This is my data extraction spreadsheet. Please organize it. Author	Year	Study Design	Sample (n)	Age (mean)	BMI	Lipedema Type	Lipedema Stage	Intervention	Duration	Frequency	Results	Adverse effects	Relevant Findings	Title	Inclusion?
Flores, et al	2024	Single arm						Liposuction effects on serum vitamin D						"High-Volume Liposuction in Lipedema Patients: Effects on Serum Vitamin D
"	Yes
Lundanes et al	2024	RCT	70, 35 intervention group	"47.3
± 10.9 years"	36.9 ± 4.9 kg/m	All	All	"low-energy low-carbohydrate (CHO) diet with a low-energy
diet (control) in female patients with lipedema"	8 Weeks	Full time	"LCD group had a significantly larger reduction in body
weight and FM (both kilograms and percentage) compared with the control group. LCD group had a reduction in strongest, weakest, and average pain; pain
now; and pain interference with daily activities and a larger reduction
compared with the control group in strongest pain, weakest pain,
and pain now. Both groups reported improvement in several QoL variables, namely physical functioning, energy, general health, self-esteem,
work, total QoL, and appearance.  Fat mass (FM), fat-free mass (FFM), total body
water (TBW), intracellular body water (ICW), and extracellular
body water (ECW) were included in the analysis
"		"A low-energy LCD seems to be superior to a standard low-fat control
diet in reducing pain in female patients with lipedema. However,
improvements in QoL can be achieved regardless of the dietary
approach. "	Effect of a low-carbohydrate diet on pain and quality of life in female patients with lipedema: a randomized controlled trial.	Yes
Michelini et al	2023	Single arm	15	38.0±10.6	26.1±3.3		2	effects of defocused and radial shock wave therapy, mesotherapy, and kinesio taping on pain, circumferences of lower limbs, echographic/ elastosonographic pattern of subcutaneous adipose tissue (SAT), and quality of life in patients with lipedema	4 Weeks	eight sessions, twice a week	Significant reductions of pain and circumference measurements were seen in patients at each follow up. This was associated with significant reduction of thickness, echographic pattern improvement, and increased elasticity of SAT, with consequent positive impact on the quality of life and disability reported by the patients.	"Small hematomas at
the injection points of mesotherapy, which
disappeared within 24-72 hours"	"improved clinical and functional ultrasound findings in patients affected by lipedema in the early stages of lower limbs, SF-12 questionnaire statistically significantly increased both in physical and mental
composite scores (Table 3). The ICF analysis
showed an improvement of ""body function"" (B
domain) and ""activities and participation"" (D
domain), revealed a decrease in NRS
score (Table 1) and in lower limbs circumference measurements (Table 2) at each follow
up"	Defocused and Radial Shock Wave Therapy, Mesotherapy, and Kinesio Taping Effects in Patients with Lipedema: A Pilot Study.	Yes
Jeziorek et al	2023	CT	113 female participants, 56 with lipedema and 57 with overweight/obesity (BMI >25 kg/m2 ) without lipedema, 52 participants completed the study	 39.0 (33.0, 62.0)		All	All	low-carbohydrate, high-fat (LCHF) diet on body composition, leg volume, and pain reduction in women with lipedema compared to overweight or women with obesity	7 Months	Full time	Both groups experienced a similar weight reduction, amounting to 12.9% compared to the baseline (-10.8 kg vs. -11.9 kg; p = 0.14, for lipedema and women with overweight/obesity, respectively). The most reduction was in body fat mass. Improvements in various parameters were observed, except for ankle circumferences, which decreased more in the lipedema group. Lipedema participants showed significantly reduced pain levels following the LCHF diet (4.6 ± 2.6 vs 3.0 ± 2.3; p < 0.001).		LCHF diet may be benefical for lipedema patients	The Benefits of Low-Carbohydrate, High-Fat (LCHF) Diet on Body Composition, Leg Volume, and Pain in Women with Lipedema.	Yes
Di Renzo et al	2023	CT	22 8 patients underwent MMKD combined with carboxytherapy sessions (KDCB group), 8 underwent MMKD nutritional treatment alone (KD group), and 6 patients underwent only carboxytherapy sessions (CB group)					modified Mediterranean ketogenic diet (MMKD) in combination with carboxytherapy	10 Weeks		ketogenic diet effectively induced weight and fat mass loss, including in the limbs, areas considered unresponsive to diet therapy in lipedema patients. However, the best results were obtained from the combination of the ketogenic diet and carboxytherapy, which showed improvements in both body composition and skin texture and a reduction in pain, along with an improvement in sleep quality.		Ketogenic Diet association with Carboxytherapy is benefical for lipedema patients	Modified Mediterranean-Ketogenic Diet and Carboxytherapy as Personalized Therapeutic Strategies in Lipedema: A Pilot Study.	Yes
Kirstein et al	2023	Single arm	34	40.72 (±12.54) years	33.13 kg/m2 (±7.8)		All	Liposuction		median of 2 (mean = 2.38) liposuctions,	demonstrated 2.67 times higher pain questionnaire scores before surgery compared to after the surgery (p = <0.001 95% CI 2.09–3.25), pain and pressure sensitivity was 1.97 times higher prior to surgery (p = <0.001 95% CI 1.21–2.71). heavy leg sensation was 3.33 times higher prior to surgery (p = <0.001 95% CI 2.52–4.13). Walking limitations  2.26 higher values prior to surgery (p = <0.001 95% CI 1.49–3.03).   PHQ-9 values were 2.37 times higher before the surgery (p = 0.003, 95% CI 0.84–3.89)		Liposuction improves QOL for lipedema patients, enhancing physical and psychological well-being	"Patient-Reported Outcomes of Liposuction for Lipedema Treatment.

