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Living with Lipedema The challenges and Frustrations. Linda Anne Kahn CLT-LANA HHP Lymphatic Therapy Services San Diego. There are many physical, mental and emotional challenges that confront Lipedema patients on a daily basis. So Many Emotions!.

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Living with lipedema the challenges and frustrations

Living with Lipedema The challenges and Frustrations

Linda Anne Kahn CLT-LANA HHP

Lymphatic Therapy Services

San Diego

LAKAHN 8/29/2014

There are many physical, mental and emotional challenges that confront Lipedema patients on a daily basis

LAKAHN 8/29/2014

So many emotions
So Many Emotions!

  • So many difficult emotions can be triggered by having to live with this frustrating fat disorder.

  • One of the most frustrating aspects of Lipedema is the uncertainty involved.

  • The tissue can often increase in size and then decrease for apparently no reason.

LAKAHN 8/29/2014


LAKAHN 8/29/2014


  • Treat physically

  • Seek emotional support

  • Seek nutritional guidance to avoid additional weight gain and to lose.

  • Lifestyle

  • Complex Decongestive Therapy

    • Lymph massage

    • Compression

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  • Deep breathing

  • Education

  • Support & encouragement

  • Psychological support

  • Self massage

  • Relaxation

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  • Severe dieting and “starving” may lead to an even bigger discrepancy between trunk and extremities

  • Burning calories through physical exercise may not lead to the desired reduction of fat in affected area

LAKAHN 8/29/2014

Our modern day diet
Our modern day diet

  • Today’s Western dietary pattern –

  • High intake of saturated fatty acids, trans fatty acids, and processed foods;

  • Low intakes of mono- and poly- unsaturated fatty acids, dietary fiber, and micronutrients.

  • This diet is pro-inflammation and exacerbates the condition of the Lipedema Patient

LAKAHN 8/29/2014

Food and inflammation
Food and inflammation

  • Inflammation can be aggravated by diets high in refined, hydrogenated vegetable oils, fatty meats and high-fat dairy

  • Foods cooked at high temperatures.

  • Fried foods, fast foods, soft drinks, baked goods

  • Margarine, potato chips, high sugar foods.

  • Grain-fed beef, processed meat (eg, deli meats or hotdogs), refined-grain products, eggs, French fries, high-fat dairy products

  • Sweets, desserts.

Lipedema Linda Anne Kahn CLT-LANA 8/31/2014

Carbohydrates fuel inflammation

  • Carbohydrates provide glucose - energy.

  • High-glycemic carbs

    • blood sugar spikes

    • trigger or worsen inflammatory responses.

    • ( bread, beigels,potato)

  • Low-glycemic carbs

  • mild impact on blood sugar levels

  • Reduce inflammation.

  • (nuts, beans, legumes, oats)

LAKAHN 8/29/2014

  • The typical Western diet contains 16 to 30 times more omega-6 fat than omega-3.

  • Today, sodium is eaten in the form of sodium chloride from processed foods.

  • Carbohydrates today are mostly highly processed as compared to highly fibrous and complex carbohydrates in fruits, vegetables and limited grains.

LAKAHN 8/29/2014


LAKAHN 8/29/2014


Inflammation can be aggravated by diets high in refined hydrogenated vegetable oils, fatty meats & high-fat dairy

  • Foods cooked at high temperatures.

  • Fried foods, fast foods

  • Margarine,potato chips, baked goods, high sugar foods.

LAKAHN 8/29/2014

Avoid omega 6 fatty vegetable oils
Avoid Omega 6 Fatty Vegetable Oils

  • Corn, safflower, cottonseed and sunflower oils

    • Highly refined

    • high in omega 6 fatty acids,

    • long chain triglycerides

  • Promote inflammation

  • Chemically unstable and oxidize quickly

  • Oxidation promotes inflammation leading to risk of cancer and other diseases.

LAKAHN 8/29/2014

Avoid trans fats
Avoid - Trans fats

  • Trans fats - deep fried foods, baked goods and margarine

  • Increase the body's inflammation levels

  • Common sources of saturated and trans fats

    • red and processed meats, high-fat cheeses, stick margarine, whole milk and commercially-prepared cookies, pastries and crackers

LAKAHN 8/29/2014

Essential fatty acids
Essential Fatty Acids

  • Role in the body's inflammatory processes.

  • Decrease several markers of inflammation

  • Need balance of omega 3 and omega-6 (1:3)

  • Omega 3 fatty acids reduce inflammation

  • DHA &EPA -Mackerel, lake trout, herring, sardines, albacore tuna, wild salmon and halibut.

