Lipedema – The Disease They Call FAT:
An Overview for Clinicians eBook

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Lipedema – The Disease They Call FAT: An Overview for Clinicians is a monograph that provides a clinical synopsis of this condition. This monograph covers the history of lipedema and includes sections on epidemiology, etiology, pathogenesis, clinical features, diagnosis and how to differentiate between lipedema and other disorders, such as lymphedema and obesity. Treatment options, both conservative and surgical, and prognosis are also reviewed.

Written with the clinician in mind, it is a practical overview of the condition and provides important information for healthcare providers who treat women.



published in collaboration with
Lymphatic Education & Research Network (LE&RN)

What is lipedema?

Lipedema is a fat disorder that affects women and is often mistaken for simple obesity. Believed to be hormonal in nature, lipedema usually develops at puberty, but can develop or worsen later in life due to hormonal changes associated with pregnancy, menopause, or gynecological surgery.

Estimates of the incidence of lipedema range as high as 11% of the post-pubertal female population, which is approximately 17 million women in the United States alone.

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About the Authors

A collaboration amongst experts worldwide brings knowledge of the lymphatic system, and specifically lipedema, lymphedema and obesity. A process that took 18 months Lipedema-The Disease They Call FAT: An Overview for Clinicians offers a thoughtful and concise overview of this little known and generally mis-diagnosed fat disorder for healthcare professionals and for patients as well.

Erez Dayan, MD

Dr. Erez Dayan is from the Harvard Plastic Surgery Program in Boston, Massachusetts. He has been actively involved in seminal research related to surgical treatments for lymphedema and new technology and imaging modalities for assessing fluid and fat content of various body parts. He has lectured and published on these topics on over 100 occasions nationally and internationally.

Julie N. Kim, MD

Dr. Julie N. Kim is in her first year of residency in Plastic and Reconstructive Surgery at the University of Texas Health Science Center at San Antonio. She recently completed her residency in General Surgery at Mount Sinai Beth Israel in New York City. At MSBI she was fortunate to work with both Dr. Mark Smith and Dr. Erez Dayan who introduced her to the intricacies of both lymphedema and lipedema.

Mark L. Smith, MD, FACS

Dr. Mark L. Smith is Professor and System Vice-Chairman of the Department of Surgery at Hofstra Northwell School of Medicine and Director of Reconstructive Oncology for Northwell Cancer Institute. He is also Director of the Friedman Center for Lymphedema Research and Treatment at The Center for Advanced Medicine and Co-Director of the Lipedema Project. He is an expert in the field of cancer reconstruction and lymphatic surgery.

Catherine A. Seo, PhD

Dr. Catherine Seo is Co-Director of the Lipedema Project and Founder and Director of Lipedema Simplified, LLC. She produced and directed the documentary The Disease They Call FAT. She holds a doctorate in Media Psychology. She has developed online courses on lipedema for patients and healthcare professionals as well as multi-media learning tools.

Robert Damstra, MD, PhD

Dr. Robert J. Damstra is a dermatologist at the Nij Smellinghe Hospital in Drachten, the Netherlands. He co-founded the Drachten Working Group on Lymphedema in 1995 expanding the hospital’s reach to include a specialized expertise center for the diagnosis and treatment of lymphedema and lipedema. The Center collaborates with many national and international groups to put lipedema on the agenda and to create more awareness and recognition of this disease.

Prof Wilfried Schmeller, MD

Professor Dr. Wilfried Schmeller is dermatologic surgeon with expertise in phlebology and lymphology. His background includes the Department of Dermatology at the Universtity of Luebeck, the Vein Clinic in Bad Bertrich, and the Rosenpark-Klinik in Darmstadt. He founded the Hanse-Klinik in Luebeck in 2002 to treat patients with lipedema with liposuction. He has published many scientific articles with this topic. Prof. Schmeller is head of the working group Operative Lymphology of the German Society of Lymphology and has been participating in the new German Guidelines for Lipoedema.

Yvonne Frambach, MD

Dr Yvonne Frambach is a board certified dermatologist who specializes in allergology and medicinal tumour therapy. She has treated chronically ill patients particularly those suffering from inflammatory diseases and tumours as well as those with lipedema and lymphedema. She has been a physician at the Hanse-Klinik since 2014.

