Basics & definition
Understanding lipoedema
What exactly is lipoedema? Here you will find everything you need to know about the basics of this chronic condition.
Medically reviewed byDr. med. Martin Reifenrath, Specialist in Plastic and Aesthetic SurgeryLast reviewed:
Definition
What is lipoedema?
Lipoedema is a chronic fat distribution disorder that affects almost exclusively women. It is a recognised disease – not a lack of discipline or “just being fat”.
Lipoedema typically occurs on the legs, hips and buttocks, and often on the arms as well, while the hands and feet characteristically remain unaffected.
Topics at a glance
Everything important about lipoedema
From the first symptoms and the stages to the causes – here you will find well-founded information.
Symptoms & stages
From the first signs to stage III – recognise the typical features and understand how the condition develops.
Lipoedema vs. lymphoedema vs. obesity
Three conditions that are often confused. Learn about the key differences.
Causes & risk factors
Genetics, hormones, triggers – what we know today about how lipoedema develops.
The key facts
Lipoedema at a glance
Understand the basic features of this often misunderstood condition.
Almost only women
Lipoedema affects almost exclusively women. In men it is extremely rare and has only been described in isolated case reports.
Chronic, but can be influenced
Lipoedema does not go away, but according to the guideline it does not necessarily progress – with a stable weight, it often stays the same for years. Weight gain and hormonal changes can make it worse.
A recognised disease
Lipoedema is medically recognised and has nothing to do with a lack of discipline. Effective treatment options are available.
Affected areas of the body
Where does lipoedema occur?
Lipoedema affects only the limbs – that is, the arms and legs. Other areas of the body, such as the abdomen, flanks, back or neck, are not part of the typical presentation of lipoedema.
A characteristic feature: the hands and feet stay slim while the arms and legs become larger. This disproportion is often the first sign of lipoedema.
Legs & knees
From the hips to the ankles
Arms
Upper and lower arms down to the wrists
Hips & buttocks
Transition zones to the limbs
Hands & feet stay slim
A characteristic distinguishing feature
Important to understand
What lipoedema is not
Many of those affected meet with a lack of understanding from the people around them. Here are the most important clarifications.
Not excess weight
Lipoedema is not the result of eating too much. The diseased fatty tissue does not respond to diets or calorie-reduced eating.
Not a question of discipline
However much exercise those affected do, lipoedema fat cannot be reduced this way. It is a disease, not a weakness of character.
Not lymphoedema
Although the two conditions can look similar, they are fundamentally different. An assessment by a specialist is essential.
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Facts & figures
Lipoedema in figures
10%
Of all women
possibly affected
60%
Family
history detectable
100%
Female
Only women affected
3
Stages
of the condition
A major problem
Often unrecognised for years
The condition is often not recognised or wrongly classified for years. Many of those affected go through a long ordeal and frequently meet with a lack of understanding from those around them.
Remarks such as “You just need to exercise more” or “That’s just the way you’re built” are, sadly, part of everyday life for many patients.
- Frequent misdiagnoses
- Lack of knowledge
- Emotional strain
- Social stigma
Important for cost coverage
Diagnosis & health insurance
For costs to be covered by German statutory health insurance (GKV), a correct diagnosis is crucial.
For a medically confirmed diagnosis – especially for German statutory insurance cover – a written report by a specialist in angiology, dermatology or physical and rehabilitation medicine, or a doctor with additional training in phlebology, is essential.
In addition to taking a detailed medical history, these specialists also perform a duplex ultrasound scan to rule out other conditions such as chronic venous insufficiency or lymphoedema.
- Specialist report
- Duplex ultrasound
- Documentation of the stage
- Treatment recommendation
Good to know: requirements for German statutory cover
For patients insured in Germany: where lipoedema has been confirmed, the cost of liposuction at all stages can be covered by statutory health insurance since October 2025, subject to certain requirements. What matters is a written report by a specialist approved for this purpose (e.g. in angiology or dermatology) and proof of prior conservative therapy (at least 6 months). You no longer need to submit an individual application to your health insurer.
Read on
Deepen your knowledge
Find out more about symptoms, stages, causes and how lipoedema differs from other conditions.
Frequently asked questions
FAQ on the basics
What exactly is lipoedema?
Lipoedema is a chronic, painful fat distribution disorder that affects almost exclusively women. It involves pathologically altered fatty tissue that appears symmetrically on the arms and legs, and whose uneven distribution barely changes with diets or exercise. It is a recognised disease and has nothing to do with a lack of discipline.
Can men get lipoedema too?
Only in very rare exceptional cases. According to the medical guideline, lipoedema affects almost exclusively women; in men, only isolated cases have been described, usually together with a hormonal disorder. In men, large, painful legs almost always have other causes.
Which parts of the body are affected?
Lipoedema affects only the limbs – that is, the arms and legs, including the hips and buttocks as transition zones. A characteristic feature is that the hands and feet stay slim. Other areas of the body, such as the abdomen, flanks, back or neck, are not part of the typical presentation of lipoedema.
Will health insurance cover the treatment?
For patients with German statutory health insurance: where lipoedema has been confirmed, the cost of liposuction at all stages can be covered by statutory health insurance since October 2025, subject to certain requirements. What matters is a written report by a specialist in angiology, dermatology or physical and rehabilitation medicine, or a doctor with additional training in phlebology, as well as proof of prior conservative therapy. You no longer need to submit an individual application to your health insurer. We perform operations covered by statutory health insurance at our NATIONALKLINIK Wertheim – preparation and aftercare remain at the location near you.
Can lipoedema be cured?
Lipoedema is a chronic condition that cannot be cured completely, but it can be treated very well. Conservative therapy (compression, lymphatic drainage, exercise) can relieve the symptoms. Surgical liposuction can permanently remove the diseased fatty tissue and considerably improve quality of life.
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