"	Yes
Kodim et al	2023	Single arm	519 liposuctions in 178 patients	45 ± 15.5 years		All	All	tumescent liposuction			"mean lipoaspirate volume of 4905 ± 2800 mL. All patients reported at least a 50% pain reduction after liposuction, while 96 achieved a pain reduction ≥ 90%. The pre-operative pain intensity (p = 0.000) and the lipedema stage (p = 0.032) exerted a significant impact on absolute pain reduction. There was no association of pain reduction to volume loss.141 pacientes relataram comorbidades. A comorbidade mais
comum foi hipertensão arterial com 32,6%"		Liposuction in tumescent anesthesia is an effective and safe method to reduce both pain and volume in patients with lipedema.	[Microcannular liposuction in tumescent anesthesia in lipedema patients: an analysis of 519 liposuctions].	Yes
Seefeldt et al	2023	Single arm	860 Patients, 250 participants of the underlying study underwent liposuction (29%).		32 kg/m2 +- 7.69 kg/m2.
		 124 patients were classified as stage 1 (14 %), 523 as stage 2 (61%), 165 as stage 3 (19%) and 18 as stage 4 (2%). 30 patients (3%) did not respond to any stage.	effect of liposuction on appearance, pain and coexisting diseases		"Liposuction of the thighs was performed 234
times (92%), 188 times in the lower legs (74%), 126 in the
upper arm (49%), 107 in the area of the buttocks (42%), 101
in the lower arms (40%) and 52 in the abdominal area (20%).
73% received more than one liposuction."	 positive effect on pain reduction in patients with lipedema after liposuction (NRS 2.24) compared with pre-liposuction pain perception (NRS 6.99) and pain perception of patients with conservative treatment (NRS 6.26). Significant differences were shown in the perception between the stages of lipedema and in the reduction of pain perception by liposuction.		"t liposuction should be considered as an effective multimodal
treatment for pain reduction in patients with lipedema.
