Lipolymphedema: Understanding the Overlap Between Lipedema and Lymphedema

Lipolymphedema is a condition that often goes unrecognized, yet it affects a significant number of people—especially women—who suffer from disorders of the lymphatic and fat distribution systems. It represents the clinical intersection between two distinct yet related medical conditions: lipedema and lymphedema.

In this post, we’ll break down what lipolymphedema is, how it develops, how it’s diagnosed, and the most effective treatment options available. Whether you’re a patient, caregiver, or medical professional, understanding this condition is key to managing it effectively and preventing further complications.

Lipolymphedema is a chronic condition that arises when lipedema progresses and leads to secondary lymphedema. It is marked by abnormal fat accumulation and impaired lymphatic drainage, usually in the lower limbs. As the lymphatic system becomes increasingly compromised, fluid builds up in the affected tissues, leading to swelling, discomfort, and risk of infection.

In essence, lipolymphedema is the coexistence of lipedema and lymphedema—two separate conditions that overlap to create a more complex clinical picture.

To truly grasp what lipolymphedema is, it helps to first understand the two underlying conditions that contribute to it.

Lipedema is a chronic fat disorder that primarily affects women. It causes symmetrical fat accumulation in the hips, buttocks, thighs, and sometimes the arms. Unlike obesity, lipedema fat is resistant to diet and exercise and is often painful or tender to the touch.

• Affects mostly women (often hereditary)
• Symmetrical fat deposits
• Pain, heaviness, and tenderness
• Does not typically affect hands or feet
• Bruising easily

Lipedema is not caused by lymphatic dysfunction, but the excess fat can eventually obstruct lymph flow, leading to secondary lymphedema.

Lymphedema occurs when the lymphatic system fails to properly drain fluid, causing swelling in the affected area—often a limb. This can be due to congenital issues (primary lymphedema) or more commonly as a result of surgery, radiation, or trauma (secondary lymphedema).

• Asymmetrical swelling
• Skin thickening and fibrosis
• Pitting edema in early stages
• Affects hands and feet
• May lead to infections (e.g., cellulitis)

As lipedema advances—particularly if left unmanaged—the excess fatty tissue may compress lymphatic vessels, impairing lymph flow. This leads to fluid buildup, transforming what was once purely a fat distribution disorder into one that now includes true lymphatic dysfunction.

This stage is known as lipolymphedema and is considered a late-stage manifestation of lipedema.

In clinical practice, identifying this transition is crucial, as it influences both the diagnosis and the recommended treatment strategy.

People with lipolymphedema often experience a combination of symptoms associated with both lipedema and lymphedema:

• Progressive swelling in the legs and ankles
• Fat pads with nodular or grainy texture
• Skin feels tight or thick
• Difficulty fitting into clothing due to swelling
• Pain, heaviness, and sensitivity to pressure
• Risk of skin infections (like cellulitis)
• Stemmer’s Sign may be positive (inability to pinch skin on toes)

Diagnosing lipolymphedema requires a thorough clinical assessment and medical history. Since the condition mimics other disorders—such as chronic venous insufficiency or simple obesity—misdiagnosis is common.

• Physical examination (checking for asymmetry, pitting edema, and fat distribution)
• Patient history (family history of lipedema, onset during puberty or pregnancy)
• Stemmer’s Sign test (positive in lymphedema, negative in pure lipedema)
• Lymphoscintigraphy (a nuclear imaging test to assess lymphatic function)
• Bioimpedance spectroscopy (to measure extracellular fluid)

Need to find a specialist? The Norton School offers a Therapist Referral Directory for certified lymphedema therapists.

While lipolymphedema cannot be cured, it can be effectively managed with a combination of therapies that address both fat accumulation and fluid buildup.

CDT is the gold standard for managing lymphedema and by extension, lipolymphedema. It includes:

• Manual Lymphatic Drainage (MLD): A gentle massage technique to stimulate lymph flow

• Compression therapy: Using garments or bandages to reduce swelling

• Decongestive exercises: Movement to improve circulation

• Skin care: To prevent infections

You can learn more about CDT in this Norton School blog post.

Compression helps support lymphatic function and prevent further swelling. Graduated compression stockings, wraps, or adjustable Velcro systems like the Juzo Compression Wraps are commonly used.

Explore top-rated compression products at Lymphedema Products.

• Activities like swimming, water aerobics, walking, and gentle yoga promote lymphatic drainage and reduce stiffness without stressing the joints.

While lipedema fat is resistant to weight loss, maintaining a healthy anti-inflammatory diet can reduce symptoms and prevent weight gain that worsens lymphedema. Diets rich in lean protein, omega-3 fatty acids, and low in processed carbs are often recommended.

Liposuction using tumescent techniques has shown success in reducing fat deposits in patients with lipedema and lipolymphedema. However, it should only be considered after conservative therapies and under supervision of a specialist experienced with lymphatic disorders.

Living with lipolymphedema requires proactive management, consistent therapy, and support from qualified professionals. Emotional health also matters—many patients face body image challenges and frustration with misdiagnosis or inadequate care.

Connecting with support groups, certified lymphedema therapists, and educational resources like those offered by the Norton School and Lymphedema Products Blog can make a meaningful difference.

Lipolymphedema is a complex but manageable condition that requires an integrated approach to care. By understanding its causes, recognizing the symptoms early, and implementing effective management strategies, patients can live full, active lives.

If you or a loved one is living with lipedema and beginning to experience swelling in the feet, ankles, or legs, don’t wait—early intervention is key. Speak to a healthcare provider or certified lymphedema therapist to explore your options.