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& Mikhailidis, D

Mutations in genes like AKR1C1 (linked to adipogenesis and progesterone levels) and PIT1 (involved in growth and sex hormones) have been found in affected families.13,14AKR1C1 mutation is believed to reduce aldo-keto reductase activity, increasing levels of allopregnanolone (a potent analgesic) while also decreasing prostaglandin F2-alpha levels and raising progesterone levels, which stimulate adipogenesis.15 The disproportionate accumulation of adipose tissue in the lower body, particularly coinciding with periods of hormonal fluctuation, suggests that dysregulation of estrogen signaling plays a key role in the pathophysiology of lipedema

Huhn M, Nikolakopoulou A, Schneider-Thoma J, Krause M, Samara M, Peter N, et al

For selected patients with severe obesity or obesity-related complications, procedures may also be discussed