Why Does Obesity Cause Chronic Edema?

Lipedema is a type of edema caused by abnormal fat buildup that’s symmetrical, meaning it’s equally present on both sides of the body. It’s more prevalent in women and the areas most commonly affected are  hips, thighs, legs and arms. Lipedema is also characterized by the disproportionate distribution of fat or adipose tissue while other parts of the body, such as the midsection, remain slimmer. While obesity affects the entire body, edema and lipedema cause localized fat buildup in specific parts of the body. It’s possible to have both obesity and edema/lipedema concurrently. 

5 ways obesity can lead to chronic edema

Edema is more common in people who have obesity. Obesity can contribute to the development of chronic edema because of extra pressure placed on the veins and circulatory system as well as lymphatic abnormalities. Various factors play a role in the complex relationship between obesity and edema:

1. Excessive fluid in fatty tissue: Obesity is associated with excess body fat throughout the body. As the amount of body fat increases, the fatty tissue must expand to make room for the excess fat. Under these circumstances, water can build up in the fatty tissue, causing swelling and fluid accumulation that results in edema.  
2. Pressure on lymphatic vessels: The primary role of the lymphatic system is to maintain fluid balance in the blood. In patients with obesity, excess fat places added pressure on the lymphatic vessels, which can slow or stop the flow of lymph fluid. This causes extra fluid to accumulate in bodily tissue, resulting in swelling or edema. 
3. Impaired breathing: In patients with obesity, excess body fat can weaken the respiratory muscles, resulting  in impaired breathing and lung function. Proper breathing helps move lymph. If breathing is disrupted, lymph does not drain adequately, leading to fluid buildup and edema. Obesity also causes mechanical compression of the diaphragm, lungs and chest cavity, which can lead to restrictive pulmonary damage. 
4. Limited physical activity: Physical activity helps prevent fluid buildup in bodily tissue by promoting lymph drainage. Insufficient activity interferes with blood flow and circulation, causing lymph accumulation.  
5. Chronic venous disorders: Obesity is a risk factor for venous disorders, which are diseases that damage the veins responsible for carrying blood from organs and tissues back to the heart. When this process is impaired, increased pressure in lower extremity veins can lead to edema. 

Can being overweight cause edema in legs?

A 2021 study found that lower-leg edema is common in patients who have obesity due to abnormal fat accumulation. Edema can make legs look swollen or puffy, and feel heavy. Not all overweight patients will experience leg swelling, and obesity isn’t the only medical condition that can cause edema in the legs. If you’re experiencing leg swelling, a healthcare provider can evaluate you and address your concerns.  

Does weight loss help with edema?

Weight loss can help reduce the severity of edema. Losing weight is recommended to mitigate the impact of health issues that contribute to edema, such as obesity, heart disease and chronic venous disorders. Traditional weight-loss measures typically aren’t effective for edema, especially if other medical conditions are involved. If you have edema, you might find it hard to lose weight in the affected areas even if the rest of your body changes size. While weight loss can help manage edema, it’s best to see a healthcare professional for personalized guidance.

5 tips for weight loss

1. A balanced diet: Consuming a balanced, nutritious diet is essential for weight loss.  Manage your portion sizes to prevent overeating, pay attention to food labels, and eat regular meals. Consuming nutrition-dense foods such as fruits, vegetables, and whole grains can help you stay fuller, longer.
2. Regular exercise: Aerobic exercise, such as brisk walking, jogging and biking, is especially beneficial for weight loss. Strength training helps preserve muscle mass during weight loss.
3. Adequate sleep: Lack of sleep can cause weight gain due to increased calorie intake during waking hours and impairment of hunger hormones. Aim for at least seven hours of sleep every night.
4. Support and guidance: A sense of community can help you during your weight loss journey. Consider joining a gym with fitness classes or a support group. It’s also helpful to work with a professional, such as a dietitian, nutritionist or physician, who can help you achieve your goal in a healthy way. 
5. Medication: People who are overweight or have obesity might benefit from taking a weight-loss drug, such as semaglutide (the active ingredient in Wegovy and Ozempic)  or another GLP-1 agonist.