  • α-Linolenic acid[ALA] -Walnuts, organic canola oil, flaxseed, olive oil chia, hempseed, nuts

  • Omega 3 fatty acids reduce inflammation

  • Drake, Victoria. " Micronutrient Research for Optimum Health” Victoria J. " Linus Pauling Institute. Websearch

Lipedema Linda Anne Kahn CLT-LANA 8/31/2014

Medium chain fatty acids
Medium chain fatty acids

  • Unlike long chain triglycerides, MCT’s bypass the lymphatic system –enter portal vein during lipid digestion.

  • They are easily absorbed - little strain on lymphatic system

  • Provide a quick source of energy.

  • Lessens lymph load

  • Cold pressed coconut oil, caprylic acid

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Anti inflammatory foods
Anti-inflammatory Foods

LAKAHN 8/29/2014

Mediterranean diet
Mediterranean diet

  • Consists of fish, fruits and vegetables, nuts, olive oil, beans, legumes and whole grains.

  • Moderate in alcohol and lean red meat and eliminates processed meat, refined carbohydrates and whole-fat dairy products.

    Salas-SalvadoJ,Casas-Agustench P, Murphy MM, Lopez-UruarteP,Bullo.

    . 2008 Feb;19(1):63-8. “Mediterranean diet and metabolic diseases.”

LAKAHN 8/29/2014

Paleo diet
Paleo Diet

  • Lean proteins

  • Fruits

  • Vegetables

  • Healthy fats from nuts, seeds, avocados, olive oil, fish oil and grass-fed meat

  • Ancestral diet

  • Must supplement with Vitamin D

  • NO fast food

  • NO packaged foods

  • NO dairy

  • NO grains

  • NO sugar, candy, juices

  • NO refined processed food

LAKAHN 8/29/2014

Anti inflammatory diet menu
Anti-inflammatory diet menu

  • One serving of fruit and free range eggs- Breakfast

  • One serving of fruit as a mid-morning snack

  • Large vegetable salad with at lunch and dinner that includes two servings of vegetables.

  • Salmon, mackerel, sardines or herring -omega-3

  • Free-range chickens and their eggs

  • Grass-fed beef –has more beneficial types of fatty acids.

  • Leafy green vegetables and orange, red, or yellow vege -anti-oxidant content.

  • Onions and garlic for the allium content,

  • Highly anti-inflammatory spices: ginger, turmeric, cayenne, cloves, oregano, rosemary and nutmeg

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More anti inflammatory menu
More Anti-inflammatory Menu

  • Beans and lentils

  • Eat a rainbow salad daily

  • Whole grains - quinoa and millet

  • Green tea, chai tea, rooibos tea

  • Berries

  • Avocadoes

  • Nuts – raw unsalted

  • Chia, hemp, flax seeds,

  • Sunflower seeds

  • Cold pressed virgin olive oil

  • Spices

    • Tumeric, ginger, curry

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Anti inflammatory food choices
Anti-inflammatory Food choices

  • Easily digested foods

  • Fresh-prepared lean proteins

  • Low glycemic foods

  • Nutrient dense food - make every calorie count

    • nutrients and antioxidants. 

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Dr andrew weil s anti inflammatory pyramid
Dr Andrew Weil’s Anti-inflammatory Pyramid

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Quench inflammation
Quench Inflammation

  • A diet high in vegetables, fish, fruit and whole grains and omega fatty acids - chia seeds, avocadoes, olives is advised.

  • Avoid refined carbohydrates and sugar, as well as limit intake of sodium.

  • Incorporate low-glycemic carbohydrates, high in fiber - quinoa, brown rice, beans and lentils.

  • Healthy fats from fish - wild salmon, herring and mackerel, olive oil, nuts and seeds

  • Thomas D, Elliott EJ, Baur L. Low glycaemic index or low glycaemic load diets for overweight and obesity (Review). Cochrane Database Syst Rev. 2009;3:1-38.


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Herbs and supplements
Herbs and Supplements

  • Selenium has been shown to decrease edema in tissue

  • increases the efficacy of physical therapy for lymphedema

  • reduces the incidence of erysipelas infections in patients with chronic lymphedema

  • it lowers free radical production in part by increasing glutathione peroxidase

    Micke, O., Bruns, F., Schäfer, U., Kisters, K., Hesselmann, S., and Willich, N. (2000) Selenium in the treatment of acute and chronic lymphedema. Trace Elements and Electrolytes 17, 206-209Kasseroller, R. G., and Schrauzer, G. N. (2000) Treatment of secondary lymphedema of the arm with physical decongestive therapy and sodium selenite: a review. Am J Ther 7, 273-279

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  • Bioflavonoids are coumarins, fragrant chemical compounds  found in many plants.   

