For a Better Life


Lipedema & Malnutrition

Author Summary: A patient with lipedema was told she was just overweight. After she became so malnourished, she required hospitalization and parenteral nutrition, but her large legs and arms persisted. 


Patient: Female, 41-year-old

Final Diagnosis: Malnutrition

Symptoms: Leg edema • weakness

Medication: —

Clinical Procedure: Lymphatic mapping

Specialty: Dermatology • Endocrinology and Metabolic • Surgery


Rare co-existence of disease or pathology


Lipedema is a common condition that presents as excessive fat deposition in the extremities, initially sparing the trunk, ankles, and feet, and is found mainly in women, usually occurring after puberty or pregnancy. Lipedema can progress to include lipo-lymphedema of the ankles and feet. This report is of a 41-year old woman with Stage 3 lipedema and lipo-lymphedema with excessive lower body fat since puberty, with progression to swollen ankles and feet despite dietary caloric restriction.

Case Report:

A 41-year-old woman noticed increased fat in her legs since age 12. Her weight and leg size increased until age 21, when she reached a maximum weight of 165 kg, and underwent a Roux-En-Y gastric bypass. Over 12 months, she lost 74.8 kg. Her trunk significantly reduced in weight, but her legs did not. Fifteen years later, she became progressively weaker and swollen over her entire body during recovery from hysterectomy surgery. Laboratory test results showed hypoalbuminemia (2.0 g/dL), lymphopenia, and hypolipoproteinemia. She was diagnosed with protein and calorie malnutrition with marked gut edema requiring prolonged parenteral nutrition. After restoring normal protein, her health returned and her pitting edema resolved, but her extremities remained enlarged. She was subsequently diagnosed with lipedema.


This report demonstrates that early and correct diagnosis of lipedema is important. Women who believe the condition is due to obesity may suffer the consequences of calorie or protein-calorie deficiency in an attempt to lose weight.

Read the full paper here.  (Or PDF below.)
Citation Wright TF, Herbst KL. A 41-Year-Old Woman with Excessive Fat of the Lower Body Since Puberty with Progression to Swollen Ankles and Feet Despite Caloric Restriction, Due to Lipedema and Protein-Calorie Malnutrition: A Case of Stage 3 Lipedema. Am J Case Rep. 2021;22:e930306. Published 2021 May 7. doi:10.12659/AJCR.930306

Got A Question?

Ask Dawn

  • This field is for validation purposes and should be left unchanged.

Meet Dr. Wright

Dr. Wright

Meet Dr. Thomas Wright, medical director of Laser Lipo and Vein Center. Dr. Wright is a board certified Phlebologist and cosmetic surgery specialist, with over 15 years of practicing experience. A graduate of the University of Missouri Columbia medical program, Dr. Wright was one of the first two hundred surgeons to become a diplomate in Phlebology.

read more

* Results May Vary From Person to Person