Matthew A. Carmody, MD

Dr. Matthew Carmody is Assistant Professor of Medicine at Harvard Medical School and an internist affiliated with Mount Auburn Hospital. He specializes in Internal Medicine and has been instrumental implementing PatientCentered Medical Home (PCMH), a team-based health care delivery model led by a health care provider that is intended to provide comprehensive and continuous medical care to patients with the goal of obtaining maximized health outcomes.

Prof Etelka Földi, MD

Professor Etelka Földi. MD is one of the world’s foremost authorities on the lymphatic system. She and her husband, Professor Michael Földi. MD founded the Society of German Lymphologists in 1969. Their seminal textbook on lymphology, Földi’s Textbook of Lymphology: for Physicians and Lymphedema Therapists is currently in its third edition and has become a classic treatise on the management of Lymphedema.

Stanley G. Rockson, MD

Stanley G. Rockson MD is the Allan and Tina Neill Professor of Lymphatic Research and Medicine and Stanford University and directs the Stanford Center for Lymphatic and Venous Disorders, where he conducts basic and clinical research in lymphatic disorders, including lipedema. He is the Founding Chair of the LE&RN Scientific and Medical Advisory Committee. Dr. Rockson has authored more than 150 scientific papers, reviews, book chapters, and books devoted to various aspects of lymphatic biology and disease, vascular biology, and cardiovascular medicine.

What experts are saying about the monograph

“As a clinician, I expect this will quickly become a  “standard reference” on Lipedema.  The clinical information is concise, thorough, and up to date. The monograph is a helpful reference whether checking stages, differential diagnosis or current treatments. It has become a great teaching document in our clinic for therapists, students and patients alike. It will be a helpful reference to share with physicians as we discuss strategies for care management.”

Jean Flanagan Jay, DPT, PT, CLT
Director, Rehabilitation Services
Brigham and Women’s Faulkner Hospital
Boston, Massachusetts USA

“This is a high-quality, comprehensive summary of the ‘State of the Art/ Science’ relating to lipoedema/lipedema. This disease badly needs attention both from healthcare professionals in order to improve patient care, and from scientists to improve our basic understanding of this disease with a view to improved treatment. I am hopeful this monograph will provide the platform for such advances.”

Peter Mortimer, MD
Professor of Dermatological Medicine
Molecular and Clinical Sciences Institute (Dermatology Unit)
St. George’s, University of London
London, England UK

“This monograph on Lipedema should be required reading for medical students, and residents in all US training programs. Yes, “obesity” is everywhere but it’s clearly not just one disease. We clinicians need to see the shades of grey within our population that appears to be overweight. The phenotype of Lipedema is obvious once one learns its characteristics and if one can make the correct diagnosis a whole new world is opened for a patient. So think about the millions of woman who go to their doctor(s) complaining or even just wondering about why their legs look and feel different yet leave with incorrect information. It is up to those of us who know about Lipedema to teach those who don’t. This monograph is a key part of that process.”

S. Scott Tapper, MD, FACS, RPVI
Symmetry Vascular Center
Adjunct Professor of Surgery
Lake Erie College of Medicine
Stuart, Florida USA

This comprehensive monograph is the much needed guide that many clinicians have been waiting for. Not only does this work foster enlightened discourse and mulitidisciplinary collaboration, it highlights how very far we have come in our understanding of lipedema. Even though we still have far to go, this book lights the way by putting everything in a foundation of science and compassion.

Leslyn Keith, OTD, CLT-LANA
Central Coast Lymphedema Therapy
San Luis Obispo, CA, USA

““Finally, someone (Doctors Erez Dayan, Mark L. Smith, Catherine A. Seo, and many concerned other experts) comes along to illuminate a disease that has eluded scientific daylight. Patients, plastic surgeons, and everyone who cares about people who are unfortunate enough to be struggling with lipedema owe many congratulations to you.

This monograph on lipedema is a singular achievement. In textbook fashion, it describes the pathogenesis, diagnosis, and treatment of a condition that disables and humiliates but does not kill. Those who suffer from it – until now – have been relegated in many unfortunate instances to second class patients; their doctors do not know, in fact, may never have heard of the disease lipedema, and therefore cannot provide a meaningful treatment, or worse yet, even suggest one.

