Episode 102 Summary

  • Lipoedema (lip-eh-dee-mah) is a disease of loose connective tissue. It is a body fat, or adipose cell disorder. It sounds very similar to the unrelated disease lipidemia (lip-id-ee-me-ah) which is a blood fat disorder and more widely understood within the medical community. Many medical professionals may not even be aware of lipoedema as it is not taught in medical schools, and often misdiagnose it as simple obesity or lymphodema, a disorder of the lymphatic system. Lipoedema was first discussed in the USA in 1940 with a diagnostic criteria being determined in the 1950’s. This is not a newly discovered disorder. 
  • The Foldi Clinic in Germany estimated that 11% of women have this condition. This is not a rare disorder, but awareness is low. It also may occur in males with hormonal disturbances. 
  • Lipoedema is distinct from lymphoedema, and obesity - It can occur alongside obesity and lipoedema can progress into lipo-lymphoedema, with lymphatic fluid accumulation as the lymphatics are impacted by the accumulation of fat over time. It may also be present in the absence of obesity. This fat does not respond to calorie restriction.
  • Symptoms of lipoedema
    • Individuals with lipoedema have symmetrically disproportionately enlarged loose connective tissue (fatty tissue) in affected areas. The most commonly affected areas are the lower body and legs and the upper arms, but lipoedema can also affect the abdomen, breasts and lower arms.
    • Nodules can be felt under the skin. Often, but not always, the affected areas are painful.
    • A heavy feeling in the legs is common. 
    • Excessive weight gain can occur very quickly when lipoedema is triggered to progress, often by hormonal changes in puberty, pregnancy and menopause.
    • The upper body often remains disproportionately smaller with a small waist. 
    • A fat pad is often present under the knee.
    • As the condition progresses, larger lobules of fatty tissue develop that can overhang the knees particularly and it can affect mobility. 
    • Often women identify with the feeling that their legs are simply “different” to those around them. 
    • Women with lipoedema often have lower muscle mass than would be expected for an obese women of the same weight. 
    • Often with weight loss, including following bariatric surgery these individuals will lose weight from everywhere other than their lipoedema affected areas. 
  • Eat Less Move More is unhelpful and in fact harmful - especially for women with lipoedema. Increasing exercise can increase inflammation for women with lipoedema. They often have downregulated metabolisms from a life-time of dieting and calorie restriction, which can compromise their reproductive system, mental health and immune system. It is essential to get enough protein, as these are the building blocks of life. Long term deprivation can also trigger cravings and binging as the body struggles to get enough nutrition to survive.
  • Diet culture is incredibly harmful as it encourages an all or nothing mentality - It blames and shames women who are overweight and places an unhealthy emphasis on the number on the scale.
  • Lipoedema is diseased fat - It is not normal fat tissue or adipose tissue. It does not look like regular adipose tissue under the microscope, with enlarged multi-nucleated cells. It does not respond in the same way as regular adipose tissue to lowering insulin levels. There are leaky capillaries in the affected tissue, which increase the growth of fat cells and lead to an accumulation of fluid, which is bound to the fat cells by GAGs (glycosaminoglycans). There is a chronic inflammatory response in the affected tissues
  • Next week we will chat to Megan about the steps toward diagnosis, if you suspect you may have lipoedema, and what can be done to manage lipoedema.  

Lipoedema Australia:

https://www.lipoedemaaustralia.com.au/  

Complete our questionnaire written by doctors to find out the likelihood that you have lipoedema

Megan Pfeffer: 

Megan Pfeffer is an Australian-based clinical nutritionist and the founder of I Choose Health, an international online and Melbourne in-person nutrition consulting clinic. Specialising in ketogenic nutritional therapy for women with lipoedema, lymphoedema, and breast cancer, Megan helps women to take back control of their health with evidence-based approach supported by clinical and personal experience.

Megan follows a ketogenic lifestyle to manage her own health. In early 2019 she discovered she had lipoedema and was diagnosed with breast cancer in mid-2020 (she is now cancer-free), and credits intermittent fasting and keto for helping her manage these conditions.

