Lymphedema vs Lipedema: How to Tell the Difference

Lymphedema and lipedema are two different conditions that are often mistaken for each other. In short, lymphedema is swelling caused by a buildup of lymph fluid, while lipedema is an abnormal buildup of fat tissue, usually symmetrical in the legs and sometimes the arms. Some people have both. Getting the right diagnosis matters, because the two are managed differently.

What is lymphedema?

Lymphedema is long-term swelling that happens when lymph fluid cannot drain properly and collects in the tissues. It is often caused by damage to the lymphatic system, for example from cancer surgery or radiation. It commonly affects one limb and can include the hand or foot.

What is lipedema?

Lipedema is a condition in which fat tissue builds up abnormally, usually in the legs and hips, and sometimes the arms. It is almost always symmetrical, affecting both sides equally, and it tends to spare the feet, which can create a noticeable cuff at the ankle. Lipedema often runs in families and is frequently tender to the touch.

The key differences

• Cause: lymphedema is fluid; lipedema is fat tissue.
• Symmetry: lymphedema is often one-sided; lipedema is usually symmetrical.
• Feet: lymphedema can involve the foot; lipedema usually stops at the ankle.
• Pitting: early lymphedema often pits when pressed; lipedema usually does not.
• Tenderness and bruising: lipedema is often tender and bruises easily; lymphedema is usually not painful in the same way.

Can you have both?

Yes. Over time, lipedema can affect lymphatic drainage and lead to lymphedema as well. When the two occur together it is called lipo-lymphedema. This is one reason a professional assessment is so important.

How are they diagnosed?

Both are usually diagnosed through a physical exam and medical history with a clinician experienced in these conditions. They look at the pattern of swelling, whether it is symmetrical, whether the feet are involved, and how the tissue feels. Additional tests are sometimes used to confirm the diagnosis or rule out other causes.

Why the distinction matters

Because lymphedema and lipedema respond to different care, an accurate diagnosis leads to the right treatment plan. Compression can play a role in both, but the overall approach differs. If you are not sure which you have, ask for a referral to a lymphedema therapist or a clinician familiar with lipedema.

Frequently asked questions

Is lipedema just being overweight?

No. Lipedema is a distinct medical condition involving abnormal fat distribution, and it does not respond to diet the way ordinary weight gain does. It deserves proper assessment and care.

Does compression help lipedema?

Compression can be part of managing lipedema, especially to support the tissue and help with any accompanying swelling. Your clinician can advise on the right approach and compression level.

Can lipedema turn into lymphedema?

It can. Long-standing lipedema may affect lymphatic drainage over time, leading to lipo-lymphedema, where both conditions are present.

How do I know which one I have?

The most reliable way is an evaluation by a clinician experienced in lymphedema and lipedema. They will look at the pattern, symmetry, and feel of the tissue to tell them apart.

This article is for general education and is not medical advice. Please see a qualified clinician for diagnosis and a personalized plan. Trusted resources include the Lymphatic Education and Research Network (LE&RN) and the National Lymphedema Network.

Written by the LympheDIVAs team. We have made beautiful, medical-grade compression for people living with lymphedema since 2006.