Myth: Weight loss has no impact on lipedema
The Myth Explained
Because women with lipedema often report that dieting does not change the disproportionate fat on their legs, many have come to believe — and are often told — that weight loss has no effect at all on the disease.
This message can be found across social media and even in some clinical materials:
- “lipedema fat doesn’t respond to weight loss.”
- “Dieting is pointless when you have lipedema.”
- “Nothing changes unless you have liposuction.”
Understandably, this leads to frustration, hopelessness, and the belief that lifestyle changes are irrelevant. But this is not the full picture.
The Facts
1. Lipedema fat is resistant — but not untouchable
The S2k Guideline (2024) clarifies:
“While lipedema tissue itself is not eliminated by weight reduction, obesity and excess weight exacerbate the condition. Weight reduction is therefore important to stabilise the disease course.” (S2k Guideline, 2024, Section 2.7, paraphrased)
In other words, lipedema tissue is stubborn, but managing overall weight — particularly abdominal fat — has a direct impact on disease severity.
2. Evidence shows weight loss stabilise or improve symptoms
The Forner-Cordero (2025) cohort study demonstrated:
“Progression was related to abdominal fat increase, evaluated as waist-to-height ratio (WHtR). When the patient gained abdominal fat, the volume of their lower limb also increased.” (Forner-Cordero I, Muñoz-Langa J. Is lipedema a progressive disease? Vascular Medicine, 2025)
This confirms that overall body composition influences lipedema — and that preventing abdominal fat gain helps keep symptoms stable.
3. Weight reduction improves mobility and reduces pain
While lipedema tissue itself may not fully recede, patients often experience:
- Better mobility
- Reduced pain and heaviness
- Improved cardiovascular health
These changes improve overall quality of life, even if disproportionate fat distribution remains.
4. Restrictive dieting can be harmful
Bertsch & Erbacher (2018) warn against repeated restrictive dieting, which can worsen weight cycling and disproportionately increase fat in the lower body after weight regain. Instead, they advocate for sustainable, balanced approaches to nutrition and lifestyle.
Q&A for Patients
- Should I even try to lose weight, if lipedema fat doesn’t disappear?
In most cases, weight stabilisation and overall feeling of well-being have higher priority. That said, weight reduction can still reduce pain, strain, and progression. - Does weight loss change the shape of my legs?
Yes. Weight loss affects the whole body – face, arms, hands, breast – and of course the legs. But there will not be a disproportional weight loss that affects only the legs. Most women with lipoedema experience a pain reduction when they lose weight.— the disproportion remains. But symptoms like heaviness and mobility limitations often improve. - What approach works best?
Gentle, sustainable changes in diet and regular physical activity in combination with compression are most effective for long-term stability.
If you’ve tried to lose weight in the past and felt like nothing changed, you are not alone. Many women with lipedema share that frustration. But here’s the truth: even if lipedema fat itself does not disappear, your efforts are an important good step.
Every step toward healthy habits supports your joints, your energy, and your future stability.
You deserve encouragement, not blame.
The goal is not perfection, it’s well-being… and care that helps you in living a full life (again).
Futher Reading for Healthcare Professionals
From the ILA Co-Presidents
“As ILA, we stand for providing evidence-based information to support healthcare professionals and women with lipedema in achieving the best possible diagnosis and treatment. We are committed to dispelling misinformation, and we encourage open dialogue that reflects diverse perspectives to move science forward.”
– Ad Hendrickx and Gabriele Erbacher, ILA Co-Presidents, September, 2025.