A Detailed Examination of the Effects of Ketogenic Diet on Lipoedema

4/28/2026

Fundamental Principles of the Ketogenic Diet and Its Relationship with Lipoedema

The ketogenic diet is defined as a nutritional approach characterized by low carbohydrates and high fats. The primary aim of this diet is to convert the body's energy source from glucose to ketone bodies. Lipoedema is a condition, typically seen in women, characterized by excessive fat accumulation in the lower extremities. The effects of the ketogenic diet on lipoedema have become a research topic in recent years, and conflicting findings have emerged on this subject. Some studies suggest that the ketogenic diet may positively affect body fat composition in individuals with lipoedema [1].

The positive effects of the ketogenic diet on inflammation are also noteworthy. The pathophysiology of lipoedema is often associated with chronic inflammation, and in this context, the anti-inflammatory properties of the ketogenic diet may present a potential strategy for managing this condition [2]. However, the side effects observed in some individuals during the application of the ketogenic diet and its long-term effects are not yet clearly understood.

This article will comprehensively address the effects of the ketogenic diet on lipoedema, its potential benefits, and possible harms. Additionally, the protective role of lipoedema, its metabolic effects, and differing views on treatment will also be discussed.

Positive Effects of the Ketogenic Diet on Lipoedema

The positive effects of the ketogenic diet on lipoedema have been studied in numerous research projects. For instance, a study conducted by Lundanes et al. (2024) thoroughly examined the effects of low-carbohydrate diets on pain and quality of life in women with lipoedema. In this study, a significant reduction in pain levels among participants was observed [3].

The effects of the ketogenic diet on adipose tissue are also important. A study by Jeziorek et al. (2023) revealed that low-carbohydrate diets positively influence body composition. In individuals with lipoedema, a reduction in leg volume and a decrease in overall body fat percentage were observed as a result of following a ketogenic diet [4]. These findings support the potential benefits of the ketogenic diet in the treatment of lipoedema.

Another advantage of the ketogenic diet is its ability to lower insulin levels. Lipoedema is associated with insulin resistance; therefore, managing insulin levels may contribute positively to the treatment process in individuals with lipoedema. Low carbohydrate intake can effectively reduce insulin levels and decrease fat storage [5].

Potential Harms and Side Effects of the Ketogenic Diet

While the ketogenic diet has some positive effects, potential harms and side effects should also be considered. It is believed that long-term application may have negative effects on metabolism. Extended use of the ketogenic diet may lead to vitamin and mineral deficiencies, which could result in additional health issues in individuals with lipoedema [6].

Another concern is the psychological effects of the ketogenic diet. Low carbohydrate intake could lead to mood changes and eating disorders in some individuals. Particularly, individuals with lipoedema may be psychologically more sensitive to these issues. Therefore, creating diet plans that include psychological support is important [3].

Additionally, due to the unique pathophysiology of lipoedema, it should not be forgotten that the ketogenic diet may not yield the same positive effect in every individual. Genetic and hormonal differences could alter the diet's effectiveness. Thus, adopting a personalized approach rather than considering the ketogenic diet as a primary treatment for lipoedema is essential [7].

The Protective Role of Lipoedema: A Metabolic Perspective

Although lipoedema is often perceived as a negative condition, some researchers suggest that it may have a protective role. A study conducted by Amato (2025) stated that lipoedema could function as a protective mechanism in terms of energy storage and chronic inflammation [8]. This perspective leads to the evaluation of lipoedema as an adaptation developed to protect the body, particularly during pregnancy.

In this context, it is thought that the adipose tissue of lipoedema may function as an energy reserve in a manner similar to that of adipose tissue during pregnancy. This situation may enhance the body's ability to cope with stressful conditions. The idea that lipoedema reflects the body's fat storage mechanisms and may be protective under specific conditions requires further research [9].

Furthermore, the effects of lipoedema on inflammation should also be considered. In individuals with lipoedema, adipose tissue may lead to the release of inflammatory cytokines. However, the positive or negative effects of this situation on the overall health of the body have yet to be clarified. Therefore, the protective role of lipoedema and how this role is evaluated in clinical management is an important topic of discussion [10].

Nutritional Approaches and Lipoedema Management

Beyond the ketogenic diet, different nutritional approaches are also suggested for managing lipoedema. Low-fat diets, the Mediterranean diet, and other dietary protocols are alternatives that can be considered in managing lipoedema. A systematic review conducted by De Oliveira et al. (2025) evaluated the effects of these diets on lipoedema and showed that certain diets could improve patients' overall health [2].

Moreover, individuals' dietary preferences and cultural factors can also influence diet choices. Considering individual differences in the treatment of lipoedema may enhance the success of the treatment process. Therefore, adopting a multidisciplinary approach is recommended; nutritionists, physiotherapists, and psychologists can work together to develop strategies suitable for the needs of individuals with lipoedema [11].

In conclusion, developing customized nutrition plans that address individual needs is important in the management of lipoedema, alongside specialized dietary approaches like the ketogenic diet. This provides a holistic approach that considers not only physical symptoms but also psychological health conditions.

