Do you agree that lipedema almost exclusively occurs in women?
Yes
No
Please rate your answer on lipedema ocurring almost exclusively in women above.
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Should stages of lipedema be referred to by numerals (Stage 1, 2, 3 etc.), their descriptions below, or both?
Stage 1: Normal skin surface, enlarged hypodermis, small tissue masses
Stage 2: Indented skin surface, larger tissue masses
Stage 3: Large deforming extrusions of skin and tissue with very large masses
* must provide value
Numbers only
Descriptions only
Numbers and descriptions
In your experience, should lipedema WITH lymphedema be described as Stage 4 or lipolymphedema.
For example, a woman may have Stage 2 could develop lymphedema then have Stage 2 with lipolymphedema, or Stage 2 and Stage 4.
* must provide value
Lipolymphedema
Stage 4
In your experience, which stage of lipedema can develop lipolymphedema?
Choose all apply.
* must provide value
Please rate your answer on lipolymphedema above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Most women with lipedema that you see in practice have which stage of lipedema:
* must provide value
1
2
3
The stages of lipedema are progressive.
Stage 1 progresses to 2.
* must provide value
Yes
No
The stages of lipedema are progressive.
Stage 2 progresses to 3.
Yes
No
Please rate your answer about progression above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Is lipedema tissue ALWAYS painful to the touch?
[Please recognize that in Europe, a disorder called lipohypertrophy looks like lipedema, and the tissue feels nodular, but it is not painful and therefore not considered lipedema (e.g. Journal of Lymphoedema, 2017, Vol 12, No 1).]
* must provide value
Yes
No
Paper that describes lipohypertrophy
Lipedema tissue can be non-painful and painful in the same person
* must provide value
Yes
No
A person can have no pain and still have lipedema.
* must provide value
Yes
No
Please rate your answer about pain above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Should the description of lipedema include a reference to pain, for example, +pain or -pain?
* must provide value
Yes
No
Please rate your answer about pain above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Should the pinch test be included in the diagnostic criteria for lipedema?
"A (careful!) pinch test in an area with lipedema causes pain, but not one done on the abdomen or back."
[not the same as the pinch test for cellulite]
All About Lipedema Offprint
https://www.humanmed.com/documents/human_med_offprint_Lipedema_english_may2015.pdf
Yes No
Please rate your answer about pinching above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
If there is pain with lipedema, is the pain a burning nerve-type pain?
* must provide value
Yes
No
What causes lipdema pain?
Choose all that apply.
* must provide value
Please rate your answer to the cause of lipedema pain above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
If there is pain with lipedema, when does the pain occur?
Check all that apply.
* must provide value
Please rate your answer for when lipedema pain occurs.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Are you aware of a condition called lipohypertrophy?
* must provide value
Yes
No
Is one difference between lipohypertrophy and lipedema the presence of pain in lipedema?
* must provide value
Yes
No
Is one difference between lipohypertrophy and lipedema the presence of edema in lipedema?
* must provide value
Yes
No
Rate your answers for lipohypertrophy as above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Lipedema tissue always has edema whether pitting or non-pitting.
* must provide value
Yes
No
Please rate your answer about edema above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Should a negative Stemmer sign be part of the diagnostic criteria for lipedema?
Negative is no edema, positive is presence of edema.
* must provide value
Yes
No
Please rate your answer for the Stemmer sign criteria for lipedema above.
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
There are different types of lipedema.
Type I: Pelvis, buttocks and hips (saddle bag phenomenon)
Type II: Buttocks to knees
Type III: Buttocks to ankles
Type IV: Arms
Type V: Lower leg
Should these types be revised to a more descriptive terminology?
* must provide value
Roman numerals
Descriptive
Roman numerals and descriptive
Better descriptions
Should an ultrasound showing increased subcutaneous fat thickness be included as part of the diagnosis criteria of lipedema, including in women with Type I and II?
Increased fat thickness >12mm at 6-8 cm above the malleolus
Reich-Schupke, S., Altmeyer, P., & Stucker, M. (2013). Thick legs - not always lipedema. J Dtsch Dermatol Ges., 11(3), 225-233
* must provide value
Yes
No
Please rate the ultrasound diagnostic criteria of lipedema above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Should identification of frozen pea-sized nodules in lipedema fat described as "styrofoam balls in a bag" or "beans in a bag" be included as diagnostic criteria for lipedema?
