Effect of Weight Loss on Body Composition and Metabolic Function in Women With Lipedema (Lipedema)

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  • sponsor
    Washington University School of Medicine
Updated on 9 April 2022
Accepts healthy volunteers


Lipedema is a disorder characterized by massive, bilateral accumulation of fat below the waist and in the legs. Enlargement of the lower extremities is often accompanied by leg pain and accumulation of fluid. Little is known about the functional changes that lead to fat accumulation and pain in women with lipedema. The goals of this project are to conduct a comprehensive characterization of abdominal and femoral fat tissues in lean and obese women with lipedema and to evaluate the potential effect of diet-induced weight loss as a therapy.

Once enrolled in the study, the following tests will be conducted on lean women with lipedema: characterization of body composition (fat tissue distribution), insulin sensitivity (response to insulin) and adipose tissue biology. The following tests will be conducted on obese women with lipedema: characterization of body composition (fat tissue distribution), insulin sensitivity (response to insulin), adipose tissue biology, and immune system function/inflammation. As control, we will have BMI-matched women that are metabolically normal lean (MNL), metabolically normal obese (MNO) and metabolically abnormal obese (MAO) already analyzed in different studies at Washington University (IRB 201512086). MNL, MAO and MNO subjects underwent the same testing described above for the lipedema. Therefore, we will use the data generated from IRB 201512086 as comparison groups in the statistical analysis to understand differences and similarities between lipedema and obesity.

A second aim of the study is to determine the effect of diet-induced weight loss on body composition, insulin sensitivity, and adipose tissue biology in women with lipedema. The results from this second aim of the study will hopefully provide important insights on the efficacy of diet therapy in managing lipedema.


Once informed consent has been obtained, participants will complete 1 screening visit.

The screening visit includes a medical history, physical examination, pregnancy test (for women of childbearing potential), blood tests, urine drug test, an oral glucose tolerance test, resting electrocardiogram (ECG), and questionnaires.

Baseline testing will be performed in 2 visits requiring 1 inpatient overnight stay and will require ~30h to complete testing. Testing will include imaging scans to determine leg muscle mass; abdominal (belly) fat mass and liver fat content; DXA scan; blood samples; hyperinsulinemic-euglycemic clamp procedure; immune system function/inflammation (performed exclusively in obese with lipedema subjects and BMI-matched controls); and adipose tissue biopsies.

Once Baseline Testing is completed, participants will start 8-10% dietitian and/or behaviorist guided weight-loss for about 4 to 6 months.

Participant will keep a food diary and have weekly visits (in person or remote) with a study dietitian and/or behaviorist.

After weight loss, the testing completed during baseline will be repeated.

Study procedures:

  1. Medical History & Physical Exam
  2. Urine Drug/Pregnancy Test
  3. Blood pressure, pulse, height, weight, shoulder and waist circumference measurements
  4. Electrocardiogram (ECG)
  5. Blood tests for routine lab analyses
  6. Oral Glucose Tolerance Test (OGTT)
  7. Screening Questionnaires
  8. Dual energy X-ray absorptiometry (DEXA)
  9. Magnetic Resonance Imaging (MRI) for Body Composition to determine (a) the amount of fat in the liver, abdomen (belly), and lower leg; and (b) how much muscle mass is in the thigh
  10. Metabolism study (hyperinsulinemic-euglycemic clamp procedure)
  11. Abdominal and Thigh Fat biopsies
  12. Immune function (performed in obese with lipedema subjects and BMI-matched controls).

Condition Lipedema, Metabolism
Treatment Weight Loss, Mediterranean diet
Clinical Study IdentifierNCT03271034
SponsorWashington University School of Medicine
Last Modified on9 April 2022


Yes No Not Sure

Inclusion Criteria

Diagnosis of Lipedema
lean women with lipedema (BMI >19.5 kg/m² and <26.0 kg/m²)
women with obesity and lipedema (BMI >30.0 kg/m² and <50.0 kg/m²)

Exclusion Criteria

Medical, surgical or biological menopause
Previous bariatric surgery
Diagnosis of Type 2 Diabetes
HbA1C <5.7%
Structured exercise >2 days/week for ≥35 minutes of intense exercise (e.g., jogging, activity that cause heavy breathing and sweating) or ≥150 minutes per week of structured exercise (e.g., brisk walking)
Unstable weight (>4% change in weight during the last 2 months before entering the study)
Significant organ system dysfunction (e.g., diabetes, severe pulmonary, kidney or cardiovascular disease)
Cancer or cancer that has been in remission for <5 years
Polycystic Ovary Syndrome
Major psychiatric illness
Conditions that render participant unable to complete all testing procedures (e.g., severe ambulatory impairments, limb amputations, or metal implants that interfere with imaging procedures; coagulation disorders)
Use of medications that are known to affect the study outcome measures (e.g., steroids, non-statin lipid-lowering medications) or increase the risk of study procedures (e.g., anticoagulants) and that cannot be temporarily discontinued for this study
Smoke cigarettes >10 cigarettes/week
Consume >14 units of alcohol per week
Pregnant or lactating women
Persons who are not able to grant voluntary informed consent
Persons who are unable or unwilling to follow the study protocol or who, for any reason, the research team considers not an appropriate candidate for this study, including non-compliance with screening appointments or study visits
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