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The first thing Becca Golden noticed was her pants.<\/p>\n
Throughout the spring and summer of 2023, her pants stopped fitting. Her legs became puffy, with a rippled texture and heavy ache. Within a year, the 32-year-old, Austin-based podcaster went up four pant sizes, gained 30lb and found herself in constant leg pain. She had always had a little bit of cellulite, she says, but while her upper body appeared mostly unchanged, now her legs seemed to belong to a \u201cdifferent person, overnight\u201d.<\/p>\n
Working out with a trainer didn\u2019t seem to help her lose weight, nor did walking more. \u201cPeople would say: \u2018Well, just go on a walk, you\u2019ll feel better.\u2019 And every time I went on the walk, I felt exhausted,\u201d she says.<\/p>\n
Searching the internet for her symptoms, Golden came across the Lipedema Foundation, an organization focused on a condition that sounded a lot like what she was going through.<\/p>\n
The Lipedema Foundation describes lipedema as a chronic, progressive disorder in which abnormal fat tissue accumulates disproportionately in the lower body and sometimes upper arms, causing pain, heaviness and easy bruising.<\/p>\n
Lipedema is resistant to diet and exercise, Golden read \u2013 no amount of change will affect it. It is not obesity, but is often mistaken for it. Nor is it lymphedema, a condition in which lymph fluid accumulates in the body, often after cancer surgeries affecting lymph node functionality. The two are frequently confused, and in some cases one can trigger the other.<\/p>\n
Lipedema was first formally described at the Mayo Clinic in 1940, then named and clinically documented a decade later. Yet, despite occurring in an estimated 10% of women, lipedema is not well understood by doctors.<\/p>\n
\u201cThere are very few physicians that are able to diagnose lipedema,\u201d says Dr Guillermo Oliver, director of the center for vascular and developmental biology at Northwestern University.<\/p>\n
\u201cIt was never taught to us in medical school,\u201d says Dr David Amron, a Los Angeles plastic surgeon who has performed roughly 12,000 lipedema liposuction surgeries over nearly three decades. \u201cThey gave it a weak name,\u201d he says of the disease. \u201cIt got confused with lymphedema. It sounds almost made up.\u201d<\/p>\n
According to Amron, \u201cbetween 90 and 95%\u201d of patients who come through his door have diagnosed themselves, usually after online research or, increasingly, seeing a social media post. Recently, the musician Doja Cat described on TikTok her \u201cepiphany\u201d that she may have lipedema, and web searches for the condition are on the rise.<\/p>\n
What causes the condition is \u201cnot yet clear\u201d, says Oliver. Doctors do know it can be genetically inherited from either parent, and that it has a hormonal component related to bursts of estrogen women tend to experience during puberty, pregnancy and menopause, he says.<\/p>\n
This hormonal component is why lipedema presents almost exclusively in women. At times of estrogenic change, the condition seems to accelerate. It can develop from stage one lipedema \u2013 during which swelling may not even be noticeable to the patient \u2013 through a progressive intensification culminating in stage four lipedema, when patients can carry an amount of excess fat on their legs that affects their quality of life severely.<\/p>\n
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In 2020, Diann Paz, now 52, had a hysterectomy to remove a large tumor. Within weeks, her legs were red, swollen and painful. She went to several doctors before a vein specialist finally diagnosed her with lipo-lymphedema, a co-occurrence of unusual fat cells and a blocked lymphatic system. \u201cI had stage four already, where it\u2019s the worst it can be,\u201d she says.<\/p>\n
Today, standing for more than five minutes is unbearable. Paz uses a scooter for anything beyond short distances. After more than 30 years in banking, she is unemployed and applying for disability. \u201cIt\u2019s affected me in every way,\u201d she says. Simple tasks like cooking and standing in line have become difficult, and the stress of her situation has been intense.<\/p>\n
Amron and others believe that lipedema results from weak connective tissue that allows fluid to leak into a patient\u2019s fat layer, where fat cells begin replicating, inflammation occurs and fibrous scar tissue begins to form the condition\u2019s telltale nodules: a lumpy texture visible through the skin and firm to the touch. Lipedema patients often see a \u201ccuff\u201d or a stark demarcation between their significantly swollen lower legs and their unchanged feet.<\/p>\n