Fife, C. E., Maus, E. A., & Carter, M. J. (2010). Lipedema: a frequently misdiagnosed and misunderstood fatty deposition syndrome. Adv, 23(2), 81-92
* must provide value
Yes
No
Fife article with description frozen pea size nodules in lipedema far
Please rate your answer about the small nodules in lipedema tissue above as part of lipedema criteria above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
On palpating the fat, what do you find in people with lipedema?
Choose all that apply.
* must provide value
Knowing that in obese women with lipedema, approximately 30% can have affected hands and feet (fat on hands and feet):
http://www.archivesofmedicine.com/medicine/lipedema-fat-and-signs-and-symptoms-of-illness-increase-with-advancing-stage.php?aid=6744
Should hands and feet unaffected be part of the diagnostic criteria?
Yes
No
Paper showing hands and feet can be affected in lipedema
Please rate your answer on affected hands and feet above.
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Should easy bruising be part of the diagnostic criteria for lipedema or should vascular fragility be used instead?
Vascular fragility includes easy bruising, capillary fragility, venous dilation, petechiae and cherry angiomas.
Szolnoky et al. Complex decongestive physiotherapy decreases capillary fragility in lipedema. Lymphology 41 (2008) 161-166
* must provide value
Easy bruising
Vascular fragility
Neither
Both
Article on capillary fragility in lipedema.
Please rate your answer to easy bruising or vascular fragility as above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Should a disproportion between the upper and lower body be included as part of the diagnostic criteria for lipedema?
* must provide value
Yes
No
Please rate your answer for disproportion as part of the diagnostic criteria for lipedema above.
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Should a symmetrical involvement of the body in terms of lipedema tissue distribution be included as part of the diagnostic criteria for lipedema?
* must provide value
Yes
No
Please rate the symmetric aspect of lipedema as part of the diagnostic criteria for lipedema above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Should persistent enlargement of the legs after elevation be part of the diagnostic criteria for lipedema?
* must provide value
Yes
No
Rate your answer for lipedema persisting after elevation of the legs.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Do you think lipedema tissue can be found on the scalp of women with lipedema?
Scheufler O, et al. Hyperplasia of the subcutaneous adipose tissue is the primary histopathologic abnormality in lipedematous scalp. Am J Dermatopathol. 2003 Jun;25(3):248-52.
* must provide value
Yes
No
Paper on lipedematous scalp
Please rate your answer on lipedema tissue on the scalp.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
In order to be more descriptive about lipedema, should a percentage value be ascribed to the amount (surface area) of subcutaneous fat tissue affected by lipedema? For example, if all subcutaneous tissue is affected except the head, the person affected by lipedema would be described as having 90% of all subcutaneous fat tissue affected.
* must provide value
Yes
No
Should a loss of tissue elasticity (for example "angel wings" on the upper arm or increased pocket of fat on the upper, inner medial thigh) be included as part of the descriptive diagnostic criteria for lipedema?
* must provide value
Yes
No
Should a positive family history of lipedema be diagnostic criteria for lipedema. In other words, if lipedema is not in the family, then a diagnosis of lipedema is not likely.
* must provide value
Yes
No
Should a family history of lipedema be sought when diagnosing the condition initially.
* must provide value
Yes
No
Please rate your answer on heredity above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Can a surgical procedure instigate the development of lipedema assuming a person has a propensity (genetics) to develop lipedema?
* must provide value
Yes
No
Please rate your answer on on the surgical history above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Are hypermobile joints important in the assessment of lipedema?
* must provide value
Yes
No
Please rate your answer on hypermobility above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Do you think the pathophysiology of hypermobility can worsen the stage of lipedema?
* must provide value
Yes
No
Please rate your answer on hypermobility and stage above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Can pregnancy be an important contributor to the development of lipedema?
* must provide value
Yes
No
Please rate your answer on pregnancy above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Is puberty an important contributor to the development of lipedema?
* must provide value
Yes
No
Please rate your answer on puberty above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Can menopause contribute to the development of lipedema?
* must provide value
Yes
No
Please rate your answer on menopause above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Is venous disease a part of lipedema?
* must provide value
Yes
No
Please rate venous disease as part of lipedema above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Should hypothermia of the skin be part of the diagnostic criteria for lipedema.
* must provide value
Yes
No
Please rate your answer on hypothermia above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Should all people with lipedema be offered Complete Decongestive Therapy (CDT; evaluation, manual lymphatic drainage, bandaging, exercise, skin care, education) on diagnosis?
