Standard of care for lipedema in the United States

Author:

Herbst Karen L123ORCID,Kahn Linda Anne24,Iker Emily25,Ehrlich Chuck26,Wright Thomas27ORCID,McHutchison Lindy28,Schwartz Jaime23,Sleigh Molly29,Donahue Paula MC210,Lisson Kathleen H211,Faris Tami212,Miller Janis213,Lontok Erik214,Schwartz Michael S215,Dean Steven M216,Bartholomew John R217,Armour Polly218,Correa-Perez Margarita219,Pennings Nicholas220,Wallace Edely L221,Larson Ethan222

Affiliation:

1. Department of Medicine, University of Arizona, Total Lipedema Care, Beverly Hills, CA and Tucson, AZ, USA

2. The US Standard of Care Committee

3. Total Lipedema Care, Los Angeles, CA, USA

4. Lymphatic Therapy Services, San Diego, CA, USA

5. Lymphedema Center, Santa Monica, CA, USA

6. Lymph Notes, San Francisco, CA, USA

7. Lipedema Surgical Solutions, O’ Fallon, MO, USA

8. Carolina Vein Center, Durham, NC, USA

9. Lighthouse Lymphedema Network, Atlanta, GA, USA; Centura Health, Colorado Springs, CO, USA

10. Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN, USA

11. Solace Massage and Mindfulness, San Diego, CA, USA

12. Independent Contractor, Kansas City, KS, USA

13. Olathe Health, Olathe, KS, USA

14. Barth Syndrome Foundation, Larchmont, NY, USA

15. Pasadena Plastic Surgery, Pasadena, CA, USA

16. The Ohio State University Wexner Medical Center, Columbus, OH, USA

17. Cleveland Clinic, Cleveland, OH, USA

18. Fat Disorders Resource Society, Laurel, MD, USA

19. Physical Medicine Institute, Orlando, FL, USA

20. Campbell University School of Osteopathic Medicine, Buies Creek, NC, USA

21. Yogamatrix Studio, Orlando, FL, USA

22. Larson Plastic Surgery, Tucson, AZ, USA

Abstract

Background Lipedema is a loose connective tissue disease predominantly in women identified by increased nodular and fibrotic adipose tissue on the buttocks, hips and limbs that develops at times of hormone, weight and shape change including puberty, pregnancy, and menopause. Lipedema tissue may be very painful and can severely impair mobility. Non-lipedema obesity, lymphedema, venous disease, and hypermobile joints are comorbidities. Lipedema tissue is difficult to reduce by diet, exercise, or bariatric surgery. Methods This paper is a consensus guideline on lipedema written by a US committee following the Delphi Method. Consensus statements are rated for strength using the GRADE system. Results Eighty-five consensus statements outline lipedema pathophysiology, and medical, surgical, vascular, and other therapeutic recommendations. Future research topics are suggested. Conclusion These guidelines improve the understanding of the loose connective tissue disease, lipedema, to advance our understanding towards early diagnosis, treatments, and ultimately a cure for affected individuals.

Funder

National Heart, Lung, and Blood Institute

Publisher

SAGE Publications

Subject

Cardiology and Cardiovascular Medicine,General Medicine

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