Lipedema: What Is It, and How Can We Help You?

Lipedema (also spelled lipoedema) is a chronic condition of the adipose tissue that affects almost exclusively women. It is characterized by an abnormal, symmetrical, and often painful accumulation of fat, primarily in the hips, thighs, legs, and sometimes the arms. The feet and hands are generally spared, sometimes creating a characteristic “bracelet” or “cuff” effect.

According to estimates frequently cited in France (by patient organizations and specialized media), it could affect as many as one in ten women. However, it remains largely underdiagnosed, with an average delay in diagnosis of about 20 years. Many women are told for years that all they need to do is “eat better and exercise more,” even though the fat associated with lipedema is resistant to diets and conventional exercise.

This article, intended as a reference resource for people seeking information on lipedema in France—and more specifically in Versailles and the Île-de-France region—details the symptoms, diagnosis, stages, and treatment options. Special attention is given to two approaches often offered in physical therapy and physical medicine practices: lymphatic drainage and Tecar therapy.

Unlike simple weight gain or obesity, lipedema is a condition affecting the subcutaneous fat tissue. Fat accumulates disproportionately relative to the torso (which is often slender) and in a bilateral, symmetrical pattern. It is frequently associated with pain, hypersensitivity to touch, and fragile capillaries that make bruising more likely.

Triggering or aggravating factors are often hormonal: puberty, pregnancy, and menopause. Genetic, inflammatory, and microvascular factors are also cited. The disease is not caused by a lack of willpower or poor eating habits. It was recognized by the World Health Organization in 2018.

Patients often describe the following symptoms:

The diagnosis is primarily clinical. It is based on the patient’s medical history, symptoms, and physical examination. The physician (often an angiologist, phlebologist, dermatologist, or specialist in lymphology) notes the symmetrical distribution of fat, the absence of fat on the feet and hands, and assesses the pain.

Additional tests may be ordered to rule out other conditions (blood work, venous Doppler ultrasound, and sometimes lymphoscintigraphy if associated lymphedema is suspected). There is no specific blood marker.

Difference from lymphedema: Lymphedema is a problem with fluid drainage (often unilateral or asymmetrical, affecting the foot). Lipedema is primarily a disorder of adipose tissue (symmetrical, with the feet unaffected). The two conditions can coexist (lipolymphedema).

Difference from obesity: The fat associated with lipedema is resistant to diet and exercise and is accompanied by characteristic pain and hypersensitivity.

Traditionally, three morphological stages are distinguished:

The categories describe the affected areas (hips only, down to the knees, down to the ankles, with or without involvement of the arms). These classifications help describe the disease, but the perceived severity (pain, quality of life) does not always correlate with the visual stage.

There is no curative drug treatment. The goal is to relieve symptoms, maintain mobility, protect the skin, slow the progression of the disease, and improve quality of life. Management is multidisciplinary.

Conservative pillars:

When these measures are no longer sufficient and the functional impact is significant, specialized liposuction (tumescent techniques, WAL/water-assisted, etc.) may be considered. It aims to remove pathological fat while preserving the lymphatic system. It is not a purely cosmetic procedure.

Manual lymphatic drainage (using methods such as the Vodder or Leduc techniques, or similar approaches) is a very gentle, slow, and painless massage. It directs lymph and interstitial fluid toward the drainage areas.

What he can bring to the table:

Important limitations: Lymphatic drainage does not remove fat from lipedema. Its effect is primarily temporary and affects the fluid component. It is most effective when combined with compression (bandages or garments worn immediately after the session). In cases of pure lipedema without a lymphatic component, the benefits may be more limited. It is contraindicated in certain situations (acute infection, recent phlebitis, etc.). In Versailles and the Paris region, many physical therapists trained in lymphology offer these sessions as part of a comprehensive treatment plan.

Tecartherapy (Capacitive and Resistive Energy Transfer) is a physical therapy technique that uses high-frequency current. It produces deep thermal and non-thermal effects, promoting microcirculation, tissue drainage, and tissue remodeling.

A recent randomized controlled trial (2025) conducted in women with stage 2 lipedema evaluated the addition of six TECAR sessions (over three weeks) to standard treatment (compression + walking program). The results showed a greater reduction in limb circumference (particularly in the supra-malleolar region, with benefits maintained at three months), a significant reduction in pain in the short term (at one month), and an overall improvement in quality of life.

These benefits were observed in addition to standard care. TECAR therapy is neither a standalone treatment nor a miracle cure, but it appears to be a promising adjunct for relieving pain and improving local volume and comfort in stage 2 lipedema. At a clinic in Versailles or elsewhere in the Île-de-France region, TECAR therapy can be combined with lymphatic drainage and compression to optimize conservative treatment outcomes.

Lipedema is a little-known but common chronic condition that deserves recognition and appropriate treatment. Combining compression, adapted physical activity, lymphatic drainage, and—depending on the case—Tecar therapy can significantly improve the comfort and quality of life for many patients in Versailles and throughout France.

Early diagnosis and multidisciplinary care remain essential. Don’t hesitate to consult a specialized healthcare professional for a personalized evaluation.