Background: Lipedema is a disease of the subcutaneous adipose tissue that was first clinically recognized in the mid-1900s. Lipedema can have a significant impact on physical appearance, mental health, and well-being: people with lipedema, lovingly called “Lippies”, not only complain about their physical appearance, but also the presence of a bunch of symptoms that worsen the quality of life, which is why it is important to study treatments that may have positive effects mainly in the affected areas. Reducing inflammation is the main target of the multidisciplinary treatment of lipedema. Many studies have shown a significant reduction in body fat and in the painful component of lipedema following integrated treatment and, above all, the high fat ketogenic diet. Therefore, we compared the efficacy of a High Fat Ketogenic Diet (HFKD) in patients suffering from lipedema to test the hypothesis that this approach is more effective than a Low Carb Antinflammatory non-ketogenic Diet (LCAD) on reducing the anthropometric measures in the affected areas and on improving symptoms.