Standard of care for lipedema in the United States

Karen L. Herbst, Linda Anne Kahn, Emily Iker, Chuck Ehrlich, Thomas Wright, Lindy McHutchison, Jaime Schwartz, Molly Sleigh, Paula M.C. Donahue, Kathleen H. Lisson, Tami Faris, Janis Miller, Erik Lontok, Michael S. Schwartz, Steven M. Dean, John R. Bartholomew, Polly Armour, Margarita Correa-Perez, Nicholas Pennings, Edely L. WallaceEthan Larson

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: Lipedema is a loose connective tissue disease predominantly in women identified by increased nodular and fibrotic adipose tissue on the buttocks, hips and limbs that develops at times of hormone, weight and shape change including puberty, pregnancy, and menopause. Lipedema tissue may be very painful and can severely impair mobility. Non-lipedema obesity, lymphedema, venous disease, and hypermobile joints are comorbidities. Lipedema tissue is difficult to reduce by diet, exercise, or bariatric surgery. Methods: This paper is a consensus guideline on lipedema written by a US committee following the Delphi Method. Consensus statements are rated for strength using the GRADE system. Results: Eighty-five consensus statements outline lipedema pathophysiology, and medical, surgical, vascular, and other therapeutic recommendations. Future research topics are suggested. Conclusion: These guidelines improve the understanding of the loose connective tissue disease, lipedema, to advance our understanding towards early diagnosis, treatments, and ultimately a cure for affected individuals.

Original languageEnglish (US)
Pages (from-to)779-796
Number of pages18
Issue number10
StatePublished - Dec 2021
Externally publishedYes


  • Lipedema
  • chronic venous disease
  • hypermobility
  • lymphedema
  • standard of care

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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