Summary of Dr. Rockson’s presentation on Lipedema and Inflammation

Dr. Stanley Rockson: The Lymphatic System: Inflammation & Lipedema

The first International Symposium on lipedema was held in New York City on April 1st, 2015. Medical experts from around the world came together to share new research and hypotheses regarding the possible causes and treatment options for lipedema, a disease about which very little is understood. lipedema is a chronic disorder marked by the abnormal accumulation of fatty tissue in a specific part of the body, most often the legs and buttocks, and also occasionally, the arms. While the cause of lipedema is unknown, there seems to be a strong hereditary link. At present there is no cure available, and limited treatment options include changes in diet and exercise, as well as lymph drainage and other procedures commonly used to treat lymphedema. Please visit our site for more education, or for more patient care related information.

Speakers at the symposium offered up their most recent finding and theories. Based on 20 years of research and personal treatment of over 600 new lipedema patients annually, Dr. Stanley Rockson, MD of Stanford University presented a compelling hypothesis entitled “The Lymphatic System: Inflammation and lipedema”, in which he drew from established studies, both his own and others’, to demonstrate how intimately these three factors are intertwined. His basic thesis is that lipedema, essentially a disease of excess fat, is, at its root, is a lymphatic abnormality. His first set of slides strongly supports his hypothesis. The slides show a study using dye injected in the leg of a patient with lymphedema and one with lipedema, which reveals distinctly different, yet dramatically similar lymphatic abnormalities in the two. Dr. Rockson approaches his subject from varying angles, all of which point towards the validity of his thesis.

Fat and the Lymphatic System

There is a close relationship between fat and the lymphatic system. Imaging studies show that the lymphatic vessels are surrounded by fatty tissue that remains present despite severe calorie restriction. Inherited lymphatic abnormalities often lead to an accumulation of fatty tissue in the liquid of the abdomen and chest, and it is clear that when the lymphatic system isn’t functioning properly lipid transport is compromised, making it difficult or impossible for the liver to eliminate excess fat molecules. There are two mechanisms that signal healthy lymphatic function. In mouse studies, researchers have experimented with eliminating one or the other of these signals, and have discovered consistent fat accumulation as a result of lymphatic defects. Studies also show that breast cancer induced lymphedema leads to a tremendous increase in fat, and that in the later stages of lymphedema the effected limb contains a much higher volume of fat, and relatively little excess fluid

Fat and Inflammation

Science has established a strong link between excess visceral fat and inflammation. The overgrowth of visceral fat deposits is considered an inflammatory disease. Studies demonstrate that the overgrowth of visceral fat induces an “inflammatory cascade” which negatively impacts the immune system, white blood cells, hormonal balance and leads to the death of adipose cells.

The Lymphatic System and Inflammation

The lymphatics serve three main functions: lipid and fluid transport, and they play an important role in healthy immune function. Skin harvesting studies, where skin cells are taken from a particular patient from both the healthy arm and the arm with lymphedema, clearly show major differences between the two. When tissue senses an accumulation of fluid there is a dramatic increase in both immune dysfunction and inflammation.

Fat and Lipedema

Additional mouse studies have involved creating lipedema though controlled trauma to the tail. Results show that the further you get from the obstruction (in other words, the more pronounced the lipedma) the more fatty tissue is present. The fat droplets increase in both number and size as you move down the mouse’s tail. In addition, the hormones related to fat metabolism become more pronounced. These studies indicate a two way street – obesity leads to impaired lymphatic flow, and impaired lymphatic flow results in obesity.

Dr. Rockson readily admits that his theory of lymphatic disorders as the main cause of lipedema is based on conjecture and inference, although it is inarguable that there is solid science behind the relationship among fat, inflammation and lymphatic system. Fledgling trials show some success in the treatment of lipedema using systemic anti-inflammatory drugs presently used to treat Lymphedema. Dr. Rockson is confident that lymphatics are great place to look for clearer answers to the puzzles regarding lipedema, and to hopefully discover improved treatment options, and perhaps, one day, a cure

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