Cost saving can be achieved, when conservative treatment
options are replaced by liposuction in the case of nonpitting lipedema."	Breaking the circle-effectiveness of liposuction in lipedema.	Yes
Wright et al	2023	RCT	36, lipedema with secondary symmetrical lymphedema, 26 completed	43.3 ± 9.4	36.5 ± 6.4			"comparing Pneumatic Compressive Device plus conservative care
(PCD+CC) versus conservative care (CC) "			"In most of the SF-36 domains of functioning, both PCD+CC and CC groups showed improvements but these improvements did not reach statistical significance in this small study. There was a  statistically significant improvement from baseline to follow-up in the pain domain in the PCD+CC group only. Leg bioimpedance measurements were significantly
improved from baseline to follow-up for both treatment
groups but there was not a statistically significant difference
between treatment groups"		"conservative management with graduated compression and PCD significantly improves the leg
circumference and bioimpedance measurements in patients with lipedema even after a single session. Leg pain,
fatigue, and tightness also show significant improvement
in both treatment groups suggesting that, at a minimum,
women with lipedema should be prescribed compression
garments. The RAND SF-36 quality-of-life and the
PROMIS mobility measures showed improvements ( NS)"	Effect of pneumatic compression device and stocking use on symptoms and quality of life in women with lipedema: A proof-in-principle randomized trial	Yes
Jeziorek et al	2022	CT	91 women, (LCHF; n = 46 MFMC; n = 45)	43.2 ± 12.8 	"LCHF Diet (n=46)BMI [kg/m2]	31.0 ± 6.8		MFMC Diet (n=45) 33.5 ± 9.2"	All	All	compare effectiveness of two diets: low-carbohydrate-high-fat diet (LCHF) and medium-fat-medium-carbohydrate diet (MFMC) in body weight, body fat and limb circumference reduction in patients with lipedema.			We have not found any significant differences in anthropometric measurements at the baseline between groups. Body weight and all anthropometric parameters decreased significantly in both groups after 16 weeks of diets, excluding the circumference above the right ankle for the MFMC diet which did not change. The LCHF diet contributed to reduction of body weight (-8.2 ± 4.1 kg vs -2.1 ± 1.0 kg; p < 0.0001), body fat (-6.4 ± 3.2 kg vs 1.6 ± 0.8 kg; p < 0.0001), waist (-7.8 ± 3.9 cm vs -2.3 ± 1.1 cm; p < 0.0001), hips (-7.4 ± 3.7 cm vs -2.5 ± 1.3 cm; p < 0.0001), thighs and calves' circumferences compared with the MFMC diet. We observed reduction of pain in the extremities and mobility improvement in LCHF group (data not shown).		The LCHF diet was more effective than MFMC in body weight, body fat and lower limb circumferences reduction.	The Effect of a Low-Carbohydrate, High-Fat Diet versus Moderate-Carbohydrate and Fat Diet on Body Composition in Patients with Lipedema.	Yes
Kruppa et al	2022	Single arm	106	41	Median 31.6	All	All	liposuction		total of 298 large-volume liposuctions (mean lipoaspirate, 6355 ± 2797 ml).	"median follow-up of 20 months, a
median complex decongestive therapy score reduction of 37.5 percent (interquartile range, 0 to 88.8 percent; p < 0.0001) was observed. An improvement in lipedemaassociated symptoms was also observed (p < 0.0001). The percentage reduction in
complex decongestive therapy scores was greater in patients with a body mass index
less than or equal to 35 kg/m² (p < 0.0001) and in stage I and II patients (p = 0.0019)"	"1.3% wound
infections
• 0.7% seromas
• 0.3%
postoperative
bleeding"	"Liposuction reduces the severity of symptoms and the need for
conservative treatment in lipedema patients, especially if it is performed in
patients with a body mass index below 35 kg/m² at an early stage of the disease."	"A 10-Year Retrospective before-and-after Study of Lipedema Surgery: Patient-Reported Lipedema-Associated Symptom Improvement after Multistage Liposuction.

"	Yes
Schlosshauer et al	2021	Single arm	69	50.6 ± 12.8	33.4 ± 7.1			Liposuction		" average number of liposuction sessions performed was 2.9 ± 1.9, with a mean
volume of 1868 ± 885.5 mL of fat removed per side"	"QoL in patients with lipoedema
was low (score > 4.0) on every single subscale as well as
on the global score Following liposuction treatment, lipoedema patients
showed a significant improvement regarding diseasespecific QoL on all subscales and for the global score
(2.9 ± 1.0) (Figure 1). The best QoL was found in the
areas of social and daily life (both 2.8 ± 1.1), followed by
physical complaints with a mean score of 2.9 ± 1.0.
Regarding the generic QoL, the most considerable difference was found in the area of QoL, which improved to
6.6 ± 1.5 compared to before liposuction, and also the lowest of
the three general QoL scores (6.2 ± 1.8). Finally, the general health status had the highest mean score after liposuction treatment (6.9 ± 1.7"		" Liposuction greatly improves the QoL in lipoedema patients.
A higher number of liposuction treatment sessions seem to have a positive effect
on general health status in these patients"	"Liposuction treatment improves disease-specific quality of life in lipoedema patients.
