Lipedema vs. Cellulite: Here’s How You Can Differentiate Them

Two completely different conditions look the same at first glance. One is harmless and just skin-deep, but one is a silent disease progressing. Despite affecting 11% of women worldwide, lipedema is frequently overlooked or misdiagnosed as harmless cellulite, delaying much-needed medical attention. Lipedema vs. cellulite: which is it? This article unpacks the differences between lipedema and cellulite, helping you understand what your body might be trying to tell you.

Lipedema vs. Cellulite: Key Differences

Cellulite and lipedema are often discussed together due to their impact on appearance, but they are distinct conditions with unique causes and symptoms:

Feature	Lipedema	Cellulite
Definition	A medical concern where fat builds up in certain areas and affects tissues	A cosmetic condition where fat collects under the skin
Appearance	Swollen, uneven, dimpled, or bumpy skin	Dimpled, bumpy, or uneven skin without swelling
Causes	Unclear, may involve hormones or genetics	Involves weight, diet, hormones, genetics, or pregnancy
Symptoms	Pain, swelling, bruising, and limited flexibility in affected areas	Usually harmless and does not cause physical discomfort
Treatment	Decongestive therapy, compression, a healthy lifestyle, or liposuction	Creams, laser treatments, radiofrequency, and lifestyle changes

Lipedema: Symptoms And Treatment

Lipedema often goes unnoticed early on, but knowing its signs can help you get the proper care.

It typically affects the lower half of the body, with symptoms that go beyond ordinary weight gain.

Common symptoms of lipedema include:

Disproportionate body shape: A clear size difference between the upper and lower body, with feet usually unaffected.
Chronic pain or tenderness: Legs may hurt constantly or when touched.
Swelling and heaviness: A persistent heavy feeling in the legs, often worsening by day's end.
Fat buildup: Fat accumulation in the hips, thighs, and legs, and eventually in the arms.
Loose or baggy skin: Skin folds may develop due to the expanding fat tissue.
Bumps under the skin: The fat may feel irregular, with small, firm lumps noticeable beneath the surface.
Frequent fatigue: Feeling tired often, even when you haven't done much.

Though lipedema fat doesn't typically respond to standard weight loss methods, several treatments can help manage symptoms and make daily activities easier.

Treatment options include:

Exercise and diet: Low-impact exercises and a healthy, anti-inflammatory diet can help with movement and swelling.
Compression therapy: Wearing tight garments or using air-filled leg sleeves can reduce swelling and pain.
Manual lymphatic drainage (MLD): A gentle massage that helps drain lymph fluid from swollen parts, relieving pressure and pain.
Liposuction: Procedures like tumescent or water-assisted liposuction remove diseased fat and relieve pressure, though multiple sessions might be needed.
Medications and supplements: Selenium, metformin, or resveratrol may help with inflammation, swelling, or fat metabolism.
Complete decongestive therapy (CDT): Combines MLD, compression, targeted exercises, and skincare for a comprehensive symptom management plan.
Bariatric surgery: While not a direct solution for lipedema fat, it may help reduce leg size in some cases.

Since lipedema is different from regular obesity, it requires a personalized treatment plan.

Consider talking to a healthcare provider to find the best approach for you.

What Is The Pinch Test For Lipedema?

The pinch test is a quick and simple method often used to spot early signs of lipedema.

It involves gently pinching the skin and deeper tissue in areas where lipedema usually appears, such as the thighs or lower legs.

Focus on how the tissue feels between your fingers and whether there’s any pain.

Regions affected by lipedema may feel tender and have a different texture compared to other body parts.

You could feel lumps beneath your skin, like small beans, which could point to fibrotic tissue.

For a confirmed diagnosis, consult a specialist for a complete evaluation.

Will Insurance Cover Liposuction For Lipedema?

It’s often hard to get insurance approval for a liposuction procedure to treat lipedema.

Most insurance companies view it as cosmetic unless it’s medically urgent.

You may need to prove that:

Your lipedema is causing serious issues (chronic pain, limited movement, frequent infections)
Non-surgical treatments (compression, diet changes, physical therapy) haven’t helped
The surgery is medical, not appearance-related

Insurance providers often require medical records to corroborate this, including:

A confirmed diagnosis by your doctor
Imaging tests or physical exam results
Doctor’s notes showing that other treatments did not work
A letter explaining why surgery is medically necessary

Some plans may also include extra conditions, such as requiring:

A stable weight over a certain period
A Body Mass Index (BMI) below a set limit
A board-certified surgeon experienced in lipedema surgery
Use of specific techniques like tumescent or water-assisted liposuction

Despite providing every requested document, the final decision is at the insurance company’s discretion.