* must provide value
No
Yes
Yes only if edema is present
Please rate your answer on CDT above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
If people with lipedema should be offered CDT on diagnosis, in the initial phase of treatment, how many times a week do they need treatment?
1
2
3
4
5
6
7
If people with lipedema should be offered CDT on diagnosis, how long do they usually need treatment in months on average?
1
2
3
4
5
6
Other
Which of the following stages of lipedema require bandaging?
* must provide value
Approximately what percentage of people with lipedema improve with CDT?
* must provide value
10
20
30
40
50
60
70
80
90
100
What kind of physical therapy other than CDT should be offered to women with lipedema?
* must provide value
What kind of compression is commonly used for lipedema in the absence of lymphedema?
Choose all that apply.
Please note that mm Hg can differ by Class depending on the source - a standard set of values is included below.
* must provide value
What areas of the body of women with lipedema are usually compressed with garments?
Choose all garments for those area of lipedema tissue that are compressed.
Choose all that apply.
* must provide value
When should compression be worn?
Choose all that apply.
* must provide value
Does Endermologie (Roller combined with sequential suction) play a role in the care of people with lipedema?
* must provide value
Yes
No
Does the Lymphstar Pro play a role in the care of people with lipedema?
The Lymphstart Pro uses: 1) physical vibration with low frequency sound waves, 2) an electrostatic energy field, and 3) dynamic wave pulses that create harmonics and additional pressure waves.
* must provide value
Yes
No
Does Far Infrared Sauna play a role in the care of people with lipedema?
* must provide value
Yes
No
Does the HIVA Mat play a role in the care of people with lipedema?
* must provide value
Yes
No
Does shock wave therapy play a role in the care of women with lipedema
Siems et al. Anti-fibrosclerotic effects of shock wave therapy in lipedema and cellulite. Biofactors. 2005;24(1-4):275-82
* must provide value
Yes
No
Paper on shock wave therapy.
Please rate your answer for shock wave therapy for lipedema.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Does deep tissue therapy play a role in the treatment of people with lipedema?
Subcutaneous adipose tissue therapy reduces fat by dual X-ray absorptiometry scan and improves tissue structure by ultrasound in women with lipoedema and Dercum disease. Ibarra M et al. Clin Obes. 2018 Sep 24.
Pilot study: whole body manual subcutaneous adipose tissue (SAT) therapy improved pain and SAT structure in women with lipedema. Herbst KL, Ussery C, Eekema A. Horm Mol Biol Clin Investig. 2017 Sep 20;33(2).
Yes
No
Paper #1 on deep adipose tissue therapy for lipedema.
Paper #2 deep adipose tissue therapy for lipedema.
Please rate your answer to deep tissue therapy for lipedema above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Should pneumatic sequential compression pumps be used for treatment of lipedema?
* must provide value
Yes
No
Only if lymphedema is present
Please rate your answer on pumps above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
What are exercise recommendations for people with lipedema?
Check all that apply.
* must provide value
What are dietary recommendations for people with lipedema?
Check all that apply:
* must provide value
Should selenium supplementation be recommended for women with lipedema and lipolymphedema?
Bruns F, et al. Selenium in the treatment of head and neck lymphedema. Med Princ Pract. 2004 Jul-Aug;13(4):185-90.
Micke O et al. Selenium in the treatment of radiation-associated secondary lymphedema. Int J Radiat Oncol Biol Phys. 2003 May 1;56(1):40-9
Nourollahi, S.; Mondry, T.E.; Herbst, K.L. Bucher's broom and selenium improve lipedema: A retrospective case study Alternative and Integrative Medicine 2013, 2, 1-7
* must provide value
Yes
No
Paper #3 selenium lipedema case study
Please rate your answer on selenium above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Should vitamin D be tested for and recommended as supplementation if low for people with lipedema?
* must provide value
Yes
No
Please rate your answer on vitamin D use in lipedema above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Should amphetamine (dextroamphetamine, Adderall, phentermine or other) be offered to people with lipedema to reduce fat and improve lymphatic pumping?
De Micheli Glasser, A.H. The effects of catecholamines and adrenoceptor blocking drugs on the canine peripheral lymph flow. Br J Pharmacol. 1975 Apr;53(4):499-504.