"	Yes
Di Renzo et al	2021	CT	29, 14 LIPPY and 15 CTRL	"CTRL 27.52 ± 5.22	LIPPY 35.50 ± 12.17"		All	All	modified Mediterranean diet therapy (mMeD	4 weeks		LIPPY showed a decrease of FM in upper and lower limbs. No significant differences in Δ% between the groups were observed for the lean mass (LM). In LIPPY, an increase in the patients’ ability to perform various daily physical activities related to the loss of arms’ and legs’ fat was observed. A significant difference in the waist circumference Δ% between the LIPPY and CTRL groups was observed (p = 0.022). In the LIPPY group, weight and BMI were significantly reduced (p = 0.025; p = 0.021) he EQ-5D highlighted a significant improvement of the perceived quality of life in the lipoedema patients, with the total score decreasing from an average value of 8.3 ± 1.8 at baseline to a value of 6.9 ± 1.4 after four weeks of treatment (p < 0.05). No clinically significant modification were observed regarding the VAS (baseline: 64.7 ± 18.3; 4 weeks: 69.9 ± 18.3; p = 0.47), the fibromyalgia severity scale index (p = 0.21) and the Fibromyalgia Assessment Status scale (p = 0.75). No significant results were observed in the CTRL group related to EQ-5D, VAS, fibromyalgia severity scale index and Fibromyalgia Assessment Status scale, probably because these subjects did not usually experience pain or other discomfort in their daily life (data not shown).			"Potential Effects of a Modified Mediterranean Diet on Body Composition in Lipoedema.

"	Yes
Baumgartner et al	2021	Single arm	60	54.1	79.7	All	" 18 (¼ 30%) had
stage I lipedema and 42 (¼ 70%)"		"Their postoperative time interval was 13 years and
3 months on average after the first procedure and
12 years and 4 months after the last procedure"		"In all seven items and in the subtest “overall
impairment”, the patients’ assessments before liposuction were significantly higher than at the following
survey  Overall impairment Reduction in quality of life Cosmetic impairment Restriction of movement Bruising Edema Sensitivity to pressure Sensitivity to pressure"		"As was already the case after 4 and 8 years, all patients
with lipedema still describe pronounced improvements
in their findings and symptoms after an average of
12 years after liposuction procedure(s) with highly significant differences to the initial findings."	Improvements in patients with lipedema 4, 8 and 12 years after liposuction.	Yes
Atan et al	2021	RCT	33			3	Stage III or IV	" Group 1 (CDT plus exercises), Group 2 (IPCT plus exercises),
and Group 3 (control—exercises alone) "	30 sessions of combined (aerobic, strengthening, and stretching) exercise program	CDT in Group 1 and IPCT in Group 2 five times a week for 6 weeks.	"Limb volumes ( p = 0.017, gp2 = 0.562 for right;
p < 0.001, gp2 = 0.775 for left), pain ( p = 0.045, gp2 = 0.199), and physical functioning subscore of SF-36
( p = 0.040, gp2 = 0.465) differed significantly between treatments originating from Group 1"		"All programs improved outcome measurements after the intervention. However, when the difference between treatments was investigated, CDT administered in addition to the exercises has been shown to
provide significant improvements in reducing limb volumes, pain, and physical function.
Clinical trial registration number: The study was registered at the US National I"	"The Effects of Complete Decongestive Therapy or Intermittent Pneumatic Compression Therapy or Exercise Only in the Treatment of Severe Lipedema: A Randomized Controlled Trial.

"	Yes
Volkan-Yazici	2021	Single arm	20	 43.7 – 15.5.		Lower limb	Any	"complex decongestive physiotherapy (CDP)
plus intermittent pneumatic compression (IPC) applications on lower extremity limb circumference and volume
in patients with lipedema."	f 24 – 4 days of treatment.	Every day	significant reduction was found in the circumference of 3 of the 5 points of measurements performed in the left limb, whereas statistically significant reduction was found in the circumference of 4 of the 5 points of measurements performed in the right limb		CDP is effective in the treatment of lower extremity lipedema	"The Effects of Complex Decongestive Physiotherapy Applications on Lower Extremity Circumference and Volume in Patients with Lipedema.

