Myth: Lipedema occurs on the abdomen
The Myth Explained
It is sometimes claimed that lipedema can spread beyond the legs and arms to include the abdomen. This idea is repeated in online groups and sometimes in medical discussions, where abdominal fat is mistakenly labelled as lipedema tissue.
The reasoning seems plausible: if lipedema involves abnormal fat distribution, why not the belly too? And because many women with lipedema also struggle with abdominal weight gain, the assumption feels convincing.
But the scientific evidence is clear: lipedema does not involve the abdomen.
The Facts
1. Lipedema is defined as limb-specific fat distribution
The S2k Guideline on lipedema (2024) defines the condition as:
“A painful, disproportionate, symmetrical distribution of adipose tissue on the extremities — most commonly the legs and sometimes the arms — occurring almost exclusively in women.” (S2k Guideline, 2024, Section 2.1)
There is no mention of the abdomen in the diagnostic definition. The guideline confirms that fat distribution in the trunk, including the abdomen, belongs to other conditions (such as obesity).
2. Abdominal fat is a sign of obesity, not lipedema
Bertsch & Erbacher (2018) explain that what some interpret as “lipedema of the abdomen” is in fact visceral or central obesity, which is common in the general population and also in women with lipedema.
They emphasise:
“The isolated disproportionality of the female leg without the above symptoms is called lipohypertrophy… Fat in the abdominal region is not lipedema.” (Phlebologie 2018: lipedema – Myths and Facts, Part 1, paraphrased)
3. Misdiagnosis risks confusion and harm
Calling abdominal fat “lipedema” leads to:
- Incorrect diagnosis
- Wrong therapeutic focus
- Missed opportunities to address obesity-related health risks, such as cardiovascular disease and diabetes
The Forner-Cordero (2025) study further highlights that abdominal fat (measured via waist-to-height ratio) is an independent driver of progression — but it is not lipedema tissue.
4. Abdominal fat and lipedema can co-exist
It is true that many women with lipedema also have central obesity.
This overlap may make the two conditions appear linked, but they are distinct. If you’re gaining fat on the abdomen, that’s obesity. It is important to know that obesity is a disease, and not a personal failure.
In most cases, lipedema and obesity occur together—and therefore both diseases must be treated. And yes, both conditions can be treated effectively.
Q&A for Patients
Can lipedema spread to my stomach?
No. Lipedema affects the legs and sometimes arms, not the abdomen. Fat in the belly area is usually due to obesity, never lipedema.Why does my abdomen get bigger if I have lipedema?
Because lipedema and obesity often occur together, and weight gain often shows up in the abdomen. But this is not lipedema tissue.- Does abdominal fat matter for my lipedema?
Yes — an increase in abdominal fat is usually part of an overall weight gain, and with weight gain, the lipoedema symptoms can increase. Keeping the waist-to-height ratio under 0.5 is important for stability.
If you’ve been told that your abdominal fat is “lipedema of the stomach,” it is understandable to feel confused.
The truth is: abdominal fat is not lipedema.
This distinction matters because it means:
- Your condition is not spreading uncontrollably
- You can take steps to manage abdominal fat that directly helps your symptoms
- You have power and agency — lifestyle strategies and treatment choices matter
It is true that many women with lipedema also have central obesity. It is important to know, however, that obesity is a disease, and not a personal failure, and that you deserve encouragement, not blame.
The goal is not perfection, it is well-being and care that helps you in living a full life.
Futher Reading for Health Care 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.