Sjoberg, T.; Alm, P.; Andersson, K.E.; Norgren, L.; Steen, S. Contractile response in isolated human groin lymphatics. Lymphology. 1987, 20, 152-160.
McHale, N.G.; Allen, J.M.; Iggulden, H.L. Mechanism of alpha-adrenergic excitation in bovine lymphatic smooth muscle. Am J Physiol. 1987, 252, H873-878.
McHale, N.G.; Thornbury, K.D. The effect of anesthetics on lymphatic contractility. Microvasc Res. 1989, 37, 70-76.
* must provide value
Yes
No
Please rate your answer on amphetamine use in lipedema above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Should diuretics be avoided in women with lipedema?
* must provide value
Yes
No
Please rate your answer on diuretic use in lipedema.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Should calcium channel blockers that cause vasodilation and edema be avoided in people with lipedema?
* must provide value
Yes
No
Please rate your answer on calcium channel blocker use in lipedema above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Should corticosteroids that cause edema be avoided in women with lipedema?
* must provide value
Yes
No
Rate your answer on corticosteroid use in lipedema above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
What lab tests should be ordered or followed for people with lipedema?
Choose all that apply.
* must provide value
Is anxiety common in lipedema?
* must provide value
Yes
No
Please rate your answer on anxiety above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Is depression common in women with lipedema?
* must provide value
Yes
No
Please rate your answer on depression in lipedema above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Are eating disorders common in women with lipedema?
* must provide value
Yes
No
Please rate your answer on eating disorders in lipedema.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Is lymph sparing liposuction surgery part of the initial management recommendations for lipedema?
* must provide value
Yes
No
Please rate your answer on liposuction for lipedema.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Do hormones (birth control, hormone replacement therapy) exacerbate lipedema?
* must provide value
Yes
No
Please rate your answer on hormones for lipedema.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
What percentage of the time are the arms affected in a person with lipedema?
* must provide value
0 10 20 30 40 50 60 70 80 90 100
What imaging tests or other testing modalities are useful for diagnosing lipedema?
Check all that apply.
* must provide value
Which lymph sparing liposuction is effective for safe reduction of lipedema fat?
Check all that apply:
At what stage or lipedema can a person undergo lymph sparing liposuction?
Choose all that apply.
What are the recommendations for anesthesia during lymph sparing liposuction for lipedema?
Check all that apply
What are the common risks for people who have lymph sparing liposuction for lipedema?
Choose all that apply.
Rate your opinion on risks for lipedema above.
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Is it a requirement for people who had successful liposuction to wear compression garments for the rest of their lives?
* must provide value
Yes
No
Rate your opinion on compression after liposuction for lipedema above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Is there an age cutoff for liposuction for lipedema?
* must provide value
Yes
No
I don't know
What is the age cutoff for liposuction for lipedema?
Are there any solid contraindications for liposuction for lipedema? PLEASE COMMENT.
What sort of DVT prophylaxis is necessary for lipedema liposuction? PLEASE COMMENT.
What is the ratio of tumescent fluid to lipoaspirate? PLEASE COMMENT.
Is there a maximum operative time to stay under for liposuction for lipedema? PLEASE COMMENT.
What should tumescent solution contain? PLEASE COMMENT.
Where should liposuction for lipedema procedures be performed? PLEASE COMMENT.
Is there a max volume of lipoaspirate for inpatient liposuction? PLEASE COMMENT.
Is there a max volume of lipoaspirate for outpatient liposuction? PLEASE COMMENT.
Should drains be used after liposuction for lipedema?
Yes
No
Should port sites be closed after liposuction for lipedema?
Yes
No
Do you recommend nutritional followup in the postoperative period after liposuction?
* must provide value
Yes
No
Do you recommend MLD after liposuction?
* must provide value
Yes
No
How do you manage recurrent lipedema after liposuction surgery? PLEASE COMMENT.
What are recommendations for brachioplasty for people with lipedema?
A - Strongly recommends. Good evidence.
B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies.
C - Recommends. The recommendation is based on expert opinion.
D - Recommends against. The recommendation is based on expert opinion.
E - Recommends against. Based on fair evidence.
F - Strongly recommends against. Based on good evidence.
I - Recommends neither for nor against.
NA - Not applicable (please use sparingly)
What are the recommendations for thigh lift for people with lipedema?
A - Strongly recommends. Good evidence.
B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies.
C - Recommends. The recommendation is based on expert opinion.
D - Recommends against. The recommendation is based on expert opinion.