    • Bioflavonoids - Vitamin P (hesperidin, rutin, citrin, flavones and flavonols) - water-soluble super-antioxidants found in citrus, broccoli, brussel sprouts, mangoes, papayas and more.

  • May assist in connective tissue maintenance

  • Fend off free radicals to promote immune function

  • May help maintain healthy blood vessel walls.

    • Horse chestnut seed extract

    • Quercetin

    • Grapeseed extract

    • Pycnogenol (French Maritime pine)

LAKAHN 8/29/2014

Anti oxidants

  • N-acetyl cysteine (NAC)

    • an amino acid derived from L-cysteine

    • antioxidant, which reduces free radicals in the tissue, thus preventing tissue damage

  • Grape Seed Extract or (pycnogenol)

    • antioxidant that protects against damage caused by free radicals – bioflavonoid

    • capillary leakage, peri-vascular inflammation and subcutaneous edema were all reduced

  • De Rosa SC, Zaretsky MD, Dubs JG, et al. N-acetylcysteine replenishes glutathione in HIV infection. Eur J Clin Invest 2000;30:915-29.

  • Gillissen A, Nowak D. Characterization of N-acetylcysteine and ambroxol in anti-oxidant therapy. Respir Med 1998;92:609-23.

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  • Butchers Broom

    • lymph pump

    • 100 mg three times day

  • Ubiquinone - Coenzyme Q 10 200 IU daily

  • Alpha -Lipoic acid

  • Bioflavonoids

    • treat diseases of blood vessels & lymph system

    • 500 mg twice daily

  • Horse chestnut

    • Strengthens the lymphatics and reduces edema

    • 250 mg horse chestnut with a 1/4 tsp Rutin Powder twice a day.

LAKAHN 8/29/2014

Supplements cntd
Supplements (cntd )

  • Noni – anti-inflammatory, antioxidant

    • May inhibit formation of blood vessels that contribute to lipomatosis

  • Liver support –milk thistle, dandelion root

  • Tumeric – anti-inflammatory

  • Trace minerals, selenium –

    • reduce edema

    • 50 mcg daily

  • Adrenal support –eleuthro root, rhodiola

  • Wobenzyme - systemic enzymes

  • Vitalzyme – systemic enzymes

    • reduce fibrotic tissue and edema

  • Conjugated linoleic acid (CLA) has been shown to decrease the volume of adipocytes and thus reduce body fat.

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Mind body connection
Mind/ Body Connection

  • Aromatherapy

  • Guided Imagery

  • Visualization

  • Meditation

  • Hypnotherapy

  • Laughter

  • Deep Breathing

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Balancing the body and mind
Balancing the Body and mind

  • Evidence based research has established that there is a connection between the body and the mind

  • It has been proven that stress lowers white blood cells and that the relaxation response increases immunity.

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Health benefits of laughter well known and documented

Laughter elevates the brain’s endorphins

Improves digestion

Enhance breathing

Stimulates lymphatic flow


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Reduce stress
Reduce Stress

  • Understand how to support mental and spiritual health

  • The “Relaxation Response” will help the body-mind connection and enhance immunity

  • Aromatherapy

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  • Aromatherapy is a powerful therapy utilizing essential oils from plants

    • The oils can help on a physical and emotional level

    • They may be antifungal, antimicrobial, antiviral, oxygenating

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Rejuvenating the lymphatic system
Rejuvenating the lymphatic system

  • Movement and Exercise Therapy

  • Deep Breathing

  • Yoga

  • Pilates

  • Self massage

  • Swimming

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Body mind activities
Body Mind Activities

  • Tai chi

  • Meditation

  • Guided imagery,

  • Relaxation techniques

  • Hypnotherapy

  • Stress management programs

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  • Lymph circulation

  • Enhances digestion and elimination

  • Deeper and easier relaxation and sleep

  • Stimulates the lymphatic system

  • No trauma to musculoskeletal system.

Lipedema Linda Anne Kahn CLT-LANA 8/31/2014

Whole body vibration
Whole Body Vibration

  • Whole-body vibration consists of low-amplitude, high-frequency stimulation (shaking) of the body

  • Increases oxygen uptake

  • Increases blood & lymph

  • Reduces pain & inflammation

  • Promotes the immune response

  • Helps joint strength & flexibility

  • Aids in detoxification & removal of wastes

  • More trials are needed

Lipedema Linda Anne Kahn CLT-LANA 8/31/2014

Dry brushing for health
Dry brushing for health

  • Eliminates bacterial toxins which contribute to the skin's total toxic load

  • Excites lymph and blood circulation, nerve transmission, sweat and oil gland and skin pore function and the healthy functioning of the skin

  • Skin-brushing supports venous and lymphatic drainage of the skin.