Clinical Trials and Future Research

Clinical trials evaluating the effects of the ketogenic diet on lipoedema are critical for increasing knowledge in this field. In recent years, numerous randomized controlled studies have been conducted investigating the effects of the ketogenic diet on women with lipoedema. The results of these studies indicate that the ketogenic diet provides positive effects on pain, body fat composition, and quality of life in individuals with lipoedema [5][6].

Future research should include the long-term effects of the ketogenic diet, its side effects, and comparisons with other dietary approaches. Additionally, further research on the pathophysiology of lipoedema could help in developing new strategies for managing this condition [12].

In summary, the effects of the ketogenic diet and other nutritional approaches on lipoedema should be addressed within a multidisciplinary framework, and personalized solutions should be developed. Effective and sustainable treatment methods should be established, taking into account individuals' health statuses, genetic backgrounds, and psychological needs.

References

Amato ACM, Amato JLS, Benitti DA (2024). The Efficacy of Ketogenic Diets (Low Carbohydrate; High Fat) as a Potential Nutritional Intervention for Lipedema: A Systematic Review and Meta-Analysis.. Nutrients. PubMed.https://doi.org/10.3390/nu16193276
de Oliveira J, de Paula ACP, Guimarães VHD (2025). Clinical or cultural? Dietary interventions for lipedema: a systematic review.. Maturitas. PubMed.https://doi.org/10.1016/j.maturitas.2025.108716
Lundanes J, Sandnes F, Gjeilo KH, Hansson P, Salater S, Martins C, Nymo S (2024). Effect of a low-carbohydrate diet on pain and quality of life in female patients with lipedema: a randomized controlled trial.. Obesity (Silver Spring, Md.). PubMed.https://doi.org/10.1002/oby.24026
Jeziorek M, Chachaj A, Sowicz M, Adaszyńska A, Truszyński A, Putek J, Kujawa K, Szuba A (2023). The Benefits of Low-Carbohydrate, High-Fat (LCHF) Diet on Body Composition, Leg Volume, and Pain in Women with Lipedema.. Journal of obesity. PubMed.https://doi.org/10.1155/2023/5826630
Lundanes J, Storliløkken GE, Solem MS, Dankel SN, Tangvik RJ, Ødegård R, Holst JJ, Rehfeld JF, Martins C, Nymo S (2025). Gastrointestinal hormones and subjective ratings of appetite after low-carbohydrate vs low-fat low-energy diets in females with lipedema - A randomized controlled trial.. Clinical nutrition ESPEN. PubMed.https://doi.org/10.1016/j.clnesp.2024.11.018
Lundanes J, Naustvoll TG, Tangvik RJ, Martins C, Nymo S. (2025). Hedonic hunger and eating behavior after low-carbohydrate versus low-fat diets in females with lipedema and obesity.. Europe PMC.https://doi.org/10.3389/fnut.2025.1716592
▼Abstract
<h4>Introduction</h4>Lipedema is a chronic female disease, characterized by an excessive accumulation of subcutaneous adipose tissue in the limbs and is commonly mistaken for obesity, although the two conditions often coexist. Obesity is associated with increased hedonic hunger and dysfunctional eating behavior. However, these aspects have not been investigated in females with lipedema and obesity.<h4>Objectives</h4>The objective of this secondary analysis from a randomized controlled trial was to compare changes in hedonic hunger and eating behavior following two different low-energy diets, low-carbohydrate (CHO) or low-fat, in females with lipedema and obesity.<h4>Methods</h4>Females with lipedema and obesity (body mass index (BMI) 30-45 kg/m<sup>2</sup>) were randomized to two different low-energy diets (1,200 kcal), low-CHO diet (LCD) (75 g CHO) or low-fat diet (180 g CHO) for 8 weeks. Hedonic hunger was assessed using the power of food scale (PFS) and eating behavior was assessed using the Dutch Eating Behavior Questionnaire (DEBQ) pre- and post-intervention.<h4>Results</h4>A total of 70 females were included with a mean age of 47 years, and a BMI of 37 kg/m<sup>2</sup>. The LCD group reported a reduction in Food Present (<i>p</i> < 0.001) and in Aggregated Score (<i>p</i> = 0.035) from the PFS, while no changes were seen in the low-fat diet group, with changes in Food Present over time being significantly different between groups (<i>p</i> = 0.050). The low-fat diet group reported increases in Restrained Eating from the DEBQ (<i>p</i> = 0.036) while only the LCD group reported decreases in Diffuse Emotions (<i>p</i> = 0.040), however, no differences between groups were found.<h4>Conclusion</h4>A LCD may induce more favorable changes in hedonic hunger and eating behavior than an isocaloric low-fat diet in females with lipedema, which may be related to altered metabolic signaling pathways related to satiety and reward.
Lundanes J, Nes VF, Aakervik O, Ryan L, Hansson P, Rokstad AM, Martins C, Nymo S (2025). Changes in Cytokines and Fibrotic Growth Factors after Low-Carbohydrate or Low-Fat Low-Energy Diets in Females with Lipedema.. Current developments in nutrition. PubMed.https://doi.org/10.1016/j.cdnut.2025.104571
Amato AC. (2025). The Evolutionary Theory of Lipedema: A Perspective on Energy Storage and Chronic Inflammation.. Europe PMC.https://doi.org/10.7759/cureus.88809
▼Abstract
