Lipedema: a professional community's view

Abstract

BACKGROUND: Lipedema is a chronic disease characterized by abnormal growth of subcutaneous fatty tissue. More than 10% of women have varying degrees of lipedema. Despite the high prevalence of this pathology, to date, there are no full-fledged clinical guidelines, and only sporadic publications have devoted to this disease in the literature.
 AIM: To determine the level of immersion of members of the professional community in the diagnosis and treatment of lipedema.
 METHODS: Within the framework of the online educational event “Lipedema: 2023” held on the platform “Actual Phlebology” on 22.08.23, 74 physician participants anonymously answered 14 questions on the diagnosis and treatment of patients with lipedema.
 RESULTS: In this study, 83.8% of the respondents adhered to the hereditary theory of lipedema development. Only one obvious feature of lipedema, the presence of bilateral symmetrical disproportionate proliferation of adipose tissue on the extremities, was reported by the absolute majority (98.6%) of the specialists interviewed. Less than half of the professional participants noted features such as a feeling of tightness and an excessive tendency to hematoma formation with worsening of symptoms overnight. More than half of the respondents (54.1%) admitted that they were unfamiliar with the classification of lipedema. The main method of conservative treatment of lipedema was considered therapeutic exercise by 74.3% of the respondents. The most popular method of surgical treatment of lipedema is lymphatic liposuction, and which 56.8% of the participants of the professional community are ready to offer this to their patients.
 CONCLUSION: The professional community is not sufficiently immersed in the diagnosis and treatment of patients with lipedema. The diversity of current scientific evidence on lipedema requires that it be structured in the development of up-to-date national clinical guidelines.