"	Yes
Nemes et al	2020	Single arm	20	45.8+-11			II	"Bauerfeind VenoTrain CuraFlow flat-knitted ccl 2 (23-32 mmHg)
(Bauerfeind, Zeulenroda, Germany) pantyhose manufactured of 73%
polyamid and 27% elasthane and in black colour was used. Measurement (between skin and compression material) using Picopress device
(Microlab Elettronica, Nicolò, Italy)"	60 minutes previous to exam		"showed significantly greater values for LA diameter
(40.1 ± 3.6 vs 35.2 ± 4.1 mm, P < .05), LV end-diastolic diameter
(50.7 ± 3.2 vs 46.6 ± 3.5 mm, P < .05) and end-diastolic (122.8 ± 17.1
vs 96.8 ± 20.8 mL, P < .05) and end-systolic (40.5 ± 7.7 vs
33.3 ± 8.0 mL, P < .05) volumes of lipedema patients compared to
those of control proband. 14 lipedema persons LV basal rotation showed significant
reduction, while LV apical rotation represented significant
increase with unchanged LV twist 1 hour after the use of MCS"		"In patients without significant LV rotational abnormalities the
application of lower body compression with flat-knitted pantyhose led
to a significant decrease in basal LV rotation whereas apical LV rotation rose nearly to the same degree resulting in the persistence of LV 
twist at the same value. t LV in lipedema without
major rotational abnormalities is capable of the induction of change in
myocardial function with good contractility and deformation capacity.
The most plausible explanation of these LV rotational changes in
lipedema may reside in the plasticity of LV myocardium which enables
significant and opposite rotational changes without a major impact on
net twist value highlighting sufficient contractility."	The impact of lower body compression garment on left ventricular rotational mechanics in patients with lipedema-Insights from the three-dimensional speckle tracking echocardiographic MAGYAR-Path Study
	Yes
Witte et al	2020	Single arm	63	Median 35 	28.4 ± 0.6,		I or II	Water jet assisted liposuction	Mean follow up of 22 months	"12,922 ml (standard deviation
2922 ml)"	"General impairment dropped from 8 to 1
(Figure 2) and esthetic impairment from 9 to 3,  (55%) dropped  previous any
more conservative treatment"		"Occupational impairmentLiposuction using the WAL technique is highly efficient in
the treatment of lipedema and yields sustaining reduction
of fat tissue and disease-associated complaints. Aesthetic impairment General impairment  Running impairment Itching Swelling Feeling of “heavy” legs Feeling of tension Bruising Sensitivity to touch Pain decreased significantly after liposuction. The need for conservative therapy also dropped for manual limphatyic drainage and compression garments ( more than 50%)."		Yes
Schneider	2020	RCT	30	53.2	35.6	Mixed	II or III	Manual lymphatic drainage (MLD) and Vibrotherapy	30 minutes per session	six sessions	"99% of the patients showed an improvement that was
larger than the average of the patients receiving MLD
alone. The effect of the reduction of
the ankles was d = 1.2 (95% CI: 0.6 < d < 1.7), that of
the calves was d = 1.7 (95% CI: 1.1 < d < 2.3). The
largest effect was found for the reduction of lipedema
of the thighs (d = 95% CI: 2.3; 1.6 < d < 2.9) reported a higher quality
of life at the end of the treatment. The effects for
physical performance were d = 0.7 (95% CI:
0.1 < d < 1.2), for negative mood it was d = 0.8 (95%
CI: 0.1 < d < 1.6), and for the ability to relax it was
d = 1.1 (95% CI: 0.4 < d < 1.9). For positive mood it
was smallest and fell within negative 95% CI boundaries (d = 0.5, −0.01 < d < 0.9). To assess the overall
quality of life, all four scales were combined and subjected to the analyses. There was a large effect of d = 1.1
(95% CI: 0.5 < d < 1.6), indicating that patients undergoing the combined treatment benefitted more than
those receiving MLD alone"		"t combining
MLD with a new vibrotherapy treatment provides a
therapeutic advantage in treating lipedema"	Low-frequency vibrotherapy considerably improves the effectiveness of manual lymphatic drainage (MLD) in patients with lipedema: A two-armed, randomized, controlled pragmatic trial.	Yes
Wollina 	2019	Single arm	111	Median 44		All	All	low-volume micro-cannular liposuction in tumescent anesthesia	median follow up was 2.0 ± 2.1 years	 median total amount of lipoaspirate was 4,700 ml, with a range of 950-14,250 ml. 	"median reduction of limb circumference was 6 cm. The median pain level before treatment was from
7.8 ± 2.1 to 2.2 ± 1.3  at the end of the treatment. improvement of mobility could be achieved in all patients"	Serious adverse events were observed in 1.2% of procedures, the infection rate was 0% and the bleeding rate was 0.3%	 Liposuction is an effective treatment for painful lipedema	"Treatment of lipedema by low-volume micro-cannular liposuction in tumescent anesthesia: Results in 111 patients.