Megan has presented at numerous international conferences in-person in Sydney and Boston, and online in New York and Italy. She is the lead author of a 2019 keto cookbook for lipedema and co-authored a 2019 peer-reviewed research paper titled ‘Ketogenic diet as a potential intervention for lipedema’.

Megan is passionate about supporting women to understand the benefits of adopting a low carb & keto way of life. With a focus on improving health minus the blame & shame approach experienced by many overweight women. Megan’s health motto is to “Eat Food That Loves You Back!”.

I Choose Health offers one-on-one consults, an 8-week online course, luxury ‘keto for lipoedema & lymphoedema’ retreats, and a private membership group for lipoedema and keto support.

Email: [email protected]

Website: www.ichoosehealth.com.au

Megan’s online 8-week keto course ‘Keto mastermind for lipoedema & lymphoedema’ runs every 3 months https://ichoosehealth.com.au/online-courses 

Keto for lipedema research paper link: https://www.researchgate.net/publication/346677939_Ketogenic_diet_as_a_potential_intervention_for_lipedema

 

 

Show notes:

Lipoedema Part 1: What is it exactly?

 

Dr Mary Barson: (0:11)  Hello, my lovely listeners. I'm Dr. Mary Barson. 

 

Dr Lucy Burns: (0:15) And I'm Dr. Lucy Burns. Welcome to this episode of Real Health and Weight Loss.

 

Dr Lucy Burns: (0:23) Good morning, lovely listeners. It's Dr. Lucy here this morning and I am without Dr. Mary, but as you know, I always bring you a beautiful special guest when Dr. Mary is not available. And this morning I am super excited to be talking to a woman I think you will find incredibly interesting. She has a wealth of experience and information and lived experience in a condition called lipoedema. And so I'd love to welcome to the podcast, Megan Pfeffer. Welcome Megan.

 

Megan Pfeffer: (0:55) Hi, Dr. Lucy, thank you so much for having me. It's a pleasure to be here and so nice to be chatting with you.

 

Dr Lucy Burns: (1:01) Ah, wonderful, wonderful. Well, we were just chatting off air about the word lipoedema or lipo-deema or lippy-oh-deema, or all of the various connotations of the word. So I would love for you to perhaps tell us a bit about, a) the pronunciation and b) its history. 

 

Megan Pfeffer: (1:22) Sure, well, I think depending on where you are in the world on how people will pronounce it, so some people say lip-oedema, some people say lipo-edema. Of course, what we don't want people saying is lipidemia because that's actually a different condition. So doctors have heard about the lipidemia, but not so much lipoedema. So lipidemia of course, is a blood fat disorder. So quite different to lipoedema, which is a connective tissue, a loose connective tissue or body fat disorder. An adipose cell disorder. So very different conditions. But it was actually in 1940 that the Mayo Clinic in the United States first talked about lipoedema. So, you know, quite a long time ago, which is really remarkable given how little the medical community knows about it. And so in the early 1950s, they came up with some diagnostic criteria so that people could start familiarising themselves with the different symptoms that they saw were common at the time, and these are sort of slightly changing over time. And at the moment, we're trying to have that more rigorously established. So yeah, it has been around for a long time, but very little is known. It's not taught in medical schools. It wasn't taught to me as a clinical nutritionist in my health science degree. 

 

Dr Lucy Burns: (2:36) Absolutely. The first time I heard it was actually on the Keto Woman podcast where Daisy Bracken Hall was interviewing somebody about it and I'm thinking, “Ah, she's made a mistake, she means lymphedema”. Because lymphedema is quite common and most people have heard of that. And so for ages I thought, lipoedema? No, no, you mean lymphedema? And then I listened, obviously more and thought, “Oh, you're talking about a completely different condition here!”