Lipedema, characterized by the disproportionate accumulation of fat in the lower extremities, pain, and tenderness, is frequently misdiagnosed and underestimated. This evolutionary perspective reframes lipedema as an ancestral adaptive mechanism for energy storage, crucial in prehistory for female survival during periods of food scarcity. Subcutaneous fat, predominant in lipedema, conferred energetic, thermoregulatory, and cardioprotective advantages - especially for women during pregnancy and lactation - unlike men's visceral fat, which is geared toward rapid mobilization. In the modern context, inflammatory triggers such as pollution, stress, and gluten-rich diets exacerbate chronic inflammation, turning lipedema into a clinical challenge. Inflammation acts as a warning signal, and its management - rather than indiscriminate surgical removal of adipose tissue, an essential endocrine organ - is fundamental. Extensive liposuction may lead to postoperative adipose endocrine insufficiency, with metabolic and hormonal imbalances. Conservative strategies, such as ketogenic or gluten-free diets, moderate exercise, and stress management, foster a favorable metabolic environment, allowing mobilization of stored fat. This editorial advocates for a holistic and individualized approach, highlighting the connection between lipedema and conditions such as attention-deficit/hyperactivity disorder (ADHD), calls for further research into the interaction between genetics, inflammation, and environmental factors, and urges increased awareness of lipedema as a legitimate medical condition.
Lundanes J, Nes VF, Hansson P, Fristedt R, Landberg R, Martins C, Nymo S. (2026). Changes in plasma fatty acid composition in females with lipedema following low-carbohydrate vs low-fat diets and associations with pain reduction.. Europe PMC.https://doi.org/10.1186/s12937-026-01304-y
Amato AC, Amato JS, Benitti D, Santos KD. (2025). Lipedema in Men: A Retrospective Case Series of Five Patients From a Brazilian Referral Center.. Europe PMC.https://doi.org/10.7759/cureus.87332
▼Abstract
Lipedema is a chronic adipose tissue disorder traditionally considered to affect almost exclusively women, with recent estimates suggesting approximately 0.2% prevalence in men worldwide; the condition remains underdiagnosed in males due to limited awareness and scarce literature. This retrospective case series from the Amato Institute of Advanced Medicine in São Paulo, Brazil, describes clinical characteristics, diagnostic findings, and treatment outcomes of five male patients diagnosed with lipedema between January 2022 and December 2024. The patients, aged 31-58 years (mean, 42.6 ± 9.7), with a BMI of 29-42.4 kg/m², all presented bilateral, symmetrical lower extremity fat accumulation, sparing the feet, with endocrine comorbidities present in 80% of cases and one participant testing positive for HLA-DQ2/DQ8. Diagnosis was based on clinical criteria requiring bilateral symmetrical fat accumulation, disproportionate fat distribution, negative Stemmer's sign, sparing of feet, and at least two minor criteria. Conservative management, including dietary interventions over four to eight weeks, resulted in mean weight reduction of 7.0 ± 2.2 kg and lower limb volume reduction of 2.5 ± 1.1 L. These findings demonstrate that lipedema occurs in men with classical phenotypic features, and the presence of HLA-DQ2/DQ8 markers in some cases suggests potential autoimmune components and opportunities for targeted dietary interventions. Conservative management yields significant short-term improvements, warranting larger prospective studies to establish prevalence, investigate HLA associations, and optimize management strategies for male lipedema.
Kuttiatt VS, Anandan M, Elangovan N, Sadhasivam A. (2026). Report of two cases of lipedema: An under-recognized, misdiagnosed, and under-reported disorder in India.. Europe PMC.https://doi.org/10.4103/jpgm.jpgm_273_25
▼Abstract
<h4>Abstract</h4>Lipedema is a chronic adipose tissue disorder primarily affecting women, marked by abnormal, symmetrical, and disproportionate accumulation of subcutaneous fat in the lower limbs and sometimes in the arms, with hands and feet typically spared. Frequently misdiagnosed as lymphedema or obesity, lipedema presents with pain, easy bruising, bilateral nonpitting edema, and swelling that worsens throughout the day. We present two cases: Two middle-aged women reported longstanding bilateral lower limb swelling, pain, and varicose veins, without significant comorbidities. Clinical examination revealed characteristic disproportionate fat distribution and negative Stemmer's sign. Laboratory investigations and lymphoscintigraphy excluded other causes of edema. Imaging confirmed subcutaneous thickening, fat stranding, and varicosities. Both patients were advised to have conservative management including compression therapy, limb elevation, physiotherapy and dietary counseling; one patient had significant limb volume reduction. Our report underscores the importance of recognizing lipedema for early diagnosis and effective management to prevent progression and complications.
Giovanna, Pitotti (2024). Lipedema and Nutrition: High Fat Ketogenic Diet as Treatment of Choice. Journal of Gastroenterology & Hepatology Reports. Crossref.https://doi.org/10.47363/jghr/2024(5)163
▼Abstract
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