Lipoedema

Lipoedema (also spelled lipedema) is a long-term condition involving an abnormal build-up of fat, usually symmetrically in the legs, hips, and sometimes the arms, that is often tender and does not respond to diet or exercise in the way ordinary fat does. It occurs almost exclusively in women and is frequently misunderstood or mistaken for obesity or lymphoedema. While lipoedema cannot be reversed by weight loss alone, physiotherapy and conservative management at Goji Physio in Lentor, Singapore can help with comfort, swelling, mobility, and quality of life.

What is lipoedema and how is it different?

Lipoedema has a recognisable pattern that helps distinguish it from other conditions:

• Symmetrical distribution: typically affecting both legs (and sometimes arms) fairly evenly
• Sparing of the feet and hands: the feet and hands are typically unaffected by the abnormal fat accumulation, often creating a distinct “cuff” at the ankles or wrists. Swelling of the feet or hands may occur if lymphoedema develops alongside lipoedema.
• Tenderness and easy bruising: the affected tissue is often painful to pressure
• Disproportion: the lower body may be noticeably larger than the upper body
• Limited response to dieting: the affected fat tends to persist despite weight loss

Over time, lipoedema can sometimes coexist with lymphatic changes, which is one reason assessment matters.

What are the signs to look out for?

People with lipoedema often describe:

• Legs (and sometimes arms) that feel heavy, achy, or tender
• Easy bruising and sensitivity to touch or pressure
• A body shape that seems disproportionate despite diet and exercise
• Discomfort that increases through the day or with prolonged standing

What does a session at Goji involve?

Your physiotherapist will take a history of your symptoms and how they have developed, then assess the affected areas. This may include:

• Pattern and tissue assessment: noting distribution, tenderness, and tissue characteristics
• Swelling check: distinguishing lipoedema from, or alongside, lymphatic swelling
• Movement and function: how symptoms affect your mobility and daily life
• Self-management review: understanding your goals and current care

You will leave with an explanation of your presentation and a personalised, conservative management plan.

How is lipoedema managed?

Lipoedema management is conservative and focused on comfort, function, and slowing progression rather than cure. It may include:

• Compression garments: to support the tissue and manage any accompanying swelling
• Manual lymphatic drainage: where there is a lymphatic component
• Exercise and movement: low-impact activity to support mobility, circulation, and general health
• Education and self-care: understanding the condition and strategies for daily comfort

Physiotherapy works alongside your medical team, and for some people specialist medical input is also part of the picture.

Frequently asked questions

Is lipoedema just being overweight?

No. Lipoedema is a distinct condition with a characteristic pattern and tenderness, and the affected fat does not respond to diet and exercise the way ordinary fat does. It is often mistaken for obesity, which can be frustrating for those affected.

Will losing weight get rid of it?

Weight management supports overall health, but it does not typically resolve lipoedema tissue, which tends to persist. Management focuses on comfort, function, and quality of life rather than weight loss alone.

Is lipoedema the same as lymphoedema?

They are different conditions, though they can coexist. Lymphoedema is primarily about lymphatic fluid, while lipoedema involves fat tissue. Assessment helps distinguish and, where needed, manage both.

Can physiotherapy help lipoedema?

Yes. Physiotherapy can help manage pain, tenderness, swelling and mobility through personalised exercise, compression therapy and self-management strategies. Manual lymphatic drainage may also be helpful for selected individuals, particularly when swelling or pain is present. While physiotherapy cannot cure lipoedema or remove the affected fat tissue, it can help improve function and quality of life.

Does exercise help?

Yes. Exercise can improve muscle strength, build and maintain muscle mass, support circulation and mobility, and enhance overall quality of life. A combination of aerobic activities (e.g. walking, cycling or swimming) and progressive strength training is encouraged. While exercise cannot reliably eliminate lipoedema-related fat tissue, your physiotherapist can tailor a programme to your symptoms, abilities and goals.