Fat is well known to store fat and give us shape. By definition, fat is a loose connective tissue that has within it not only fat cells that store fat as triglyceride for energy, but also other cells such as fibroblasts which lay down connective tissue and immune cells which help survey and protect the tissue against invaders but also help to repair damaged tissue. Fat tissue is richly innervated by nerves. Blood vessels supply oxygen and nutrients to the tissue and lymphatic vessels remove unused nutrients, cell waste and excess fluid. Fat is therefore a complex loose connective tissue.
Sick Fat Tissue
When loose connective tissue becomes sick, it is inflamed. There are more immune cells present in higher numbers when connective tissue is inflamed. These cells include lymphocytes which can act as directors of the inflammatory process, and macrophages which can eat and remove excess fat and tissue. The macrophages direct fibroblasts to lay down connective tissue. When the connective tissue is laid down after inflammation, we call this fibrosis. The fibrosis when extensive can alter blood flow into the tissue and lymphatic flow out which can cause the fat cells to malfunction, meaning the fat cells lose their ability to respond to normal signals such as calorie restriction or exercise. Instead, the tissue become resistant to loss by diet, exercise or even bariatric surgery. When nerves sit within the inflamed and fibrotic tissue, they can also become damaged causing pain and eventually loss of function, called neuropathy. Healing the tissue can restore nerve function if treated early.
Lipedema is a loose connective tissue disease whereby fat tissue on the hips, buttocks, thighs, lower legs and arms becomes inflamed and fibrotic resulting in the inability to lose this fat normally through diet, exercise or bariatric surgery. Lipedema primarily occurs in women and is rare in men. About 50% of women with lipedema are thought to have hypermobile Ehlers-Danlos syndrome (hEDS) which is a connective tissue disease. The gene for hEDS is not known. In lipedema, weak blood vessels may leak out more fluid into the tissue causing inflammation and fibrosis.
Research on Lipedema
Research on lipedema is increasing but many of the studies are on small numbers of women. FACT Research aims to increase research on lipedema in larger numbers of women especially after treatment including lipedema reduction surgery.
The growth of painful lipomas is the Hallmark of Dercum’s disease. The lipomas can be made of primarily fat or they can also contain a lot of blood vessels called angioliopomas. There may be a genetic component to Dercum’s disease or the body may not be able to heal properly after an insult resulting in the formation of lipomas. The lipomas in Dercum’s disease are very painful and also associated with many signs and symptoms such as fatigue and joint and muscle aches.
Research on Dercum’s Disease
Very little research has been done on Dercum’s disease. FACT Research aims to increase research on Dercum’s disease.