Lipedema fat tissue carries a genetic signature suggesting dysfunction of the tiny blood vessels lining it, according to Dr Vincenza Cifarelli, an assistant professor of pharmacology and physiology at Saint Louis University who has studied the disease for seven years. Bruising may result from damage to these sensitive cell linings, says Cifarelli. But it\u2019s unclear why people with lipedema experience pain.<\/p>\n
One of the most common dismissals women with lipedema receive \u2013 that they\u2019re simply overweight \u2013 does not bear out. Cifarelli\u2019s research has found that women with lipedema tend to be metabolically healthier than those with obesity, and the condition does not appear to raise diabetes risk.<\/p>\n
There is no cure for lipedema. Additionally, interventions are relatively limited, though catching the disease early can help patients control its progression. Compression garments are often used to help manage swelling, while manual lymphatic drainage massage, compression pumps and anti-inflammatory diets can also be useful, though their efficacy may vary from person to person.<\/p>\n
For Paz, only aquatic therapy moves the needle on her pain. She\u2019d like to go daily, but insurers don\u2019t always recognize lipedema as a condition it\u2019s medically necessary to treat, meaning interventions are not always covered.<\/p>\n
GLP-1 medications are showing early promise as anti-inflammatories. Golden, who was eventually diagnosed with lipedema, says the GLP-1 tirzepatide nearly eliminated her leg pain and improved her skin texture.<\/p>\n
Lipedema-specific liposuction is the most significant intervention available. It is more technically demanding than ordinary cosmetic liposuction, requiring smaller instruments, slower technique and specialized surgeons willing to treat areas of the leg that are historically avoided, like the calf, because of the likelihood of visible scarring.<\/p>\n
\u201cFor lipedema, we cannot go fast,\u201d says Dr Marc DuP\u00e9r\u00e9, a Toronto plastic surgeon who has specialized in the condition for a decade. The outcomes, he says, are unlike anything else in his practice. \u201cThe change between happiness and satisfaction before and after is humongous,\u201d he says.<\/p>\n
Golden didn\u2019t want to rely on injections indefinitely, so she finally had surgery on her lower legs, with more planned for her upper legs and arms. It cost more than $20,000. Her insurance has already denied the bill once, though she is appealing. She had the procedure awake, standing up partway through so her surgeon could assess the results under gravity.<\/p>\n
A week out from the procedure, she has been cleaning 15 incisions per leg each evening. It\u2019s too early to tell whether her symptoms will ease completely but she\u2019s eager for the results. \u201cI had pain in my legs all the time, 24\/7, before the surgery,\u201d she says. \u201cIt\u2019s like an investment.\u201d<\/p>\n
What many patients say they need most of all is to be believed. \u201cWhen patients get a diagnosis, it helps them move forward,\u201d DuP\u00e9r\u00e9 says. It also \u201creduces depression and anxiety\u201d that can come from feeling like they\u2019re simply failing to be fit through diet and exercise.<\/p>\n
To raise the disease\u2019s profile, Amron has founded the Lipedema Society, the first medical organization dedicated to the condition, with the goal of getting it into medical school curricula within five years. Golden is spreading the word, too \u2013 on TikTok, where one of her early posts has nearly 2 million views.<\/p>\n
It\u2019s important for people not to self-diagnose too quickly, cautions Cifarelli. Content creators claim that, for instance, having indents on your ankles from wearing socks could be a symptom. But such signs may be unrelated, and many women naturally carry more weight in their lower bodies. \u201cHow lower body obesity is different from lipedema is still an active question,\u201d says Cifarelli.<\/p>\n
If you\u2019re experiencing leg heaviness or pain that affects your daily life, and weight gain in your legs that seems to have worsened around hormonal milestones, experts agree: don\u2019t panic, but don\u2019t dismiss it. Talk to your doctor, and if they\u2019re unfamiliar with the condition, the Lipedema Foundation and the Lymphatic Education and Research Network offer resources.<\/p>\n
This story was amended on 1 May 2026 to correct the name of Becca Golden.<\/p>\n