 

Megan Pfeffer: (3:01) Yeah, it really is. And it's often misdiagnosed as lymphedema, which is swelling, often asymmetrical. So lipoedema will affect both limbs. Typically, whereas lymphedema not necessarily - but we do have lipo-lymphedema, which is an added component or comorbidity to lipoedema, where over time, combined with obesity can then go on to what we call lipo-lymphedema, which is kind of that triad of lipoedema, obesity and then lymphedema. So lymphedema is where the lymphatic system isn't functioning properly and lymphedema is where the fat cells and the matrix around them aren't functioning well. So there are certainly misdiagnoses such as lymphedema or just as simple obesity. And it's really important to be raising awareness, which is why it's so fantastic for you to be including this, it's not a popular or well known condition. But it is so important to raise awareness because it does affect up to, it's estimated to affect up to 11% of people which was the Foldi Clinic in Germany who estimated that. So it affects a large percentage of the population of women worldwide. And they're being misdiagnosed and there are different treatment regimes that are needed for both conditions. So, and progression: The main thing with lipoedema is you really want to stop progression, because it can progress to, really, it can be life threatening for people and does take lives. It can really take away mobility and it can take away social connectedness and you know, with fat stigma and all of those sorts of things. So it's really important that it is diagnosed so it can be treated properly to stop that progression.

 

Dr Lucy Burns: (4:40) Ah, totally. You've hit the nail on the head there. So what are the symptoms of lipoedema? Like what would people be looking for?

 

Megan Pfeffer: (4:49)  So typically, most women will identify with some if not all of the symptoms. You don't have to have all of the symptoms, but most commonly it occurs in females, although I do I believe it's much more common in males than what is reported. So there are very rare cases reported of males with hormonal disturbance. However, I do think it's much more common, but typically it occurs in women. And some women who have always identified that they've had bigger legs. But for some people, it can be that painful leg. It can be painful to touch. So you can have disproportionately increased loose connective tissue or fat on the limbs. So that's kind of a big giveaway is that what we call that gynoid fat distribution in the lower half of the body for females, where typically doesn't cause cardiovascular disease unless obesity then follows it, because it's not that independent weight around the waist, but it will be either you can have it either in the buttocks, in the hips, in the thighs in the lower calves as well, or exclusively just in one of those areas. 

 

(5:55) So different women will identify with different parts that are problematic for them, but you can actually feel nodules under the skin. So typically, they can be like rice, the size of rice, grains, or perhaps like peas, or even as big as walnuts, under the skin, when you palpate the more weight that's there sometimes can be harder to palpate them, but you can definitely feel under the skin in a lot of the lipoedema areas, these lumpy sort of tissue. So we call them nodules. But it can also as I said, it can be painful to the touch or just painful all the time. I identify with it being painful, I have lipoedema myself and I could identify with if my partner were to have grabbed me on the thigh for example, and not grabbed me hard, but boy, it would hurt. So that sensitive touch, and also the abdomen can be affected and the upper arms. And so often the literature will just say that it's in the legs. And, for some women it's the upper arms, but some women do have it in the lower arms, it can be seen in the hands, it can be seen in the abdomen and around the breasts. So it can be more extensive than we give it credit for. And so it can also include oedema. Orthostatic oedema. So standing for long periods of time or sitting for long periods of time, can create that collection of fluid and that's resolved when you're lying down or elevating your legs. But of course the actual heaviness in the legs itself isn't alleviated. So you may have this extra feeling of swelling in the legs, some of it in the ankles, for example can be alleviated when you put them up, but not so much the legs themselves. They can just feel very heavy, and even hot weather and flying can really aggravate it so I know that hot weather can be really problematic. And yeah, aeroplane travel as well.

 

Dr Lucy Burns: (7:45)  And it's different to just how women are often a pear shape? It can be just normal to have a little fat stores on your hips and your thighs. It's different from that isn't it?