  • Eliminates bacterial toxins which contribute to the skin's total toxic load

  • Excites lymph and blood circulation, nerve transmission, sweat and oil gland and skin pore function and the healthy functioning of skin

  • Skin-brushing supports venous and lymphatic drainage of skin.

Living with lipedema
Living with Lipedema

  • Continued support encouragement by Therapist and Physician is crucial.

  • Support groups are very helpful

  • Learn from the experiences of others

    but tune into your own body

  • Actively learn and problem-solve to find what works for you.

  • Work out a routine to help prevent problems with your

  • Emotions will fluctuate, so accept all your emotions and find safe ways to express them.

LAKAHN 8/29/2014

Be compliant with your home care
Be compliant with your home care

  • Actively care for yourself and your body.

  • Find the positives about yourself, your actions, and

    your situation.

  • Take pride in how you

    face a difficult challenge and

    in the ways you care for yourself.

LAKAHN 8/29/2014

  • “Eat food - not too much - mostly plants”

  • “Don’t eat anything your great grandmother wouldn’t eat “

    “The Onivores dilemma” Michael Pollan

  • Make time every day just for you - time to meditate, walk, attend a support group

  • Do something daily that will make

    you feel restored

LAKAHN 8/29/2014

Linda Anne Kahn CLT-LANA

Lymphatic Therapy Services

San Diego

[email protected]

LAKAHN 8/29/2014

  • References

  • Weisseleder H, Schuchhardt C. Lymphedema diagnosis and therapy. 4th ed. Germany: Viavital; 2008. pp. 294–323.

  • Fife CE, Maus EA, Carter MJ. Lipedema: a frequently misdiagnosed and misunderstood fatty deposition syndrome. “Adv Skin Wound Care”. 2010 Feb;23(2):81-92;

  • John S. Yudkin, John S, C.D.A Stehouwer, J.J Emeis, and S.W. Coppack. "C - reactive protein in Healthy Subjects: Associations With Obesity, Insulin Resistance, and Endothelial Dysfunction A Potential Role for Cytokines Originating From Adipose Tissue." Arteriosclerosis, Thrombosis, and Vascular Biology. 19. (1999): 972-978. Print.

  • “Adipose tissue, adipokines, and inflammation”." Journal of Allergy and Clinical Immunology. Volume 115, issue 5, pages 911-919. (may 2005): n. page. Print.

  • 5. Balistreri, CR. Caruso C, Candore G. “The role of adipose tissue and adipokines in obesity related inflammatory diseases.” Epub2010:802078. (2010 Jul 1): n. page. Print.

  • 6. Kaiserling, E. (2006) Morphological Changes in Lymphedema and Tumors. In Foldi's Textbook of Lymphology. (Foldi, M., and Foldi, E., eds) pp. 321-390, Elsevier GmbH, Munich, Germany. Salas-Salvadó J, Casas-Agustench P, Murphy MM, López-Uriarte P, Bulló M.

  • CurrOpinLipidol. 2008

  • 7Feb;19(1):63-8. “Mediterranean diet and metabolic diseases.”

  • 8. Drake, Victoria. " Micronutrient Research for Optimum Health” Victoria J. " Linus Pauling Institute. Websearch

  • 9. Challem, Jack. The inflammation Syndrome. New Jersey: Wiley, 2003. Print.

  •  10. Calder PC, Omega-3 Fatty Acids and Inflammatory Processes. Nutrients 2012, 2, 355-374

  • 11.Geliebter A, Torbay N, Bracco EF, et al. Overfeeding with medium-chain triglyceride diet results in diminished deposition of fat. Am J ClinNutr. 1983;37:1- 

  • 12. St-Onge, M-P. Jone,P J H, "Greater rise in fat oxidation with medium-chain triglyceride consumption relative to long-chain triglyceride is associated with lower initial body weight and greater loss of subcutaneous adipose

  • 13. Thomas D, Elliott EJ, Baur L. Low glycaemic index or low glycaemic load diets for overweight and obesity (Review). Cochrane Database Syst Rev. 2009;3:1-38.

  • 14. Western diet and inflammation John Neustadt, ND IIN 2013

Lipedema Linda Anne Kahn CLT-LANA 2013