Lipedema vs. Lymphedema: What’s the Difference?
Lipedema and lymphedema both cause larger, heavier legs, so they are often confused. But they are different conditions. Lipedema is a disorder of fat tissue. Lymphedema is a buildup of lymph fluid. Knowing which one you have, or whether you have both, shapes your treatment and your insurance coverage.
Lipedema affects almost only women. It causes fat to build up evenly on both legs, from the hips to the ankles, and sometimes on the upper arms. The feet and hands are usually spared, which can leave a "cuff" of tissue just above the ankle or wrist. It often starts or worsens around puberty, pregnancy or menopause, and it tends to run in families. Diet and exercise usually don't shrink lipedema fat. Estimates of how common it is vary widely; some suggest as many as 1 in 10 women, and many are never diagnosed.
How they differ
What builds up: lipedema is fat tissue; lymphedema is lymph fluid.
Who gets it: lipedema affects almost only women; lymphedema can affect anyone, often after cancer surgery or radiation.
Where: lipedema affects both legs (and sometimes arms) evenly; lymphedema often affects one arm or leg, though it can be both.
Feet and hands: usually spared in lipedema, with a "cuff" at the ankle or wrist; often swollen in lymphedema.
How it feels: lipedema is often tender or painful to touch and bruises easily; lymphedema feels heavy, tight or full and is usually not painful to touch.
Skin test: with lipedema, the skin at the base of the second toe can usually be pinched; with lymphedema it is often too thick to pinch (a positive Stemmer sign).
Diet and exercise: usually don't reduce lipedema; exercise can help move lymphedema fluid.
The two can overlap. Over time, lipedema can strain the lymphatic system and lead to swelling from fluid as well. This is called lipo-lymphedema. Only a doctor or lymphedema therapist can tell you which you have.
How lipedema is treated
There is no cure, but symptoms can be managed:
Compression garments can ease pain and heaviness and support the tissue. Pressure should be fitted to you; for lipedema, higher pressure is not always better, and comfort matters. Flat knit garments are often a good choice because they hold their shape over uneven areas.
Manual lymphatic drainage and other hands-on therapy from a trained therapist.
Low-impact exercise such as water exercise, walking or cycling.
A compression pump may help when there is swelling from fluid as well.
Lymph-sparing liposuction is an option some specialists offer when other care isn't enough.
What about insurance?
The federal Lymphedema Treatment Act covers compression garments for a lymphedema diagnosis. Lipedema on its own is generally not covered under that benefit. If your provider also documents lymphedema (lipo-lymphedema), garments may qualify. Private plans vary, so we check your benefits before anything is ordered, and cash pay is available.
Think you might have lipedema?
Start with your doctor or a certified lymphedema therapist. Once you have a diagnosis and prescription, a Certified Compression Therapist at Midwest Compression can measure you for ready-to-wear or custom flat knit garments in Richland, MI. Call (800) 883-1549 or text (517) 657-5223.
Helpful resources
This article is general information, not medical advice. Talk with your doctor about your diagnosis and treatment.
Want to know if your insurance covers it?
Use our secure patient forms to send your information and documents. We'll check your benefits in writing at no cost before anything is ordered.
Check my coverage securely How the process works