 

Megan Pfeffer: (8:00)  It is yes because obviously as women we do have more weight there. So I guess what we're really talking about is, it can be an especially rapid accumulation of weight. You normally find excessive weight gain can happen quickly, but particularly when lipoedema is being triggered, which can happen at different times. So, it has genetic underpinnings, but it can also be affected by hormones. So at those times of hormone fluctuations, which can be as young as puberty, it can be in pregnancy, can be in menopause, but also just in weight gain. But as we know women do have weight gain anyway. So it's really that we call it that disproportionate weight gain where you're really not seeing the fat distributed all over. You're still fitting into your clothes. Quite often women with lipedema will have very small waist sizes, a very small upper body and a very large disproportionate size where you're wearing different sizes on your bottom half than you are on your top half. But that can be… it really does depend on the woman, because some people will just have swollen or larger calves that are heavy, they can feel very different and can have the lipoedema nodules in there. Some women don't experience pain. 

 

(9:13) Yes, so when you see the pictures of lipoedema though, it becomes very apparent and there's often a fat pad beneath the knee. And as the condition progresses, you can have what we call lobules that can overhang the knees as well and in different areas. So it's not a clear distinct picture of these really big wide hips with a tiny waist, though that is a really easy kind of one to spot. Yeah, but there are different, definitely different shapes and sizes. Stage one lipoedema -we stage it through to either stage three or four depending on who you're talking to - will have very different looks to it. But typically I think women will first identify with it, saying “My legs have always been different”. They always feel different. They look different from other women's legs. That to me is something if you've experienced that before is a really great place to go. Okay, maybe I'll look into this and just find out a bit more about it and see if it's possible that this could be something I have, because again, that really comes back to that early diagnosis really can help to stop that progression, because then you can introduce the lifestyle factors, that can really be helpful.

 

Dr Lucy Burns: (10:14) Absolutely. Okay. So I guess then we'd be thinking, if the weight goes on disproportionately around, maybe legs, then same with weight loss, so people will lose weight everywhere, except their, their lipoedema affected areas.

 

Megan Pfeffer: (10:30) That's right, yes. So you can have, and a classic example is people having bariatric surgery that are actually suffering malnutrition, and in starvation mode, but they still have not lost any weight off their legs. That's a very common thing that women will identify as well, that regardless of what I do, nothing seems to work. Exercising more can actually create more inflammation for women with lipoedema. So that's something else that people may identify with. They actually feel worse after excessive exercise as well.

 

Dr Lucy Burns: (11:02) Yeah, absolutely. So therefore, the mantra that we've all heard, “Eat Less, Move More'' is actually terrible for people who have lipoedema.

 

Megan Pfeffer: (11:11) It's actually not only terrible, it's doing more harm than good with the health professional community where we are supposed to first do no harm. I personally find that in my clinic, the women who come to me are often not eating enough. They've been dieting their entire lives. They've been continuously told to eat less. They've downregulated their metabolisms severely. They're not burning as many calories anymore. Sometimes , when your body isn't getting enough calories to run everything, that can compromise your reproductive system and other things that your body doesn't deem as important, because it doesn't have enough energy to run it properly. So that's a real concern and a real problem for women in this community, especially when you think of things like how important protein is. You know, if you're not eating enough calories, you're likely not eating enough protein. And that's going to have knock on effects, you're going to compromise your immune system, you're going to, , compromise your mental health and how well you're feeling, your reproductive system, everything relies on protein, it's the building blocks of life. 

 

(12:16) It's interesting because women with lipoedema don't have the same muscle mass, particularly for women with obesity and lipoedema. You would normally find that you would have an increased muscle mass to support the extra weight, whereas women with lipoedema don't tend to have that. So that to me means that it's even more important that we protect our muscle mass. And so having a healthy diet is such a big part of that. And I mean, I hear so many incredibly sad stories from women that are just blamed and shamed, we call it for their fat. That they must be lying about what they're eating. They're told that they’re clearly bingeing and eating all sorts of foods that are outside of what they're telling. And it's very hard to make a connection and help someone when you can't build the level of trust. And you can't take someone at face value that what they're eating and what they're telling you they’re eating is right. And if you have a good relationship with someone, they're going to open up and tell you what they're eating, because it helps to explain what's happening for them. They're happy to share that if they feel that they’re in a safe space with someone who won't judge them, who understands all of the different components, that happens with severe calorie restriction, because as you would know, Dr. Lucy, if you restrict calories for long enough, your body will start upregulating hormones to say, “Okay, we're taking over here, we clearly can't trust you to eat enough. You're depriving us. We can't run the body like this anymore.” It starts upregulating your hunger, you start craving carbohydrates. And that's the moment where women feel like they're failing and they don't have enough willpower. And they start eating and putting on excess weight and all that weight back on.

