MULTIDISCIPLINARY MANAGEMENT OF LIPEDEMA: EVIDENCE ON DIETARY, PHYSIOTHERAPEUTIC, PHARMACOLOGICAL, AND SURGICAL INTERVENTIONS

Lipedema is a chronic, progressive adipose tissue disorder that predominantly affects women and is associated with pain, edema, impaired mobility, and reduced quality of life. Despite growing awareness of the condition, its management remains challenging due to its multifactorial pathophysiology and the limited availability of evidence-based treatment guidelines. The aim of this narrative review was to examine current therapeutic approaches to lipedema, with particular emphasis on conservative management strategies and surgical treatment. A literature review was conducted using publications retrieved from major scientific databases, including studies, systematic reviews, meta-analyses, and clinical guidelines addressing dietary interventions, physiotherapy, pharmacological therapies, and liposuction in patients with lipedema. The available evidence was analyzed to evaluate the effectiveness of these treatment modalities and their role within a multidisciplinary management framework. Current findings indicate that dietary interventions, particularly ketogenic and Mediterranean dietary patterns, may improve body composition, metabolic health, pain, and inflammatory status. Physiotherapy, including compression therapy, exercise and complete decongestive therapy, remains a cornerstone of conservative treatment and has been shown to reduce symptom burden and improve functional outcomes. Emerging pharmacological therapies, especially glucagon-like peptide-1 receptor agonists, demonstrate promising potential but currently lack sufficient evidence for routine clinical use. Among available interventions, liposuction appears to provide the most substantial and sustained improvements in symptoms, mobility, and quality of life. In conclusion, effective lipedema management requires a multidisciplinary and individualized approach combining conservative and surgical strategies. Further high-quality randomized controlled trials are needed to establish evidence-based treatment recommendations and optimize long-term patient outcomes.