Understanding the Link Between Lipedema and Lymphedema: The Role of Obesity in Disease Progression

Today, Dr. Carol Rowsemitt delves into Famine Response Hypothyroidism, discussing its unique impact on women with lipedema, including those on a ketogenic diet.Dr. Carol “Rosey” Rowsemitt, PhD, RN, FNP, began her career as a scientist focused on ecological physiology (holding a BA in chemistry and PhD in biology) before transitioning to practice as a family nurse practitioner. Since 2003, she has specialized in weight management and understands that the body can resist weight loss by reducing metabolic rate.Dr. Rowsemitt is passionate about broadening the perspective on thyroid health and emphasizes that standard thyroid tests may not reveal the full scope of metabolic changes related to famine response.

Today, I’d like to share insights from a study by a group of clinicians in Germany, published in the medical journal Phlebologie in 2019. The article, titled Effects of Aqua Cycling as Exercise Therapy for Lipoedema, highlights the benefits of aqua cycling—a form of stationary cycling where the bike is submerged underwater, with water typically reaching the rider’s waist to chest level.The authors discuss the general advantages of water-based exercise, particularly for those with lymphedema and lipedema. Their research has certainly convinced me of the potential benefits that any form of water exercise can offer to women managing lipedema.

I first connected with Leslyn at the National Institutes of Health’s inaugural international symposium on the lymphatic system, where she presented her research showing that a ketogenic diet could benefit individuals with obesity and lymphedema-related chronic conditions. This sparked a conversation on whether keto might also help with lipedema, given the scarcity of lipedema-specific research. While Leslyn completed her research, I was in Germany working on a lipedema-focused book. When we reconnected, we began exploring keto’s potential for managing lipedema.Initially, we were advised to gather more foundational data before launching a clinical trial. As we collected anecdotal reports from women who experienced pain relief, reduced swelling, and weight loss through a ketogenic approach, we sought to validate these observations. Under the guidance of epidemiologist Monika Wahi and a dedicated team, we synthesized existing research into a hypothesis paper. This paper examines common lipedema symptoms—such as disproportionate fat accumulation, pain, edema, metabolic and hormonal imbalances, inflammation, and fibrosis—and proposes how a ketogenic diet may address each of these challenges, differing from conventional weight-loss diets.Reference:Keith L., Seo C.A., Rowsemitt C., Pfeffer M., Wahi M., Staggs M., Dudek J., Gower B., Carmody M. Ketogenic Diet as a Potential Intervention for Lipedema. Medical Hypotheses, 2020, 110435 (ISSN 0306-9877)Link to the article

In this excerpt, Dr. Eric Westman shares insights from his Lifestyle Medicine Clinic, where he has seen patients with a variety of health conditions, including lymphedema and lipedema, achieve positive outcomes through a ketogenic diet. Dr. Westman, an Associate Professor of Medicine at Duke University and board-certified in Obesity Medicine and Internal Medicine, founded the Duke Lifestyle Medicine Clinic in 2006 after years of research on low-carbohydrate ketogenic diets. He has authored several books on keto, including his latest, "End Your Carb Confusion," co-authored with Amy Berger and released in December 2020. Here, Dr. Westman discusses the importance of tailoring carbohydrate intake to improve health outcomes for those managing lipedema and lymphedema.

We’re excited to share about the publication of our article, "Ketogenic Diet as a Potential Intervention for Lipedema," released by Elsevier, one of the world’s leading medical publishers. This article was a collaborative effort by an outstanding team, and it examines how lipedema differs from obesity and lymphedema, along with its symptoms and diagnosis. We explore the potential of the ketogenic diet to alleviate symptoms of lipedema, presenting our hypothesis and advocating for further research to support women with this condition.

Today, I’d like to share an excerpt from Dr. Matthew Carmody’s presentation at the Lipedema Simplified Summer Boot Camp, held in June 2022 as part of Lipedema Awareness Month. Dr. Carmody, an Assistant Professor of Medicine at Harvard Medical School and Diplomate of the American Board of Obesity Medicine, recently retired from his practice in Internal Medicine to concentrate on lipedema and obesity medicine. In this clip, he explains the connection between circadian rhythms, sleep cycles, and lipedema.

Today, we discuss the findings from a study conducted by a team of researchers in Brazil, published in the medical journal Cureus in December 2020. The study, titled Lipedema and the Evolution to Lymphedema with the Progression of Obesity, aimed to examine the prevalence of systemic lymphedema in lipedema patients based on weight. The data indicates that a significant number of women with lipedema experience edema, which obesity may worsen, although it does not appear to be the root cause.

Today, we're exploring a study from the University of Calabria in Italy by Roberto Cannataro and Erika Cione, titled Utilizing Nutritional Supplements for Managing Lipedema: A Scientific Approach. Published in the Nutraceuticals journal in September 2022, this research highlights potential supplement strategies for managing lipedema symptoms. For those interested, you can find the full paper here.

Today, we’re examining an important study by two French physicians titled, Frequency of Lipoedema in Patients Consulting a Vein Clinic for Mild to Moderate Superficial Venous Disorder with Symptoms: A Retrospective Analysis. Published in Journal of Vascular Medicine in April 2023, this research sheds light on the frequency of lipedema in women experiencing chronic leg pain who visit vein clinics. Given the common misdiagnosis of lipedema, understanding its prevalence in these settings may improve awareness and early detection.

Today I’d like to tell you about a group of researchers in Szeged, Hungary.The paper is titled, Lipoedema: detailed left atrial volumetric and strain analysis by three-dimensional speckle-tracking echocardiography from the MAGYAR-Path Study.It was published in the peer-reviewed journal Advances in Dermatology and Allergology  in June 2022.This study aims to look at heart volume and function in patients with lipedema compared to age- and gender-matched healthy controls using 3D imaging technology. They also examined if using medical grade compression stockings for one hour would improve the measured cardiac properties.