 

Dr Lucy Burns: (13:56) Ah, absolutely. I feel like you're speaking my language, because we always say hunger, hunger will trump willpower every single day of the week. And it's because hunger is a biological driver, and it's nothing to be ashamed of. But we get so much mixed messaging as women that if you're hungry, then you must somehow be greedy, or deficient or you just don't have any fortitude. When really, it's your body screaming out for nutrients.

 

Megan Pfeffer: (14:25)  Yes, absolutely. And so many women I think can identify with, with only ever just taking the edge off their hunger. They've dieted for so long that they're having these small meals and frequent meals, which also leads into that foraging effect because when you're eating carbohydrates, as we know, and if you're eating them frequently throughout the day, you're going to be on that blood sugar rollercoaster. Then when you have the dips on the other side of that roller coaster, when your blood sugars start dipping, your body is going to make you seek out food to rebalance your blood sugar levels and like you say, it's really hard to go against that. Willpower will not win over the body's needing to survive. And it needs to reestablish that homeostasis of balanced blood sugars because that's one of the biggest things that our bodies are doing as far as nutrients in nutrients out during the day, reestablishing that homeostasis.

 

Dr Lucy Burns: (15:17) Oh, absolutely. And, I mean, I love a diet rant, and I am sick and tired of women being judged and told that they need to eat less, when so many of them are eating less. They're not eating enough. They're hungry, they're tired and they're told, “Well, if you're not thin,” - because thinness has been idolised - “if you're not, then that's because you're eating too much. And that's because you're greedy and hopeless. So it's your own fault”.

 

Megan Pfeffer: (15:47) Yeah, it's just, it's just such incredibly poor advice to be giving to people and really means, I think, a lack of understanding of really how the body works and how womens’ bodies work. Because, women, I mean, we can talk about obviously, over eating mixed in there sometimes as well. But that also becomes part of the food deprivation, the body needs fuel and needs that extra food, and will drive I think in itself, sometimes the bingeing and then some people will have bingeing disorder as well. So that can be mixed in there too. But it can be interspersed with, “Oh, my God, I've just spent the last three months depriving myself of every food I enjoy. I'm constantly hungry, I'm constantly not feeling well, and I'm getting depressed and anxious”. And all of these things when you're not fueling your body well, so and then on top of that, I think you kind of just feel like, well, what's the point of stopping all of these foods that I love that you've been craving, because you're not getting to enjoy your food, and really, essentially, we all just want to enjoy our food. And there are certainly ways to be able to do that and lose weight. And I think people think that that's an exclusive relationship.

 

Dr Lucy Burns: (16:55) And again, I think diet culture is completely responsible for that with its terminology of cheat days and breaking your diet. And it really encourages this all or nothing mentality. And that it's alright to start again on Monday. And it's like, so between now and Monday, eat as much as you can. And there’s a meme somewhere that says, ‘Eat, drink and be merry, for tomorrow, we diet’, and it's like, oooh, just enough! It isn't helpful. That all or nothing is so unhelpful.

 

Megan Pfeffer: (17:26) Yeah, absolutely. It's really time to change the language, isn't it? And to change the entire culture of eating well, and I guess that's really what we're trying to do as far as low carb and keto, though, isn't it? Really, we're walking away from what we know about losing weight, which has always just been ‘cut down the calories and weigh yourself and if you've lost weight, then you're succeeding and you're going to be healthier’. But actual health isn't really talked about as such. It's just purely about losing weight. And we know how poorly the scales are actually a measure of true weight loss when you're doing it in a healthy way. And yeah, that's another big thing for people to learn.

