strength training alone is not very effective for weight loss; there is no comparable evidence to endurance training.

Psychological support: of great importance

Women with lipedema have often spent years searching for answers and help for their condition. At first glance, affected women look obese and try to convince those around them that they have tried everything to lose weight. They often feel that their efforts are not taken seriously and suffer from the bias that parts of society have towards obese people. In combination with mobility difficulties, this often leads to emotional stress and can subsequently trigger depression. The disease has nothing to do with obesity, a fact that those affected are often unaware of for a long time. The diagnosis of lipedema is like a liberation. Nevertheless, psychological support from an expert is also important, as lipoedema is unfortunately not curable, but a lifelong burden.

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