Lipoedema versus obesity

You know better than anyone that lipedema is a chronic condition for which there's no ready-made solution. You've probably already noticed that symptoms worsen due to poor lifestyle and excess weight, or even decrease when you choose good self-care. Nutrition is a tool you can use to reduce the symptoms associated with lipedema.

Lipoedema and obesity

Susan was a young woman of 21 and came to my office to lose weight. It was great that she chose my practice for its holistic approach, but Susan's main concern was that she wanted to get rid of her heavy legs. If you're overweight, you diet, it seems obvious. However, given her build, with heavy, painful legs, it turned out to be lipedema, something you can't simply eliminate by losing weight. Fortunately, we didn't fall into the trap of dieting together, but perhaps you recognize the confusion!

Many people confuse lipedema with being overweight. Not all people with lipedema are overweight, and not all overweight people have lipedema. The vast majority of women with lipedema are overweight. Measures to reduce weight primarily affect the obesity component, but much less the uneven fat distribution of lipedema. Because you can have a high BMI with lipedema without being overweight, many patients are sometimes wrongly linked to overeating and obesity.

The development of overweight and obesity is very complex, and it's certainly not true that every pound goes through the mouth. You might get angry or frustrated when your doctor or healthcare provider brings up your weight again. Hormones, hunger and satiety, the environment, sleep, stress, pain, medication, your past diet... these are all factors that influence weight gain. It's important to map out your story together. For example, if you've been dieting for years and consistently gained weight (the yo-yo effect), there's no point in continuing. Besides a good nutrition and exercise plan, where you listen carefully to your body, there are more options these days. For example, medication (Saxenda, Ozempic) or gastric bypass surgery (metabolic surgery). If you're experiencing these issues, it's also important to monitor your nutrition together with your dietitian. It's easy to eat too little food. Then you might lose weight, but you still won't feel better.

Moreover, if you lose a significant amount of weight, your legs will still feel proportionally heavier. The lipoedema won't disappear. However, the symptoms associated with lipoedema will decrease.

Negative spiral

However, if you have lipoedema, there are a number of symptoms that can create a negative spiral, making it easier for you to gain weight.

Fatigue and heavy, painful, and tired legs, among other things, can reduce your mobility. It becomes more difficult to climb stairs and get out of a chair. This affects the amount of energy you use, increasing your risk of being overweight.

The social pressure and shame that come with lipedema can make you feel anxious, and you might start eating away your anxiety. It can also make you shy away from swimming or going to the gym, increasing your risk of becoming overweight.

What if you have gained weight?

Don't think there's a quick fix for losing weight. Dieting certainly doesn't work. You can approach the issue in several ways.

You can be at peace with your body, respect and love it, and from there, ensure you do what's necessary to take care of it. (And pssssst, those are pretty much the same things you would do to lose weight, only you're not being strict and judging yourself by the kilos.) This way, you simultaneously work on a more positive relationship with your body and on your lifestyle.

Ultimately, the goal is to ensure that you, despite your chronic condition, have the best possible life. By clearly understanding the factors above, you can begin to formulate your true needs. Is that less pain? Easier movement? More energy? Being able to participate in sports? Easier housework or work? That's up to you. I'll support you in achieving your goal by providing you with knowledge and insight into the role of nutrition in this process.