Our interview for the Parool: aware of lipedema

The body can unpleasantly surprise with strange outgrowths. An eyelid that starts twitching at regular intervals, localized hair loss or an inexplicable itch. Today: lipedema.

Pants size 44, waist size 38. With lipedema, a difference of three clothing sizes is no exception. The condition is chronic, disfiguring, painful, restrictive and often overlooked, says dermatologist Hajo Bruining of Resculpt Clinic.

In lipedema, the fat cells in the legs and sometimes the arms show abnormal growth starting at puberty, making movement more difficult. Over time, the skin can also become irregular and it hurts. "It is especially sensitive to pressure, touch and abrupt movements, such as when you play sports. It can be painful even if someone pinches your leg for fun. This often leaves a bruise, because women with lipedema bruise easily."

It occurs only in women. "It seems there is something wrong with the combustion engine of these fat cells," he said. According to Bruining, lipedema is often not recognized by doctors. Women who report to the doctor are advised to exercise more and eat less. So they lose weight, even though this does not reduce the symptoms. The yo-yoing actually worsens the fat swelling, says Bruining. "I always explain it this way: it's like a valve on a fat cell. It goes in, but it doesn't go out as easily anymore."

He advises patients to exercise a lot anyway. Swim or bike, especially sports where the arms and legs take little impact. The dietician will recommend eating few carbohydrates. Because patients with this ailment also often suffer from lymph fluid in the legs, compression stockings are used.

But also manual lymphatic drainage (getting rid of the fluid with hand massage) or pneumatic compression therapy, where air tubes around the leg massage the fluid to a place where the body can drain it more easily.

More invasive but a lot more effective is liposuction under local anesthesia, Bruining says. "In this, most of the lipedema fat is removed. The fat that's gone stays gone. If you don't gain weight, you can benefit for decades."