ÃÛÌÒÖ±²¥

Your web browser is outdated and may be insecure

The RCN recommends using an updated browser such as or

Lipoedema: the hidden womenÃÛÌÒÖ±²¥™s health condition nurses and midwives need to know about

Mary Warrilow 2 Jul 2025

Lipoedema is a chronic, painful disorder affecting connective and fat tissue, lipoedema impacts approximately 10% of women worldwide. Despite this prevalence,many go undiagnosed for years, and this Blog explores some of the key facts around this devastating illness. 

Lipoedema is a chronic, painful disorder affecting connective and fat tissue, lipoedema impacts approximately 10% of women worldwide. Despite this prevalence, many go undiagnosed for years, and this Blog explores some of the key facts around this devastating illness. 

Nurses and midwives are in a powerful position to spot early warning signs of lesser-known conditions, such as lipoedema which can often be misunderstood, misdiagnosed, and overlooked in education.

This chronic condition which affects 10% of women, causes an abnormal build-up of adipose tissue, typically from the hips to the ankles, or just hips and thighs, and sometimes in the arms, while the waist and upper body remains relatively unaffected. Despite this prevalence, many go undiagnosed for years, and many are told simply to “eat less and move more,” compounding physical and psychological suffering.

Affected limbs may appear large and out of proportion to the upper body, heavy, and painful. The fat is resistant to diet and exercise, and bruising is common. Onset is around puberty, pregnancy, or menopause, and frequently runs in families.

Left undiagnosed, lipoedema can lead to a range of complications:

  • gait or joint problems and reduced mobility
  • obesity or secondary lymphoedema
  • anxiety, depression, and loss of confidence
  • earlier-than-expected exit from the workforce
  • challenges in family life and personal relationships.

The physical impact is significant but so too is the emotional toll of living with a condition that's misunderstood or dismissed.

There is no single diagnostic test for lipoedema, but a greater awareness and a holistic approach can make a huge difference. Look out for:

  • disproportionate body shape – larger lower body vs. slimmer waist and upper body
  • pain, heaviness or tenderness in legs or arms and fatigue
  • easy bruising and soft, doughy fat tissue
  • no foot or hand swelling (unlike lymphoedema)
  • a history of weight gain around hormonal events (puberty, pregnancy, menopause)
  • multiple dress sizes difference between top and bottom halves
  • a pad of fat medially on knees and no foot swelling and ‘cuffing’ at the ankles or sometimes wrists
  • uneven appearance to subcutaneous tissues – especially over the thighs or hips and sometime small nodules can be felt on palpation.

Whether in primary care, community nursing, school health, weight management, or midwifery, you may be the first professional to recognise lipoedema.

Recognise and refer

Early recognition is key. If you suspect lipoedema, refer patients to their GP or local Lymphoedema, vascular, or dermatology services     (Referral pathways vary – some services still do not accept lipoedema patients, so advocacy is often needed.)

Educate and empower

Help patients understand: “This is a medical condition, not a lifestyle failure.”

Point them toward trusted resources like Lipoedema UK, and consider referral to psychological support if needed.

Compression and therapy

  • Flat-knit, made-to-measure compression garments can help relieve symptoms. For some with milder symptoms - lighter supportive or support wear may be helpful.
  • Adjunct therapies like Manual Lymphatic Drainage, Deep Oscillation Therapy, Intermittent Pneumatic Compression Therapy.
  • Exercise, such as swimming, walking, strength training and light weights or even gentle movement can be helpful.
  • The abnormal buildup of adipose tissue is not that respondent to normal weight management programmes and BMI can be misleading – however weight management is relevant and avoiding further weight gain is important. Although more research is needed there is some evidence that avoiding processed foods and anti-inflammatory diets can be helpful with symptoms.  In some instances a referral to weight management may be helpful.

These methods manage symptoms, but do not reduce fat volume.

Much of the evidence on specialist Liposuction has come from Germany and Liposuction is the only treatment shown to reduce lipoedema fat, symptoms and improve quality of life for those living with the condition. While NICE currently restricts this to research-only settings, a large randomised controlled trial in Germany (due late 2026-27) may shift this guidance in future.

I recently met a young patient in her 20s with mild lipoedema with concerns that her legs would worsen and “turn into my mothers”. She went on to have specialist liposuction in Germany and was delighted with the outcome and improved symptoms. Many may think that extreme in such a mild case, however, I met her mother a few months later who had not been diagnosed and explained her symptoms had worsened over the years and she was now struggling with pain, mobility issues and to keep on working.

The psychological impact

Many women suffer in silence for years, feeling embarrassed, frustrated, or broken. The stigma of being told to “try harder” or “just lose weight” is frustrating. Being seen, heard, and believed  can be transformative and offer a much needed lift, both emotionally and psychologically.

Advocacy and education: A call to action

Despite the growing recognition of women’s health issues, lipoedema is still a “Cinderella” condition—underserved, under-researched, and underfunded.

At Lipoedema UK, we see firsthand how many nurses discover the condition not only in their patients but in themselves, colleagues or their loved ones. We need:

  • greater inclusion of lipoedema in nursing and midwifery education
  • improved referral pathways and equitable access to care
  • acknowledgement of lipoedema as a key issue in the Women’s Health Strategy.

Key resources

  • . Support, education, and advocacy
  • . Free online CPD

If we want to improve health outcomes for women, we must stop ignoring lipoedema. Nurses and midwives are perfectly placed to lead this change through earlier identification, compassionate care, and confident referral.

Let’s bring lipoedema into the light.

Author: Mary Warrilow is Director of Strategic Partnerships at Lipoedema UK and a member of the RCN Women’s Health Forum. She is also an Independent Clinical Nurse Specialist and Queens Nurse. She works closely with healthcare professionals to improve diagnosis, care pathways, and education around lipoedema.

Mary Warruiow

Mary Warrilow

RCN Women's Health Forum member

Queens Nurse, Independent Clinical Nurse Specialist. Director of Strategic Partnerships at Lipoedema UK

Mary is a Queens Nurse and Independent Clinical Nurse Specialist. She is also Director of Strategic Partnerships at Lipoedema UK and a member of the RCN Women’s Health Forum. She works closely with healthcare professionals to improve diagnosis, care pathways, and education around lipoedema.

Page last updated - 03/07/2025