Lipedema vs. Lymphedema: What's the Difference?

Medically reviewed by Mohammad Khalilullah, MD, DABVLM, on August 28, 2025

If you’ve noticed your legs feel heavy, swollen, or have a buildup of fat that won’t go away with diet or exercise, you may be dealing with more than poor circulation or weight gain. Two commonly misunderstood conditions, lipedema and lymphedema, can cause leg swelling and discomfort; however, it is essential to understand that they are distinct conditions.

Knowing how to tell them apart is important, especially when vein problems may also be part of the picture. At Center for Vein Restoration (CVR), we help patients every day who are struggling with leg discomfort and don’t know where to start. 

Getting the right diagnosis is the first step to feeling better. In this blog, Mohammad Khalilullah, MD, DABVLM, lead vein physician at CVR in Winchester, VA, discusses the differences between the two conditions, why they’re often confused for one another, and how each is diagnosed.

If you’re experiencing swelling or heaviness in your legs, schedule a consultation with CVR today. A complete vein evaluation could give you the clarity you need to understand the root cause of your symptoms and take the first step toward lasting relief and healthier legs. Call our Patient Services Representatives at 240-965-3915 or book through our ONLINE SCHEDULING PORTAL. 

📅 To schedule an appointment with Dr. Khalilullah in Winchester, VA, CLICK HERE.

📅To schedule an appointment at any of CVR’s 120+ vein clinics nationwide, CLICK HERE.

Understanding Lipedema: Why Weight Loss Isn’t the Solution

Lipedema is a condition where fat builds up abnormally, often in the lower body, and becomes painful or tender to the touch. According to the Cleveland Clinic, it occurs almost exclusively in women, often beginning during hormonal changes such as puberty, pregnancy, menopause, or when taking birth control pills.

What makes lipedema different from regular weight gain is that the fat tends to build up evenly on both legs, from the hips down to the ankles, but it usually stops at the feet. This makes the lower body look disproportionate, while the upper body may remain unaffected. People with lipedema may notice:

• Legs that feel heavy or sore
• Fat deposits that don’t improve with diet or exercise
• Easy bruising
• Swelling

Even though lipedema causes swelling, it is not caused by fluid buildup, but by abnormal fat tissue. This is a key distinction when comparing lipedema to lymphedema.

How Lymphedema Affects the Legs

Lymphedema happens when the lymphatic system, which normally helps drain fluid and waste from your body, doesn’t work properly. As a result, fluid collects in the tissues, usually in one leg or arm, causing visible swelling.

According to the Mayo Clinic, lymphedema can develop after surgery, cancer treatment, or an injury that damages the lymph nodes or vessels. Some people are also born with a poorly functioning lymphatic system, and symptoms can show up later in life.

Signs of lymphedema may include:

• Swelling in one leg (or arm), often including the foot and toes
• Skin that feels tight, thick, or spongy
• Reduced flexibility or heaviness in the limb
• Frequent infections or skin changes

Over time, lymphedema can worsen without treatment, and the skin may become firm and leathery due to ongoing inflammation. Unlike lipedema, the swelling in lymphedema is primarily fluid-based, not fat.

Why Lipedema and Lymphedema Are Often Confused

It’s easy to see why these two conditions get mixed up. Both can cause swollen legs and discomfort. And, of course, they have similar-sounding names. However, there are specific differences that specialists look for during an evaluation.

Lipedema:

• Typically affects both legs evenly
• Fat buildup stops at the ankles
• Feet remain normal
• Painful and tender fat deposits
• Often linked to hormone changes

Lymphedema:

• Usually affects one limb
• Swelling includes the feet and toes
• Skin may feel tight or thick
• Often develops after surgery or trauma
• Can lead to infections if untreated

Sometimes, patients have both conditions at once, and many also have underlying vein disease. This combination can make symptoms more intense, which is why a detailed diagnosis is essential.

How Can You Know If You Have Lipedema, Lymphedema, or a Vein Problem?

A proper diagnosis starts with a careful look at your medical history, symptoms, and how your legs respond to lifestyle changes such as compression, elevation, and exercise. At your visit, a vein specialist may also recommend an ultrasound to see how blood is flowing in your legs.

Here are some signs that should prompt a visit:

• Swelling that doesn’t go away overnight or with leg elevation
• One leg looking or feeling larger than the other
• Fat deposits that don’t change with weight loss
• Legs that bruise easily or feel tender to the touch
• Skin that feels tight, hard, or changes color
• A feeling of heaviness or pressure in your lower legs

If you’re noticing any of these symptoms, it’s important to be evaluated by a provider who understands both vein conditions and lymphatic disorders. Getting the right diagnosis leads to better treatment options.

At CVR, we use ultrasound imaging to check for hidden vein issues. Identifying and treating vein disease often helps reduce overall swelling and improves quality of life, especially when it’s combined with care for lipedema or lymphedema. Call our Patient Services Representatives at 240-965-3915 or click the button below to book your consultation and start your journey to better vein health.

How Are These Conditions Treated, and How Can Vein Care Help?

Treatment for lipedema and lymphedema depends on your specific diagnosis, but in many cases, symptoms improve with a multifaceted approach. Here’s how some common treatments fit into each condition:

Treatments for Lymphedema

• Complete Decongestive Therapy (CDT): Gentle massage, compression therapy, light exercise, and skin care are used together to control swelling.
• Pneumatic compression pumps: A sleeve worn that inflates and deflates to help push fluid toward healthy lymph pathways.
• Infection prevention: Lymphedema can make skin infections more likely. Care may include antibiotics during flare-ups and steps to protect the skin.

Treatments for Lipedema

• Liposuction: In some cases, surgery can remove the abnormal fat from lipedema without harming the lymph system.
• Healthy eating and lifestyle changes: While diet alone can’t remove lipedema fat, anti-inflammatory foods and staying active can help manage pain and swelling.
• Pain relief: This can include physical therapy, pool exercises, or other methods to help with the heaviness, tenderness, and easy bruising common in lipedema patients.

Treatments for Both Lipedema and Lymphedema

Remember, it’s possible to have lipedema and lymphedema at the same time, and the combination is common enough that there’s a name for it: lipo-lymphedema. These are the treatments that can ease swelling, boost circulation, and keep limbs healthier for those working to manage both conditions:

• Compression therapy: Medical-grade compression socks, sleeves, or tights that gently squeeze the limb to reduce swelling.

• Manual lymphatic drainage (MLD): Gentle massage by a trained therapist to move trapped fluid. It’s a main treatment for lymphedema and can also help in lipedema by reducing swelling and discomfort, though it won’t remove the abnormal fat.

• Exercise and movement: Low-impact activities such as walking, swimming, cycling, or yoga to keep fluid moving and joints flexible.

• Skin care: Washing and moisturizing daily and watching for signs of infection, including redness or warmth.

The underlying goal of treatment is to reduce discomfort, slow progression, and improve your daily function. Many patients find relief when vein disease is addressed at the same time as their other condition.

Let A CVR Vein Expert Give You Answers and Relief 

If your legs feel swollen, heavy, or uncomfortable, don’t assume it’s weight gain or aging. Conditions such as lipedema and lymphedema are more common than many people think, and vein disease may be playing a hidden role in your day-to-day symptoms.

You deserve answers and a treatment plan that works for your unique body. Schedule your consultation with CVR and let our specialists help you feel better, move more easily, and get back to enjoying life with clarity, confidence, and compassionate care every step of the way. Call our Patient Services Representatives at 240-965-3915 or click the button below to book a consultation at a vein clinic near you.