Swollen Feet: Lymphedema, Lipedema or Obesity
Swelling in the legs is usually due to excessive accumulation of fluid (lymph) in the soft subcutaneous and muscle tissues.
The medical term used to describe this condition is peripheral edema or lymphedema.
There are many reasons why your legs may be swollen, the most common: venous insufficiency, pregnancy, infections, thrombosis, medications and in older people, heart or kidney failure.
Lymphedema can occur after lymph node removal surgery for neoplasms (e.g. breast cancer causes swelling in the upper limb), after radiation therapy or even due to cancer when it invades and blocks the lymph nodes in the pelvic / abdominal area.
Sometimes, however, “swollen” feet are the result of a fat storage disorder called lipoedema and is mistakenly confused with obesity. It affects women exclusively, begins in adolescence, and is characterized by a body type with large hips and legs disproportionate to the rest of the body. One characteristic of lipoedema is that the fat in these areas is resistant to weight loss efforts through diet and exercise.
Today, we know much better the physiology of lipoedema and we have ways to significantly reduce it or at least prevent its progression.
Diagnosing the cause of swollen feet is simple and usually a good history and a clinical examination by your vascular surgeon are sufficient. If there is suspicion of coexisting venous insufficiency, you will be asked to have an ultrasound of the veins.
A proper diet with limited salt intake, daily exercise and elastic stockings with graduated compression combined with lymphatic massage can significantly help reduce edema. Consult your vascular surgeon.
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