Painful fatty tissue – why is there such poor awareness about this condition?
13/4/2026
Translation: Veronica Bielawski
Pain, swelling and bruising, often coupled with prejudice and bad advice instead of a diagnosis. Lipoedema, a chronic condition affecting fatty tissue, is still widely misunderstood. Find out what defines the condition and what treatments are available.
Chronic pain in the legs, bruising at the slightest touch, and a body that can’t be changed through exercise or diet – met time and again with the same medical advice to simply move more and eat less. People with lipoedema are often stuck in this cycle for years.
Lipoedema is a chronic condition of the fatty tissue that almost exclusively affects women. It’s neither a consequence of excess weight nor of a lack of discipline – and yet that’s exactly what those affected are often accused of.
What lipoedema does to the body
In lipoedema, pathologically altered fatty tissue builds up symmetrically on the legs, hips and sometimes the arms, while the upper body, feet and hands are characteristically spared. Even light touch causes pain, bruises appear for no obvious reason and the affected areas swell noticeably towards the evening.
Unlike the fat associated with excess weight and obesity, lipoedema fat can’t be reduced through dietary changes or exercise. Studies suggest that lipoedema fatty tissue behaves fundamentally differently from normal body fat. It shows chronic low-grade inflammation, with the small blood vessels not functioning properly and oestrogen directly affecting the growth of fat cells. It’s no coincidence that the condition almost always appears or worsens when the body goes through hormonal changes. Many people first notice something is wrong during puberty, pregnancy or menopause. There’s also a genetic component to lipoedema. Up to 60 per cent of those affected report that their mother, sister or daughter has similar symptoms too.
A condition overlooked by medicine for a long time
It’s not known exactly how many women are affected. One study found signs of lipoedema in around five per cent of the women examined, while other estimates put the figure at more than twice that. This wide range is due to the fact that uniform diagnostic criteria and population-wide studies are still lacking.
Those affected often go misdiagnosed for years, for instance with obesity, lymphoedema or psychosomatic complaints. A Czech study from 2025 reported more than half of the women with a confirmed diagnosis suffered from moderate to severe symptoms of depression – likely the result of a long fight for the correct diagnosis.
Treatable, but not curable
There’s no cure for lipoedema. The first line of treatment for those newly diagnosed includes manual lymphatic drainage, compression stockings and adapted exercise. These methods help relieve symptoms and slow the progression of the condition.
The altered fatty tissue itself can only be removed surgically through liposuction, which has the greatest proven effect so far. A meta-analysis from 2024 showed that after liposuction, those affected had significantly less pain, were able to move more easily and experienced a noticeable improvement in quality of life. However, the study also points out that more than half of patients still depended on the continued use of compression garments after the operation.
A turning point in Germany – and a need for action in Switzerland
Last year, Germany made a decision that those affected had been anticipating for years. Since January 2026, public health insurers have covered the cost of liposuction, regardless of the disease’s progression. A large-scale study showed that liposuction is significantly more effective than treatment without surgery (page in German).
In Switzerland, those affected by lipoedema are still fighting. Despite the fact that liposuction has been on the list of mandatory benefits since 2021, each health insurance provider decides for itself in practice and rejections are far from rare. If you’re looking for information or support, the Swiss Lipoedema Association (website in German) is a great first port of call.
Living with lipoedema: a book recommendation
Lipoedema doesn’t just burden the body, but also the mind. Shame, self-doubt and fear of how the condition may develop are part of everyday life for many people. Because these emotional issues are often overlooked in medical practice, patients may look for practical tips on how to deal with this side of the condition in daily life. Books like «Emotional frei mit Lipödem» (Emotionally free with lipoedema) can provide support.
The authors of this self-help book, which is currently only available in German, are two women with first-hand experience. Caroline Sprott has been living with lipoedema in her arms and legs since 2010. While she’s undergone surgery, she still isn’t free of symptoms. On her blog, she shares her realistic approach to the disease, taking care not to make false promises of a cure. The second author, Marianne Jouanneaux, is an occupational therapist and consultant. In the book, she draws on both her professional experience supporting people with chronic illnesses as well as her own diagnosis of lipoedema.
To make the emotional challenges more tangible, the book is structured around fictional therapy conversations. The dialogues address typical concerns such as struggling with body image, constant pain or the feeling of being completely overwhelmed. It also includes practical exercises and worksheets. Readers can use it as a workbook to organise their thoughts.
It’s important to keep in mind that the book is purely a self-help guide, not a medical textbook. It offers no clinical or scientific explanations and can’t replace psychotherapy. Instead, it offers emotional support for women who can relate to the personal stories of lipoedema and are looking for a structured way to improve their quality of life.
Header image: Jota Buyinch Photo/Shutterstock
Anna Sandner
Senior Editor
Anna.Sandner@galaxus.deScience editor and biologist. I love animals and am fascinated by plants, their abilities and everything you can do with them. That's why my favourite place is always the outdoors - somewhere in nature, preferably in my wild garden.
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