Lipedema is a chronic and frequently misdiagnosed fat disorder that primarily affects women. For many patients, the path to an accurate diagnosis can be lengthy and complex. The condition has historically been—and still often is—mistaken for obesity or lymphedema, which can delay appropriate treatment and leave patients without the care they need.
Although progress has been made through ongoing research, education, and improved diagnostic tools, lipedema continues to be underrecognized in many medical settings. At the Advanced Lipedema Treatment Program at The Roxbury Institute, we specialize in accurate diagnosis and comprehensive management. Our approach combines advanced diagnostic evaluation, surgical expertise, and supportive care designed specifically for patients with lipedema.
Lipedema is still commonly mistaken for other conditions, most often obesity or lymphedema. While these conditions may share certain outward features—such as changes in body size or swelling—they are distinct in important ways. Unlike obesity, lipedema fat is resistant to diet and exercise and follows a very specific pattern of distribution. And unlike lymphedema, lipedema typically affects both sides of the body symmetrically, spares the hands and feet, and is often associated with pain, tenderness, and easy bruising.
Because there is no single test to confirm lipedema, diagnosis depends on careful clinical evaluation. Without assessment by a specialist trained to recognize these differences, patients may receive a diagnosis that does not fully explain their symptoms, delaying appropriate care.
If you suspect you may be living with lipedema, recognizing its hallmark signs can help guide you toward appropriate care:
If you believe you may be living with lipedema, regardless of the stage, consulting a licensed medical professional is an important next step in your journey. An accurate diagnosis is the foundation for making informed decisions about your treatment and long-term management.
While many types of physicians may encounter lipedema in their practice, a lipedema specialist remains the most qualified professional to provide a thorough diagnosis and treatment plan. These experts dedicate their careers to understanding the unique complexities of this condition. Still, different doctors can play supportive roles in your diagnostic process, often serving as the first link to connect you with a true lipedema specialist:
An accurate diagnosis is the foundation for effective treatment. Patients who receive the correct diagnosis can access therapies specifically designed for lipedema, rather than being told to simply lose weight or being treated for unrelated conditions. From surgical interventions such as lipedema reduction surgery to supportive therapies like compression and manual lymphatic drainage, appropriate diagnosis leads to targeted, effective management.
The diagnosis of lipedema is not based on a single, conclusive test like a blood test. Instead, expert medical professionals will use a combination of different evaluations, examinations, and tests to get a complete picture of your health. At The Roxbury Institute's Diagnostic & Preventative Center in Tucson, Arizona, Dr. Karen Herbst, an internationally recognized lipedema expert and board-certified endocrinologist, leads comprehensive diagnostic assessments that go beyond traditional approaches.
Comprehensive Clinical Assessment: Under Dr. Herbst's expertise, the diagnostic process involves assessing lipedema-specific physical characteristics, such as disproportionate fat accumulation between the upper and lower body. The lower body may have excess fat buildup, leading to "column-like" legs and "cankles," while the feet are often entirely spared, and in later stages appearing as though you're wearing cuffs around your ankles. Dr. Herbst and her team will also evaluate pain, tenderness, or swelling, and look for spongy, dimpled skin with hard, painful nodules beneath the surface.
Advanced Physical Examination: This portion includes specialized assessments such as: Waist-to-Hip Ratio (WTH) measurements to determine if pathological fat buildup is present. The "Pinch Test" to determine if fat tissue is painful or feels different compared to healthy tissue, and if nodules are present. Stenner's Sign Test to help differentiate between lipedema and lymphedema by assessing the ability to pinch skin between toes or fingers.
State-of-the-Art Imaging and Testing: The center utilizes groundbreaking venous Doppler ultrasound technology and other advanced imaging modalities to help rule out other lymphatic disorders and provide precise diagnostic clarity.
In-Depth Medical and Hormonal Analysis: As Head of Research and Director of Diagnostic and Preventative Medicine at The Roxbury Institute, Dr. Herbst conducts thorough evaluations that include family health history to determine genetic factors, hormonal assessments (as lipedema onset is often triggered by hormonal milestones like puberty, pregnancy, or menopause), and comprehensive analysis of symptoms including pain, brain fog, fatigue, joint issues, or decreased mobility. Dr. Herbst’s unique expertise in endocrinology allows for deeper insights into the metabolic and hormonal factors underlying lipedema and related conditions.
The Roxbury Institute’s Diagnostic & Preventative Center represents where comprehensive care meets the guiding hands of true experts. Co-founded and developed by Dr. David Amron and Dr. Karen Herbst, this center redefines diagnostic excellence within the Advanced Lipedema Treatment (ALT) program, offering pioneering strategies for diagnosing and preventing progression in lipedema and other fat disorders.
If you believe you may be living with lipedema and are ready to begin your journey with true experts, we invite you to schedule a consultation with the Advanced Lipedema Treatment program at The Roxbury Institute. Dr. Karen Herbst offers appointments both virtually and in person at our Tucson, Arizona location, while Dr. David Amron provides consultations at The Roxbury Institute locations in Beverly Hills, CA, Salt Lake City, UT, and Tucson, AZ.