"	Yes
Campisi	2019	Single arm	150 (only 40 lipedema)			Lymphedema + lipedema patients		Targeted skin products (phytotherapuetic natural products)	10 sessions 4-5 hours	2 times a week for 2 weeks	Lipedema patients presented significant reduction in dryness hyperkeratosis after the treatment. 			Inclusion of targeted skin products in the pre-surgical treatment regimen of peripheral lymphedema & lipedema	Yes
Dadras et al	2017	Single arm	25, 72 liposuction procedures 	Median 45	35,3	Mixed	All	"Liposuction . In 41 liposuctions, a vibration-assisted device
was used, and in 31 liposuctions, a water jet-assisted device was
used."		"On average, patients received 3 procedures, with a range of 1
to 7 procedures."	"significant reductions in spontaneous pain, sensitivity to pressure, feeling of tension, bruising, cosmetic impairment, and general impairment to quality of life from the preoperative period to the first postoperative follow-up, and these results remained consistent until the second postoperative follow-up.  need for CDT was reduced significantly. better and more sustainable results could be achieved if patients were treated in earlier stages. e mean volume of removed fat per liposuction was 3,106
mL (range, 1,450–6,600 mL) and the mean volume of total removed fat per patient was 9,914 mL (range, 4,000–19,850 mL)"		 Liposuction is effective in the treatment of lipedema and leads to an improvement in quality of life and a decrease in the need for conservative therapy.		Yes
Schmeller	2012	Single arm	112	 38.8 years (range 20–68			"Thirty-five
patients presented with lipoedema stage I, 75 patients with
stage II and two patients with stage III. "	Liposuction	d 349 liposuctions in total	. The average amount of fat removed was 9846 mL per person (range 1000–25 600) or 3077 mL per session (range 450–7000)	"Spontaneous pain Pain because of pressure Oedema Bruising Restriction of movement Cosmetic impairment Reduction in quality of life presented significant reduction after surgery in the 67 patients who had previously undergone
combined physical therapy. Of these, 13 patients (19Æ4%)
needed manual lymphatic drainage and compression as often
as before; 20 patients (29Æ9%) also continued with physical
decongestive therapy, but less often; 13 patients (19Æ4%) still
used compression garments; six patients (9%) declared that
they only needed manual lymphatic drainage from time to
time; 15 patients (22Æ4%) reported that they no longer
required conservative therapy"	n infection rate of 1.4%. 0.3% bleeding	"In conclusion, tumescent liposuction in lipoedema is a
highly effective method with long-term benefit concerning
body shape, together with a significant improvement of pain,
oedema, bruising and restriction of movement"	"Tumescent liposuction in lipoedema yields good long-term
results"	Yes
Szolnoky et al	2011	CT	38 (19 each)	Median 53.89				Manual Lymphatic drainage intermittent pneumatic compression (IPC), and multilayered short-stretch bandaging, control = non-ionic hydrophyl ointment daily		Daily	significant reduction of pain with a decrease in mean scores of all three measures.		Treatment of lymphedema reduces leg volume and capillary fragility, but also improves pain intensity in patients with lipedema.		Yes
Rapprich et al	2011	Single arm	25	"mean 38.0 ±
12.5 years"		"Twenty
patients had lipedema affecting the
whole leg, 3 had lipedema of the thigh,
and 2 had lower leg involvement only"		Liposuction	Follow up of 6 months	"Patients were treated in 1 to 5 sessions
(mean 2.5 ± 1.1, median 2). aspiration volume was an average of
2 482 ± 968 ml and the pure fat component was on average 1 909 ± 874 ml,
or 77 %."	The volume of the leg was reduced by 6.99 %. Pain, as the predominant symptom in lipedema, was significantly reduced from 7.2 ± 2.2 to 2.1 ± 2.1 (p < 0.001). Quality of life as a measure of the psychological strain caused by lipedema improved from 8.7 ± 1.7 to 3.6 ± 2.5 (p < 0.001)		Liposuction reduces the symptoms of lipedema significantly.	Liposuction is an effective treatment for lipedema-results of a study with 25 patients	Yes
Földi et al	2000	Single arm	261 ( 68 lymphedema, lympho-lipedema 103, lipedema 90)	Median 51		All	All	Varicose veins operation			Group 2: Swelling increased in 75% and was unchanged in 19%, improving only in 5%. Varicogenic symptoms improved only in 0.4% and worsened in 11.6%. Group III Swelling increased postop in 58.2% and remained unchanged in 31.9%, varicogenic symptoms worsened in 16.6% and improved in 0.5%.		Lymphedema and lipedema worsen in vast majority of patients if varicose veins were treated with surgery.	"The role of operative management of varicose veins in patients with lymphedema and/or lipedema of the legs.