 

Dr Lucy Burns: (18:05) Ah, absolutely! Breaking up with the scales, we call it, because your worth as a woman is not measured by the number on the scales.

 

Megan Pfeffer: (18:13) That's right. Yeah. And how you feel about yourself, day in and day out, shouldn't be dictated by what the scales say. Now, some people find that that really helps to motivate them. And if that's the case, that's really terrific. But I certainly have had a lot of people who have been disappointed that they haven't lost weight. But when I've asked them how their body measurements have changed, they have lost inches. And even though they have said yes, okay, well, I've actually lost X amount of inches from my waist, they can't quite compute that with success, because the scales aren't showing that it's any less. And so I would hate to imagine how many people have given up on low carb and keto, because the scales aren't necessarily saying anything different, not realising that there's other non scale victories.

 

Dr Lucy Burns: (18:59) Oh, absolutely. I always say to people, look, it's not your fault. It's not our fault, we have been conditioned to believe that the only measure of success is those pesky scales. And having been a dieting queen, I would step on the scale six times a day. And it truly became this like a little addiction, because I was always looking for that little bit less. So you go and do a wee, hop on the scales and then I'd feel better if the number was lower. Which when you say it out loud it's ridiculous, because clearly the number is lower because I've had a wee.  Like it's..! But it didn't matter. Because it was all just about the number. Yes, like, yeah, just just quite disordered thinking. But I was completely unaware of that.

 

Megan Pfeffer: (19:44) Yeah. And it's something that really surpasses the intellect, isn't it? It's not about intellectual knowledge, because most women know that if you go to the bathroom and weigh yourself and it's different, that you have not lost weight in that time. But just psychologically, yes, seeing that number, to feel like you're doing okay, to be told that all of these efforts you're making are somehow working, even though they're clearly not working well, if you have to go and have a wee to get some kind of response in the numbers. Yeah, it's something that we really need to change the knowledge for people.

 

Dr Lucy Burns: (20:18) And I think you absolutely made a great point there that for a lot of us, dieting, it was about restriction. It was about hunger. It was about punishing yourself at the gym. But it would all be worth it if you weighed less.

 

Megan Pfeffer: (20:33) Yes.

 

Dr Lucy Burns: (20:34) So it was like this transaction. I'm going to do all of these things and then I will weigh less and my life will be fabulous. 

 

Megan Pfeffer: (20:39) Yes. And not only not even kind of really correlating that with, “What are my health markers? How are my health markers moving with that?” and people who were doing calorie restricted diets that still allow them to have all of the the pastries and the desserts and things like that, which are really, in my mind appealing to the food addiction part of foods. So they're causing, okay, well, as long as you restrict your calories low enough, you can still keep these processed foods that you're addicted to going. And it's just this perpetual addiction in itself. So that's really problematic.

 

Dr Lucy Burns: (21:14) Yeah, absolutely. And then by using up all your calorie allowance on pastries or whatever, then you don't have any left for proper food and nutrition. So none for protein.

 

Megan Pfeffer: (21:25) Yeah, that's right. Yeah. And I guess the thing though, to bring that back to lipoedema is that there are plenty of women with lipoedema who don't have excess weight on their body, they have this diseased fat. And so even if they are calorie restricting, that they're not able to shift that fat and so that's going to be problematic, because not everyone with lipoedema has excess weight outside of that, that can be easily moved. So you could do a weight loss diet, a calorie restricted diet and lose weight, perhaps from the upper part of the body. And it's a really common thing that you lose the weight off the tummy or the upper part of the body or off the breasts, but not off the upper arms or the legs.

