Lipedema and Obesity - What's the Difference?

Lipedema is a disease that is often misunderstood or mistaken for obesity or lymphedema. According to the World Health Organization (WHO), the definition of obesity is based on the Body Mass Index (BMI). You can calculate your BMI as follows: Bodyweight (kilogram) : (Body height)² . A BMI of more than 30 kg/m² means obesity, whereas a BMI of more than 25 kg/m² means overweight. For the diagnosis of lipedema, the Waist-to-Height (WtH) ratio is more important than the BMI. The WtH ratio is beneficial to assess shape disproportions that are typical for lipedema.

In obese patients, the presence of excessive fat is associated with significant risks to their health: Overweight and obesity can both lead to chronic diseases of the heart and the cardiovascular system, diabetes, osteoarthritis, and also an increase the risk for some cancer types.

Lipedema and obesity have different characteristics that are summarized here:

Gender

• Lipedema: Almost exclusively occurs in women.
• Obesity: Occurs in both men and women.

Onset

• Lipedema: Often associated with hormonal changes: puberty, birth control pills, pregnancy, menopause, and phases of weight gain.
• Obesity: Obesity can already develop in early childhood, but it is not limited to a certain age group.

Family history 

• Lipedema: Many lipedema patients report similar signs and symptoms in other female family members.
• Obesity: Very common. 

Affected areas 

• Lipedema: Lipedema usually symmetrically affects both legs or, less frequently, the arms. The hands or feet are not affected. Enlargement of the legs often results in shape disproportion – a narrow waist and larger hips and thighs
• Obesity: Obesity affects the whole body, usually symmetrical. 

Common signs

• Lipedema: The affected limbs are often tender, sensitive, or painful. The affected area feels different from normal body fat: it feels cooler, softer, and can appear dimpled like orange-peel. 
• Obesity: No specific signs, especially no pain.

Complications and consequences

• Lipedema: Overweight, limited social life, mental distress (incl. chronic stress, depression, and anxiety), joint problems, failed diets. 
• Obesity: Significant health risks: chronic diseases of the cardiovascular system, heart, diabetes, degenerative disorders of the joints. 

Although lipedema and obesity are two different diseases, they often occur together. Experts report that up to 85% of lipedema patients are obese. Obesity in lipedema patients also increases the risk to the develop lymphedema. It can be difficult to diagnose lipedema, differentiate it from lymphedema or obesity, or find out that two or more diseases occur together.