Revised staging for lipedema
The website lipodema.com discusses a revised staging for lipodema based on a 2025 article by Al-Ghadban, S.; Evancio, J.V.; Alfiscar, P.E.F.; Herbst, K.L. New Characterization of Lipedema Stages: Focus on Pain, Water, Fat and Skeletal Muscle. Life 2025, 15, 1397. https://doi.org/10.3390/life15091397
The current stage classification is established and has been reviewed in the Standard of Care for Lipedema in the US published by Herbst et al. in 2021. However, in photographic examples of lipedema, the authors noted abrupt increases in tissue amount, texture and shape between Stage 1 and 2, and Stage 2 and 3, suggesting that the current three-stage classification may not fully capture changes in lipedema tissue; disease progression occurs along a continuum, not as discrete jumps from 1 → 2 → 3. Based on systematic physical examination findings and photographic documentation from a single specialized clinic, they propose the addition of two intermediate stages—Stage 1.5 and Stage 2.5. Similar half-stage models have already been adopted in lymphedema.
I know that many of us waver on what stage we fit in the current classification because we may have mixed features from Stage 1 but also some from Stage 2, so adding new levels makes sense.
I encourage you to follow the link to the text of the article. Compared to other studies I've read, this one seemed somewhat less technical so more easily understood. Significant as I was reading it during an insomniac's 4 am awake time!
There were several points I found interesting:
The study corroborates previous findings showing that lipedema tissue contains higher water (and sodium) levels compared to healthy, non-lipedema tissue. So we carry a higher percentage of water than people with plain obesity which may explain our rapid drop in weight during weight loss efforts as well as a rapid regaining of lost weight.
They also observed that skeletal muscle mass in all limbs significantly increased in parallel with fat mass in women with stage 3 lipedema. This finding suggests a possible compensatory mechanism, where muscle mass increases to support the excess adipose tissue. I guess that makes some sense, but they also warn that the increased muscle mass might be secondary to inflammation and swelling and ask whether the increased muscle mass affects mobility which remains to be tested.
The more we know, the more powerful we are. Enjoy!