SAT-685 Low-dose Tirzepatide For The Treatment Of Patient With Lipedema: A Case Report

Abstract Disclosure: J. Bicca: None. I. Murta: None. Background: Lipedema is a chronic adipose tissue disorder characterized by abnormal, often painful, fat accumulation, primarily in the lower limbs. Epidemiological data estimate its prevalence to range from 11–40% in the general population, with hormonal fluctuations identified as a potential trigger. A high rate of underdiagnosis has been reported. Histologically, lipedema tissue exhibits low metabolic activity and is characterized by inflammation and fibrosis. This chronic local inflammation may have systemic repercussions, including resistance to weight loss. Tirzepatide is a glucose-dependent insulinotropic polypeptide and a dual agonist of the GLP-1 and GIP receptors. It is known for its effects on weight loss and metabolic regulation, including its ability to reduce low-grade systemic inflammation and cardiovascular events. In this context, tirzepatide has shown promising clinical benefits in the management of the inflammatory component of lipedema. Clinical Case: We present the case of a 34-year-old woman diagnosed with type 2, stage III lipedema, BMI 30, with a positive paternal family history. Since puberty, she reported pain and heaviness in the legs, along with an “orange peel” skin texture, negatively impacting her quality of life and sexual well-being. Despite nutritional counseling and regular physical activity, she experienced no significant weight loss and noted frequent weight fluctuations. Laboratory tests were within normal limits. She had previously undergone treatment with semaglutide once weekly with no clinical success. Treatment was initiated with Tirzepatide at 5 mg weekly and escalated to the maximum dose. She experienced a total weight loss of 17 kg over 7 months. The medication was then gradually discontinued. The patient maintained a healthy diet and exercise regimen and continued to lose weight even after discontinuation. However, five months later, she reported worsening of the skin appearance and recurrence of pain. A decision was made to reintroduce tirzepatide at a low dose (1.5 mg weekly) to target inflammation and relieve pain despite having a normal BMI and stable weight. After 30 days of low-dose treatment, she reported complete remission of pain and improved skin texture. Conclusion: The inflammatory component in lipedema plays a significant role in the chronic pain and heaviness that compromise the quality of life and self-esteem of affected patients. Tirzepatide has demonstrated the ability to reduce low-grade systemic inflammation, as seen in its cardiovascular benefits. Clinically, it also appears to reduce the inflammatory burden in lipedema. Further clinical trials are necessary to validate and clarify this relationship. Presentation: Saturday, July 12, 2025