The advice was shared by Dr Nighat Arif, a GP andmedical educator known for her appearances on BBC and ITV
A GP has warned that struggling to lose weight could be a sign of a chronic condition. Sharing an informative video on TikTok, Dr Nighat Arif (@drnighatarif), a GP who specialises in women’s health, highlighted a condition that’s estimated to affect up to 10% of the adult female population.
Known for her appearances on BBC and ITV, the medical educator titled her video: “Four ways to get a lipodema diagnosis on the NHS.” In her video, Dr Nighat highlighted symptoms associated with lipoedema and explained how it is diagnosed. She told her 270,000 followers: “The last one, you might actually be able to do that at home by yourself.”
Dr Nighat said: “Firstly, understanding the symptoms is the key bit. If you’re finding that you’re not losing any weight despite having a calorie-restrictive diet and exercising, and you’re getting swelling elsewhere, but your hand and your feet are not being affected, then you might want to think of the diagnosis of lipodema, because there are some characteristic hallmark signs and symptoms.
“So you want to look for symmetrical fatty tissue. So fat build-up in both sides, and it’s symmetrical on the upper and the lower limbs, and the hands and the feet are spared. So typically, that’s not where you’re getting the fatty deposits, and it’s known as the cuff phenomenon or the elastic band, so the hands are slim and the feet are slim.
“Also, you want to look for pain and tenderness. So in the affected areas, the person will feel that they’re getting a lot of tenderness, particularly if you apply pressure to that. So pressure to the legs, and you’re finding that you’re tender. And also you’re finding that you’re getting a feeling of heaviness and tension in the affected limbs.”
She continued: “There’s a tendency to have cold skin, which worsens over the course of the day, and easy bruising. So without doing anything, you’re finding in your lower limbs or your upper limbs, you’re finding that you’re just easily getting these marks, or bruises, known as haematomas.”
Dr Nighat said that lipoedema is a ‘progressive condition.’ It is recognised as a chronic and lifelong condition that currently has no cure. However, it can be managed with treatments such as liposuction, manual lymphatic drainage, and lifestyle changes like healthy eating and exercise, which can help slow its progression and ease symptoms.
The doctor explained: “It’s a whole body lifelong inflammatory condition, and it mainly affects about 10% of the female population. Now, male sufferers have also been described as getting this, but that’s actually just only a few case reports that we’ve noted. It’s the initial signs of lipodema which we need to look out for, and they usually arise in the phases of hormonal changes.” This might include puberty, pregnancy, and menopause, she said.
“Not all people get all the symptoms,” the expert added. However, Dr Nighat said it’s well worth looking out for them. The GP advised: “You might need to do your own research and be aware of other related conditions such as lymphoedema, obesity and venous insufficiency, which are also related conditions and often diagnosed instead of lipoedema.”
She continued: “Look around in your family. We think that there could be a genetic predisposition. As much as 60% of patients have an affected first-degree relative. So that’s mum, sister or daughter.”
Concluding her video, Dr Nighat told people to ask to see their doctor and to share their symptom history and any ideas they might have. “Share your ideas and concerns and expectations, and say that it might be that you need a referral to a specialist clinic.”
The GP added that you might need tests such as a baseline blood test or lipid profile. She also said your doctor should take your menstrual history to examine hormonal changes.
In some cases, she said the doctor might perform a stemmer test. “A negative stemmer test is one of the criteria for lipoedema diagnosis. So just a reminder, if you don’t know, a negative sign, which is normal, is when you can fold the skin at the base of the second toe. So if you gently pinch the skin between the second toe and that can be pinched up and lifted that’s a negative sign.” She explained that a positive sign could indicate lymphoedema.
Dr Nighat said: “It can sometimes take a long time to get the correct diagnosis. Be your own detective. You are not being the problem by asking for a second, third, or fourth opinion. You are just simply advocating for your health. Because I see it. There are long-term complications of lipoedema, including chronic pain, mobility issues, joint pains, and the development of lymphoedema. There’s also psychological impact and emotional challenges. such as depression, anxiety, eating disorders and body image issues.”
The NHS says to see a GP if you have symptoms of lipoedema or swollen legs, ankles, or feet that have not improved after a few days. If your leg or legs become swollen, red, hot, and painful and you have flu-like symptoms, you should ask for an urgent GP appointment or get help from NHS 111. More information is available from Lipoedema UK.