"	Yes
Jeziorek et al	2023	CT	48 (24 each)	39.0 years 		All	All	Low-Carbohydrate High-Fat Diet on Laboratory Parameters in Women with Lipedema in Comparison to Overweight/Obese Women	7 months		statistically significant decrease in triglycerides (12.9% in lipedema vs. 33.2% in obesity) and an increase in HDL-C (9.4% in lipedema vs. 7.0% in obesity)LCHF diet did not have a negative impact on liver function and even showed slight improvements in liver parameters. were observed in both study groups. No significant impact on kidney function and in TSH levels the study did not evaluate changes in glucose–insulin functioning in lipedema patients.		LCHF diet may be a valuable nutritional strategy for both lipedema and obese patients, with a beneficial effect on weight, glucose profile, liver function, the concentration of triglycerides, and HDL-C, and with no effect on kidney and thyroid functions. The effect of the LCHF diet on LDL-C varied in different patients.	The Effect of a Low-Carbohydrate High-Fat Diet on Laboratory Parameters in Women with Lipedema in Comparison to Overweight/Obese Women
	Yes
Wright	2023	Single arm	66	51.2 ± 11.3	"34.5 ± 7.5	"			lipedema reduction surgery (liposuction with tumescent anesthesia)			Commom comorbidities hypermobile joints (50.5%), spider/varicose veins (48.6/24.5%), arthritis (29.1%), and hypothyroidism (25.9%). gnificant improvements (P ≤ 0.0009) were found for: (1) knee flexion (10 degrees); (2) gait; (3) Patient-Reported Outcomes Measurement Information System T-score (16%); (4) mobility questions: gait velocity, rising from a chair, stair ascent; (5) RAND Short Form-36 scores: physical functioning, energy/fatigue, emotional well-being, social function, general health; (6) and Bioelectrical impedance analyses total and segmental body fat mass.	The most common complication in 5.5% of these women after LRS was lightheadedness with a 2-g reduction or more in hemoglobin	LRS provided significant improvements to women with lipedema	Lipedema Reduction Surgery Improves Pain, Mobility, Physical Function, and Quality of Life: Case Series Report
	Yes
Sanchez-Jimenez	2023	CT	24 Control (n = 9), Flat (n = 7) and circular (n = 8)				Grade I = 25%; Grade II = 75%	 effect of compression tights on skin temperature in women with lipedema and to assess the effect of different knitting on skin temperature	15 days employing compression tights		skin temperature decreased in the different regions of interest after exercise in all the groups (e.g., anterior thigh (IC95% (−1.1, −0.7 °C) p < 0.001), but no differences were observed in skin temperature between groups before and after walking (p > 0.05) 		The use of compressing tights for 15 days does not alter skin temperature in women with lipedema before and after walking. The absence of differences in skin temperature between tights in the different assessments allows for obtaining the benefits of wearing compression tights during exercise without negative thermal effects.		Yes
Apkhanova et al	2021	RCT	60				All	Group 1 received a lowcalorie diet (LCD), physical exercises in the gym (PE), and physical activity (FA) in the form of daily walking up to 3-5 km/ day. Group 2 received a modified version of the Atkins ketogenic diet, physical exercises in the gym and FA, as well as nutraceutical correction of increased appetite, probiotic intestinal composition, hepatoprotection	4 WEeks		 After treatment, patients in 1st group showed a decrease in body weight, lean and active cell mass, a decrease in musculoskeletal mass, and a decrease in total water due to extracellular water. A decrease in total cholesterol and high density lipoproteins (HDL) fraction, an increase in blood triglyceride fraction was noted. Leptin decreased by 12.73%. Patients of the 2nd group showed a decrease in body weight, fat mass, lean mass, total water and extracellular water. There was a decrease in total cholesterol, triglycerides, transaminases. Leptin decreased by 32.02%, insulin decreased by 9.87%. To prevent the development of fatty hepatosis against the background of the use of KD, patients of the 2nd group received nutraceutical correction: hepatoprotector Gepamin, metaprebiotic Stimbifid-plus, modulating the formation of resident intestinal microbiota. To reduce appetite, the patients of the 2nd group were also prescribed anorexic - an algal product Nativ containing the polysaccharide fucoidan, having a prebiotic effect. Improvement of reparative processes in the liver, suppression of oxidative processes also contributed to the restoration of the sensitivity of insulin receptors, which was confirmed by the normalization of the lipid-carbohydrate spectrum of blood in patients of the 2nd group after the course of the treatment. The insulin decrease in patients of Group 2 indicated not only insulin resistance decrease , but also the lipogenesis decrease and stimulation of lipolysis. Adipose tissue reduction due to lipolysis stimulation was also indicated by a decrease in leptin expression.		