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Dealing with lipoedema: women's experiences of healthcare, self-care, and treatments-a mixed-methods study
Jönköping University, School of Health and Welfare, HHJ, Department of Nursing Science. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.ORCID iD: 0000-0003-4292-5493
Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.
Jönköping University, School of Health and Welfare, HHJ, Department of Social Work. Academy for Health and Care, Futurum, Jönköping County Council, Jönköping, Sweden.ORCID iD: 0000-0001-6804-9490
Jönköping University, School of Health and Welfare, HHJ, Department of Nursing Science. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.ORCID iD: 0000-0002-0848-6098
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2025 (English)In: BMC Women's Health, E-ISSN 1472-6874, Vol. 25, no 1, article id 171Article in journal (Refereed) Published
Sustainable development
00. Sustainable Development, 3. Good health and well-being
Abstract [en]

BACKGROUND: Lipoedema is a loose connective tissue disease primarily affecting women characterized by an abnormal build-up of painful fat in the legs and arms. In healthcare, lipoedema is often confused with obesity, and today, diagnostic tools and standardized guidelines for adequate treatments are lacking. Still, research on how affected women manage their health problems and whether they are satisfied with their care remains sparse. Therefore, this study aimed to contribute knowledge on healthcare experiences, and their use and self-reported effects of self-care and treatments among women with lipoedema.

METHODS: This national study, with a mixed-methods design, involved 245 women with lipoedema, recruited from all Lipoedema Association groups across Sweden. Data were collected between June and September 2021 through an online survey that included closed- and open-ended questions on self-care, lipoedema treatment, patient satisfaction, and healthcare experiences. Data were analysed using descriptive and inferential statistics, and qualitative reflexive thematic analysis.

RESULTS: The results showed a delay in diagnosis spanning decades, often preceded by numerous healthcare visits. Many women attempted to cope with their health problems using various self-care approaches. However, lipoedema treatments performed by healthcare providers were deemed the most effective. Overall, the women reported significantly low satisfaction with healthcare. The lowest score, 48 points out of 100, was found in the overall impression of offered care, reflecting perceived inefficiency and unmet expectations. Compared to a general Swedish female population, the most significant gaps were found in the dimensions of information and knowledge, and emotional support, 22 and 25 points lower, respectively. The women described their experiences in healthcare as a challenging and isolated journey. Four themes were generated: A lonely and demanding journey in the healthcare system; An uncertainty of and inconsistency in available healthcare; A burden of being unheard and disrespected in healthcare; and The impact of lack of knowledge in healthcare.

CONCLUSIONS: Seeking care for lipoedema is a long and burdensome journey with limited access to tailored care. Many women make significant efforts to manage their health problems independently. This emphasizes a need for timely lipoedema diagnosis, improved support, and better access to effective treatments.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2025. Vol. 25, no 1, article id 171
Keywords [en]
Access and evaluation, Health, Health care quality, Lipoedema, Mixed-methods design, Patient experience, Self-care, Surveys and questionnaires, Treatments, Women´s health
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Nursing
Identifiers
URN: urn:nbn:se:hj:diva-67576DOI: 10.1186/s12905-025-03707-1ISI: 001465453300002PubMedID: 40217279Scopus ID: 2-s2.0-105003010652Local ID: GOA;;1012236OAI: oai:DiVA.org:hj-67576DiVA, id: diva2:1952758
Available from: 2025-04-16 Created: 2025-04-16 Last updated: 2025-04-29Bibliographically approved
In thesis
1. Women with lipedema: an exploration of health, quality of life, social life, and healthcare experiences
Open this publication in new window or tab >>Women with lipedema: an exploration of health, quality of life, social life, and healthcare experiences
2025 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Lipedema is a chronic disease of adipose tissue, predominantly affecting women. Its main symptoms include an abnormal accumulation of inflammatory fat in the buttocks, hips, legs, and sometimes arms, which is associated with pain, heaviness, and easy bruising. Lipedema is often misdiagnosed as obesity, and standardized guidelines for its diagnosis and healthcare treatment are currently lacking, risking affected women not receiving adequate care and support. Still, the experiences of women living with lipedema remain unexplored.

Aim: The overall aim of this thesis was to explore health, quality of life, social life, and healthcare experiences among women with lipedema. Methods: This thesis is based on four studies with quantitative, qualitative, and mixed methods designs. The research participants were women with lipedema aged 18 years or older who were recruited from lipedema association groups in Sweden. In studies I–III, data were collected through a national online survey addressing health, health-related quality of life, sense of coherence, experiences of healthcare, self-care and treatments, health-related stigma, and social support. In study IV, data was collected through semi-structured interviews on women’s experiences of sexual health and intimate relationships while living with lipedema.

Results: Women with lipedema reported substantial physical burden, including chronic pain, swelling, leg heaviness, numbness, cold skin, feeling cold, easy bruising, and sleep problems. In addition, almost all participants reported having comorbidities. Moreover, the results revealed the extent of diagnostic delays, often spanning decades, and inadequate healthcare support, leading to dissatisfaction and unmet needs. Many women strived to manage their symptoms through self-care. However, lipedema treatments performed by healthcare professionals were reported to be more effective, but access to them was limited. Compared to an age-matched female general population, women with lipedema reported a significantly lower health-related quality of life and significantly higher levels of health-related stigma. Lipedema also negatively impacted sexual health and intimate relationships, with the affected women experiencing body shame, avoidance of intimacy, and emotional distress.

Conclusion: Lipedema significantly and negatively impacts health, quality of life, and social life. Despite the complex health issues affecting daily life, many affected women lack prerequisite care and support. Increased knowledge and competence among healthcare professionals regarding this disease, a multidisciplinary approach, and equal access to care and treatment are required to ensure early detection and provide support for women with lipedema. Keywords: Health, health-related quality of life, lipedema, mixed methods design, national survey, patient experiences, quality of care, sense of coherence, sexual health, social support, stigma, women’s health.

Place, publisher, year, edition, pages
Jönköping: Jönköping University, School of Health and Welfare, 2025. p. 88
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 144
Keywords
Health, health-related quality of life, lipedema, mixed methods design, national survey, patient experiences, quality of care, sense of coherence, sexual health, social support, stigma, women’s health
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-67680 (URN)978-91-88669-63-6 (ISBN)978-91-88669-64-3 (ISBN)
Public defence
2025-05-23, Forum Humanum, School of Health and Welfare, Jönköping, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2025-04-29 Created: 2025-04-29 Last updated: 2025-04-29Bibliographically approved

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Falck, JohannaRolander, BoJonasson, Lise-LotteMårtensson, Jan

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