E - Recommends against. Based on fair evidence.
F - Strongly recommends against. Based on good evidence.
I - Recommends neither for nor against.
NA - Not applicable (please use sparingly)
What are the recommendations for panniculectomy for people with lipedema?
A - Strongly recommends. Good evidence.
B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies.
C - Recommends. The recommendation is based on expert opinion.
D - Recommends against. The recommendation is based on expert opinion.
E - Recommends against. Based on fair evidence.
F - Strongly recommends against. Based on good evidence.
I - Recommends neither for nor against.
NA - Not applicable (please use sparingly)
What are the recommendations for abdominoplasty for people with lipedema?
A - Strongly recommends. Good evidence.
B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies.
C - Recommends. The recommendation is based on expert opinion.
D - Recommends against. The recommendation is based on expert opinion.
E - Recommends against. Based on fair evidence.
F - Strongly recommends against. Based on good evidence.
I - Recommends neither for nor against.
NA - Not applicable (please use sparingly)
What are the recommendations for management of significant venous insufficiency in lipedema?
* must provide value
Treat conservatively (elevation, compression, exercise)
Ablate with radiofrequency, laser or sclerotherapy
No recommendations
Please rate your answer on venous insufficiency above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Do you think bariatric/metabolic or weight loss surgery is recommended for patients with lipedema that have obesity fat in addition to lipedema fat that is causing metabolic complications?
* must provide value
Yes
No
Please rate your answer on bariatric surgery above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
How often should people with lipedema undergo complete decongestive therapy long term?
Choose all that apply.
* must provide value
Should women with lipedema wear daily compression garments long-term?
* must provide value
Yes
No
Please rate your answer on long term CDT above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
What type of garments are used for lipedema?
Check all that apply:
* must provide value
Please rate your answer on long term compression above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Is lymphedema a long term complication of lipedema?
* must provide value
Yes
No
Please rate your answer on lymphedema above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Is loss of mobility a long term complication of lipedema?
* must provide value
Yes
No
Please rate your answer on mobility above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Is venous disease a long term complication of lipedema?
* must provide value
Yes
No
Please rate your answer on venous disease above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Is obesity a long term complication of lipedema?
* must provide value
Yes
No
Please rate your answer on obesity above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Is joint arthritis requiring joint replacement such as total knee replacement (TKR) a long term complication of lipedema?
* must provide value
Yes
No
Please rate your answer on joint arthritis and TKR above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Is metabolic syndrome a long term complication of lipedema?
Torre YS. Lipedema: friend and foe. Horm Mol Biol Clin Investig. 2018 Mar 9;33(1)
* must provide value
Yes
No
Paper with information on metabolic syndrome risk with increasing stage of lipedema
Please rate your answer on metabolic syndrome above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Is Cardiovascular disease a long term complication of lipedema?
Szolnoky G et al. Lymphology. Lipedema is associated with increased aortic stiffness. 2012 Jun;45(2):71-9
* must provide value
Yes
No
Paper on aortic stiffness in women with lipedema
Is Cellulitis (serious skin infection) a long term complication of lipedema?
* must provide value
Yes
No
Please rate your answer on cellulitis above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Is shortness of breath a long term complication of lipedema?
* must provide value
Yes
No
Please rate your answer on shortness of breath above.
* must provide value
A - Strongly recommends. Good evidence. B - Recommends. Fair evidence. Strength of evidence limited by number, quality, or consistency of studies. C - Recommends. The recommendation is based on expert opinion. D - Recommends against. The recommendation is based on expert opinion. E - Recommends against. Based on fair evidence. F - Strongly recommends against. Based on good evidence. I - Recommends neither for nor against. NA - Not applicable (please use sparingly)
Please suggest needed areas of research for lipedema.
Please provide your name and title.
* must provide value
What is your position?
* must provide value
Please describe your experience with people with lipedema that gives you expertise in this area.
* must provide value
What is your Institution or practice? Include address, city and state.
* must provide value
What is the setting of your position?
* must provide value
Outpatient clinical
Inpatient clinical
Academic teaching
Author
Research
Other
You chose other, Please explain your position setting.
What is your email address?
* must provide value
How many years experience with lipedema do you have?
* must provide value
How many patients a week do you see with lipedema?
* must provide value
Thank you for the time you took to complete this questionnaire.
If you have questions or comments please email karenherbst@email.arizona.edu
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