 

Dr Lucy Burns: (22:03) Yes. And in fact, I like that word you just said. So lipoedema is diseased fat, it's not normal fat tissue or adipose tissue, it doesn't behave like normal adipose tissue. You know, you and I both know, and hopefully now all our listeners know that the majority of adipose tissue or fat stores is blocked by insulin. And so reversing your insulin or lowering your insulin will give you access to those. But that's not the case necessarily with lipoedema fat, is it?

 

Megan Pfeffer: (22:30) Yes. So, insulin we believe works differently in lipoedema fat cells. And because there’s also closely related with other hormones, which could be oestrogen, we're not sure, could be progesterone, could be other hormones interlinked in there, that the fat cells do behave differently. So we believe that we need to lower insulin even further, to possibly be able to access those fat cells. But only time of course, will tell that and we don't have the benefit of having any ketogenic diets studies, where we're able to then biopsy and have a look at how are these fat cells improved or different from when it was started. But we do know that lots of women have success. Clinically, we know that they're having success with weight loss and feel like they lower weight in areas where they're having problems with lipoedema. So suddenly, they are able to lose weight off their legs where previously they haven't been able to do that before. So how much of that is the actual lipoedema fat, how much of that is fluid, because of course, one of the issues with lipoedema, it's not just the fat, but it's also an accumulation of fluid. So we think that there are leaky capillaries involved. So we have this fluid loss from capillaries that the lymphatic system isn't able to keep up with. And so we get this accumulation of fluid in and around the fat cells, which then binds to what we call GAGs. They bind to these carbohydrates that actually make the fluid spongy. And so that stops it from being this fluid, you get free fluid, but you also get this bound fluid to these GAGs. And so that can really increase the size, of course of the fat cells. And with this leaky fluid that's happening that can actually increase the growth of fat cells. And then of course, we have a chronic inflammatory response, because we have these adipose cells that are enlarging and multiplying, and that of course, initiates a chronic immune response where you start getting white blood cells that are coming to the fat cells to try to fix what's going on. Of course, they can't do that. So more and more white blood cells are sent. In obesity, you'll find that the cells seem to be the same size but in lipoedema, we get what we call these multi nucleated cells, or crown like structures that actually change the shape and the size of the cells beyond what you find in obesity. So you get these disregular fat cells as well. So you have this chronic inflammatory response going on, which you also would have in obesity, and certainly in lipoedema.

 

Dr Lucy Burns: (25:04)  Megan, I think it is fascinating that this, basically, as you said, it's abnormal or diseased fat tissue that is barely spoken about, and has just been lumped in with standard fat tissue and treated the same which as you and I both know, that's it's not even a helpful way that people are generally recommending treatment of fat storage is just to restrict your food. But what I would love to do is have you back next week, so we can actually talk about the treatment of this. So what can people do about it? Because the first step, obviously, is having awareness and recognising “Oh, my God, this might be me”. And the second step then is “Oh, okay. It could be me now, what do I do? And so I think that it would be a really important conversation for us to have. So lovely listeners, keep your ears peeled because we are coming back next week to talk about the treatment and what you can actually do if you think you've got this condition to get diagnosed and then seek treatment for it. 

 

Megan Pfeffer: (26:04)  Fantastic. Thank you, Dr. Lucy. 

 

Dr Lucy Burns: (26:06)  All right. No worries. Lovelies, I will see you, hear you, talk to you next week with Megan and we're super excited. Bye for now.

 

Dr Lucy Burns: (26:21)  So my lovely listeners that ends this episode of Real Health and Weight Loss. I'm Dr. Lucy Burns.

 

Dr Mary Barson  26:28  

and I'm Dr. Mary Barson. We’re from Real Life Medicine. To contact us, please visit https://www.rlmedicine.com

 

Dr Lucy Burns: (26:39)  

And until next time, thanks for listening. The information shared on the Real Health and Weight Loss podcast, including show notes and links provides general information only. It is not a substitute, nor is it intended to provide individualised medical advice, diagnosis or treatment, nor can it be construed as such. Please consult your doctor for any medical concerns.



 

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