Advances such as liposuction provide significant long-term improvement for many patients with lipedema; those advances should become part of the body of knowledge that all physicians possess, including those in primary care and family medicine. This comprehensive and clearly written monograph is authored by a group who refused to accept black box status for lipedema any longer. It is just what the medical profession and lipedema patients have sorely needed for many years, and most importantly, it is a testimony to advances in reconstructive surgical techniques and to the perseverance of a determined group of clinicians.”

Sumner A. Slavin, MD
Clinical Associate Professor of Surgery
Harvard Medical School
Co-Director, The Program for Lymphedema, Boston Children’s Hospital
Boston, Massachusetts, USA

“Understanding lipedema and differentiating it from lipohypertrophy, lymphedema, and general obesity can be very confusing. This monograph for clinicians provides an excellent and well-referenced overview of lipedema, as well as diagnostic and therapeutic approaches currently available. For healthcare providers of various levels, this treatise will bring awareness of a condition that is so very often misunderstood and misdiagnosed, preventing patients from receiving the medical care they deserve.”

Guenter Klose
MLD/CDT Certified Instructor; CLT-LANA
Founder, Klose Training & Consulting, LLC
Lafayette, Colorado, USA

““Lipedema – the Disease They Call FAT: An Overview for Clinicians is a truly forward
thinking approach to educating clinicians and patients alike of an otherwise often
misunderstood disease. The monograph is a much needed, concise, and informative
body of work representing the state of the art in current management.”

Dhruv Singhal, MD
Director of Lymphatic Surgery
Beth Israel Deaconess Medical Center
Harvard Medical School
Boston, Massachusetts, USA

“This monograph is a recent summary of what we currently know about the disease of lipedema. It is helpful for doctors and patients alike. The therapeutic recommendations correspond to the state of science and are serious. I will recommend it to my English speaking patients.”

Stefan Rapprich, MD
Dermatologic & Lipedema Surgeon
Phlebology Hautmedizin
Bad Soden, Germany

“Lipedema is a condition that too few know anything about. Research and clinical communities have a long way to go toward appropriately recognizing, diagnosing, and understanding this disease. It is so important to educate us all as we begin to take on and conquer this condition. This reference is a good place to start.”

Gwen Randolph, PhD
Professor of Immunobiology
Head, Division of Immunobiology
Washington University in St. Louis
St. Louis, Missouri, USA

“All clinicians working in the best interest of their lipoedema/lipedema patient will find this impressive publication by a collaboration of internationally renowned experts invaluable. Experts with passion, willing to use their skills to develop a far-reaching research agenda for lipoedema and end the decades of misery lipoedema creates for all who suffer from it. My hope is that it will also encourage a wide range of new clinicians to become engaged in the mysteries of lipoedema.”

Sharie Fetzer
Chair, Lipoedema UK
LipoedemaUK.org
West Sussex, England, UK

““Despite having a PhD on the topic of adipose tissue remodeling and obesity, prior to meeting Dr. Catherine Seo a few years ago, I had barely come across anything on the topic of lipedema in the research literature. Her passion for bringing new light to this often unrecognized and largely unknown disease shines through in this excellent monograph that brings together the experiences of clinicians, researchers, and patient advocates on the topic of lipedema diagnosis and treatment. It’s a must read for patients and health care professionals dealing with untypical cases of obesity.”

Ebba Brakenhielm, PhD, Hab. Dr.
Cardiovascular Researcher
Institut National de la Santé et de la Recherche Médicale (INSERM)
Normandy University
Rouen, France

“I’ve found this monograph very useful for clinicians, a good and complete synthesis of what we know about lipedema.”

Isabel Forner-Cordero, MD, PhD
Hospital Universitari i Politecnic La Fe
University of Valencia
Valencia, Spain

About The Friedman Center

The Friedman Center for Lymphedema Research and Treatment at The Center for Advanced Medicine at Northwell Health in New York was founded in 2013. Its focus has been on offering solutions for patients with lymphedema, a debilitating condition that occurs in many patients after cancer treatment.

The Friedman Center’s scope of care now includes treatment for lipedema, a condition that can also result in lymphedema. To that end, the Friedman Center has created the Lipedema Project, a comprehensive program to increase awareness and provide education, research and treatment for lipedema. The Friedman Center is proud to sponsor the lipedema documentary, The Disease They Call FAT, the 1st International Symposium on Lipedema, the Lipedema Think Tank, the Lipedema Solutions Forum for women with lipedema in April 2015 and this online CME eduring materials course for physicians.