Thus, a ketogenic diet, accompanied by nutraceutical correction of the intestinal microbiome and hepatoprotection can be effectively used in combination with physical activity in order to reduce body weight, fat mass and edema, as evidenced by a decrease in the expression level of leptin and insulin, correlating with the levels of fat loss and free water.	Influence of Ketogenic Diet and Nutraceutical Correction in the Complex Treatment of Lower Limbs Lipedema
	Yes
Mendoza et al	2019	RCT	41 (26 lipedema)	47.1	30.12			"IPC devices only applied to the calf versus those applied to
the calf and thigh"	30 minutes		"Both devices achieved a
significant volume and perimeter reduction at calf level, no
differences were found between both. . Pain score were reduced
significantly (p<0.001) by 1.31 points after calf and thigh compression and by 1.27 points after calf compression. No significant differences were found in pain reduction between both
devices"		"Possibly intermittent pneumatic compression applied only to the calf would be enough
to reduce oedema symptoms in many cases."	"Efficacy of intermittent pneumatic compression in
the treatment of oedema comparing calf compression with calf
and thigh compression devices"	Yes
Witte	2022	Single arm	"Lower legs
n=386  Thighs complete
n = 286  Front side thighs
n = 92 Back side thighs/
buttocks
n = 87 Arms
n = 149 "	35.9			All	Water-Jet Assisted Liposuction			"e mild to
moderate circulatory reactions on average. As expected, the best results were obtained
after Lipo-Decompression of the arms. Moderate to severe circulatory reactions could be
observed after Lipo-Decompression of the complete thighs and front sides of the thighs.
With larger aspiration volumes, only for the treatment of the complete thighs in one session with p < 0.05 a relevant, significant difference between a large-volume liposuction >
4,000ml and a low-volume liposuction < 4.000ml could be observed.  "		"large-volume liposuction in lipedema can be
carried out safely by sticking to a standardised surgery procedure and the use of water-
12 of 12
jet assisted liposuction “WAL”. The observed circulatory reaction require an overnight
stay and should not be performed by discharge on the same day. . Postoperative circulatory reactions are common, but on
average,"		Yes
 Rapprich
	2015	Single arm	85					Liposuction	6 months post op	"Almost half (42.9 %) of patients were treated with three sessions. Another 42.9 % of patients were treated with
either one (16.9 %) or two (26.0 %) Mean 2.61 ± 1 sessions."	"Prior to surgery, the patients rated their
pain with a median score of 7 points (mean
6.5 ± 3 points.  median pain score had reduced to 1 (mean 2.12 ± 2 points). Overall,
a significant improvement in leg pain could
be achieved (Wilcoxon test, p <0.001). The sensitivity to touch and tenderness
of the areas affected by lipoedema was
rated preoperatively with a median score of
8 points (mean 6.5 ± 3.0). Fig. 11 shows that
liposuction significantly reduced the sensitivity to touch (Wilcoxon test p<0.001) by
¾ to 2 points (mean 2.4 ± 2.4 points). tendency of the legs to bruise median score of 8 points mean of 8.1 ± 2.2 points reduction of more than 50 % in the symptoms to a median
score of 3 points and a mean of 4.3 ± 31.1. e legs to swell was rated on the 
VAS preoperatively at a median of 7 points. Symptoms when walking initial score of 4.1 ± 3.5 after the operation to 1.2 ± 1.9. 
and a mean of 6.33 ± 3.2. When questioned
6 months after liposuction, the median
score was given as 3 points and the mean as
3.2 ± 2.5. The reduction in quality of life 8.5 +-2 to 3.3 +-2.8"		ymptoms. After completion of the liposuction for lipoedema, a significant improvement in symptoms could be demonstrated for all 15 questions in the survey. The improvement in quality of life was the most impressive. In this investigation, liposuction was found to be an overwhelmingly effective treatment for lipoedema, with an improvement in symptoms that lasted at least 6 months	"Treatment of lipoedema using
 liposuction"	Yes