Treatments for lipoedema
Although lipoedema is not ‘curable’ there are different approaches to managing and treating the condition, and problems linked to lipoedema. However, there is very little research evidence for many lipoedema treatments, and these are not always widely available. If you have a diagnosis of lipoedema you may be referred to a local lymphoedema service, or another specialist who understands lipoedema. As services are very limited they may not be available in your area. Our website will give you information on approaches to treating and self-managing lipoedema. We cannot give advice on individual treatments but include some general information below. Talk with your doctor, or practitioner for more detailed advice.
See more about getting help with lipoedema.
Compression is useful in helping to manage symptoms such as pain, heaviness and secondary lymphoedema (fluid swelling). You will need to be measured and fitted by someone who has expertise.
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There are two main approaches to surgery used in lipoedema:
Liposuction: this is removal of lipoedema fat tissue by sucking it out through a cannula from areas such as the leg, hips or buttocks, arms or abdomen sometimes over several operations. This is most usually done under general anaesthetic and the surgery usually takes around 2-4 hours. Liposuction is not widely available in the NHS, and some people chose to pay privately, sometimes going to clinics overseas. The approach taken will depend on the surgeon. Liposuction is not a cure and there is not enough research evidence to know the long-term effects. However, some people find that liposuction is significantly reduces their pain and enables them to be more mobile.
If you are thinking about liposuction we advise:
- Talk to others about their experiences
- Explore the options in the UK before deciding to go abroad for surgery
- Firstly, try other self-management approaches such as compression, healthy eating and physical activity to manage your weight and symptoms such as pain or lymphoedema
- Talk to your surgeon about your expectations and what they will offer you; how many treatments might you need?; how quickly will you heal?; how will they manage your pain after surgery?; what are the possible risks for you?
- Consider getting advice on aftercare such as fitting of compression or use of manual lymphatic drainage therapy.
Bariatric surgery: this is surgery to help reduce weight. It includes procedures such as a Roux-en-Y-Gastric Bypass or a Sleeve Gastrectomy to reduce the stomach size and enable the person to lose weight. There is evidence that weight loss surgery can help lipoedema, although this is not an easy option, and can have implications for your long-term health. In the NHS, weight loss surgery is usually only available to people who have been on a long-term weight loss programme supported by specialist dieticians and psychologists. When someone with lipoedema has weight loss surgery, their weight reduces, but the disproportionate body shape or ‘lipoedema legs’ are still obvious.
How do I get referred for surgery?
The first step is seeing your GP and requesting a referral to the weight loss services (if you want to be considered for bariatric surgery), or a reputable surgeon who undertakes liposuction.
Physiotherapy and Occupational Therapy
It is worth considering what other help is available in the NHS. Treatments with a physiotherapist can be helpful in improving your balance, mobility and muscle strength. An Occupational Therapist can help with improving function and mobility and may provide aids and equipment. Ask your doctor for a referral.
Support with mental health
If you are worried about your mental or emotional health and feel that you need support, then ask your doctor for a referral or speak to your practitioner. Lipoedema affects people in different ways, and some people have problems such as depression, anxiety, disordered eating or body dysmorphia. There are many treatment approaches available now including talking therapies, support through mental health charities, and a variety of apps. If you experience problems with your mental health, do not delay in sharing your thoughts with others, and ask for help.
Manual lymphatic drainage (MLD)
This is a gentle type of massage treatment that works on the lymphatic system. The lymphatics are a network of channels in the body that are linked to over 600 lymph nodes They drain excess fluid and waste products from the tissues, deal with inflammation and transport fats and proteins around the body. A manual lymphatic drainage therapist uses light and rhythmic hand movements on the skin, stimulating lymph nodes and lymphatic channels, combining this with breathing techniques. You will usually be treated when lying on a couch, and may need to strip down to your underwear, although the therapist will keep you covered and comfortable.
Research suggests that when someone has lipoedema for many years, the lymphatics may find it difficult to drain the tissues. The fluid may accumulate leading to heaviness and inflammation. Having MLD can help to improve symptoms such as pain or oedema. Some therapists also combine MLD with deep oscillation therapy (DOP).
Finding a therapist: MLD is sometimes available at an NHS clinic, but you may have to pay privately. Look for a therapist who is trained in the Vodder, Foëldi, Casley-Smith, or other similar techniques; ask about their qualifications if you are unsure as some beauty clinics do a much more rigorous type of lymphatic drainage that is not suitable. Check www.mlduk.org.uk for more information.
Reflexology lymph drainage (RLD)
This is a reflexology-based technique that stimulates the lymphatics on the feet. It was developed by Sally Kay in the UK and was used first for treating lymphoedema after cancer. It is now being used for lipoedema. You will be treated when lying or sitting down in a comfortable position, and will only have to remove your shoes and socks/tights. Check https://www.reflexologylymphdrainage.co.uk/ for more information.
These are tablets that are used to remove fluid from the body. They are generally used for heart problems, and doctors often prescribe diuretics such as Furosemide when someone has swollen legs or feet. However, they do not improve the lymphatic system, and are not recommended in lipoedema unless used to treat other medical conditions in the person.