Knowing your policy well and working closely with your doctor can help increase your chances of approval.

Cellulite: Symptoms And Treatment

Cellulite appears in different forms and levels, depending on its severity.

Common signs of cellulite include:

Dimpled or bumpy skin
Uneven skin texture
Orange peel or cottage cheese-like appearance

The severity of cellulite is classified into four grades:

Grade 0: Skin looks smooth with no signs of cellulite.
Grade 1: Skin is smooth when standing, but mild dimples appear while sitting.
Grade 2: Dimples are clearly visible whether you're sitting or standing.
Grade 3: Deep dimples and uneven skin always appear, regardless of position.

Cellulite can't be entirely removed, but its appearance can be reduced.

Mixing healthy lifestyle habits, medical treatments, and traditional methods can help improve skin appearance.

1. Lifestyle changes:

Exercise: Running, cycling, or strength training helps tighten muscles and improve blood flow, which can make cellulite less noticeable.
Healthy diet: Eating fewer processed foods and preservatives and choosing low-calorie, balanced meals can help prevent cellulite from worsening.

2. Medical treatments:

Approved procedures: Treatments like Cellfina®, Cellulaze®, and Qwo® focus on reducing dimples and improving skin smoothness.
Short-term options: Deep massages, acoustic wave therapy, laser treatments, and creams with caffeine or retinol can temporarily improve the appearance of the skin.
Longer-lasting options: Subcision, vacuum-assisted release, and radiofrequency treatments go deeper to address the causes of cellulite.

3. Traditional methods:

Herbal remedies: Ginkgo biloba and grape seed extract may help improve blood flow, reducing the look of cellulite.
Cupping therapy: A suction-based method from Chinese medicine that may offer temporary improvement.
Dry brushing: Brushing the skin with a stiff brush can boost circulation and temporarily make the skin look smoother.

Important Note: Everyone’s skin is different. To find out what would work best for you, consult a professional.

How Do I Know If I Have Lipedema Or Cellulite?

It’s hard to discern lipedema from cellulite at first glance, but there are a few key things to pay attention to.

If the area feels tender, bruises easily, or swells in the lower body, it might be lipedema.

Cellulite, on the other hand, neither hurts nor causes swelling.

It affects the skin’s appearance, not its feel.

FAQs: Lipedema vs. Cellulite

What Can Be Mistaken For Lipedema?

Lipedema is often mistaken for obesity or lymphoedema because of overlapping signs like swelling and fat buildup.

Both conditions share some visual similarities but differ in origin and progression.

Obesity causes fat to build up all over the body, but lipedema leads to painful fat buildup mainly in the legs and arms, and it doesn’t improve with diet or exercise.

Lymphoedema, meanwhile, is caused by fluid buildup due to lymphatic dysfunction, which can lead to swelling but lacks the symmetrical fat pattern seen in lipedema.

In some advanced cases, lipedema can progress to affect the lymphatic system or blood vessels, making diagnosis more difficult.

Visually Speaking, What's The Difference Between Lipedema And Cellulite?

Although lipedema and cellulite may seem similar at first glance, their appearance, texture, and patterns on the body are quite different.

Cellulite: Small dimples or bumps on the skin, with a texture similar to orange peel or cottage cheese. It can be found on the thighs, buttocks, and sometimes the abdomen.
Lipedema: A symmetrical buildup of fat in both legs and sometimes the arms. The feet and hands remain unaffected, creating a sharp transition where the fat ends. Like bubble wrap, the skin may look smooth or slightly bumpy, and the affected areas may bruise or mark easily.

Is It Lipedema Or Normal Fat In My Legs?

If your legs feel unusually heavy, painful, or tender and look much larger than your upper body, it could be lipedema.

Lipedema fat also tends to feel lumpy under the skin.

Normal fat doesn’t usually cause pain or create a clear difference between body areas.

Summary: Lipedema vs. Cellulite

Lipedema is a medical condition that causes painful fat buildup in the legs and sometimes the arms.
Cellulite is a harmless condition that makes the skin look bumpy or dimpled, mainly on the thighs and buttocks.
Lipedema fat feels heavy and tender and doesn’t go away with diet or exercise.
Cellulite is only a surface-level skin change and doesn’t cause pain or swelling.
Treatments for lipedema include compression, lymphatic massage, liposuction, and healthy habits.
Cellulite treatments include creams, massage, and laser therapy, but the results are primarily cosmetic.
Insurance might cover liposuction for lipedema if it’s medically necessary and other treatments fail.