According to gradphysics.com, lipodystrophy is a change in the subcutaneous fatty tissue or the fatty tissue that envelops the organs. A distinction is made between two forms, the loss of fatty tissue and the increase in fat deposits.
What is lipodystrophy?
The loss of fatty tissue is called lipoatrophy and occurs predominantly on the face, arms and legs, while an increase in subcutaneous fatty tissue – lipohypertrophy – is more likely to occur on the trunk and neck. Both types are metabolic disorders which, depending on the cause, regress, but can also be permanent.
The disease itself rarely has serious consequences, but most of those affected suffer severely psychologically from their changed appearance and, in addition, those affected often suffer from certain metabolic diseases.
The causes of lipodystrophy can be very diverse and science is far from knowing all the triggers. One of the known causes is insulin injections. If diabetics frequently inject in the same region of the body and in the same place, the effect of the insulin can lead to increased formation of fatty tissue in this area.
Then, for example, large bumps of fatty tissue develop on the abdomen. This not only looks very ugly, but also leads to another health problem. The injected insulin is increasingly poorly absorbed by the body. Another trigger of lipodystrophy is AIDS or HIV treatment. Here the causes are not yet completely clear.
However, research assumes that it is partly due to the anti-HIV drugs. HIV-infected people are given special drugs to prevent the onset of the disease, and these powerful drugs are very likely to trigger facial and leg fat wasting, so-called buffalo hump, and abdominal fat accumulation.
The information on how many patients are affected varies greatly. Recent studies indicate that between 5 and 50 percent of all people treated with antiretroviral drugs experience these side effects. But other factors could also play a role. Research in this area is still in its infancy.
There are also some genetically determined lipodystrophies. These include Dunningan syndrome and Kobberling syndrome. Both are rather rare inherited metabolic diseases. They arise from gene mutations that disrupt laminin synthesis and tend to affect the lower body. Barraquer-Simons syndrome, another gene mutation that is very rare and occurs in childhood, is not hereditary.
Girls are increasingly affected. Here, too, there is a loss of subcutaneous fatty tissue on the face and trunk. Equally rare is Parry-Romberg syndrome. It is characterized by a unilateral curvature of the face. Here not only the subcutaneous fatty tissue is affected, but often also the bones and muscles.
Symptoms, Ailments & Signs
When someone suffers from lipodystrophy, the external symptoms only become apparent at a late stage. In addition to the cosmetic problems and the associated mental stress, the disease initially causes hardly any symptoms.
In addition to the changed appearance, there is also a risk of various concomitant diseases. Patients with lipodystrophy are more likely than other people to develop diabetes, inflammation of the pancreas, kidney inflammation and certain metabolic diseases.
Diagnosis & disease progression
Bumps caused by insulin injections are, of course, easily recognized by the doctor, and looking for signs of lipodystrophy is certainly part of the treatment regimen for HIV patients. In all other cases, the diagnosis is difficult and often the disease is not recognized immediately. The course of the disease also varies greatly depending on the cause.
Lipodystrophy caused by the insulin injection disappears on its own if the patient no longer puts a needle in the affected area. Doctors therefore urgently recommend changing the injection point again and again. The course of the disease is more difficult to assess in HIV-positive patients with lipodystrophy.
On the one hand, it is not really clear which active ingredients in the medication are responsible for the adipose tissue disorder, or whether there are other factors. On the other hand, one cannot simply do without the drugs because they can prevent the outbreak of AIDS. In the forms of lipodystrophy caused by gene mutations, the course of the disease cannot be predicted either.
In most cases, lipodystrophy primarily leads to mental and psychological stress and symptoms. Those affected are usually dissatisfied with their appearance and suffer from reduced self-esteem or inferiority complexes. Psychological complaints or even depression can continue to develop and thus significantly reduce the patient’s quality of life.
Lipodystrophy also leads to an increased risk of diabetes or inflammation of the pancreas. These can also occur in the kidneys. In the worst case, these can lead to complete kidney failure and thus death. Patients are then dependent on dialysis or a donor organ in order to survive. Likewise, lipodystrophy can cause various metabolic diseases and thus limit the everyday life of those affected.
Treatment of lipodystrophy can take place with the help of medication. The symptoms can also be alleviated with the help of liposuction. Complications usually do not arise. In most cases, the life expectancy of the patient is not changed due to lipodystrophy. Surgical interventions can also be carried out to limit the symptoms.
When should you go to the doctor?
If changes in the subcutaneous fatty tissue are noticed, medical advice is required. While lipodystrophy is not a serious condition, it does require diagnosis and treatment. People who notice unusual changes in their skin or suddenly suffer from physical complaints should ideally inform their family doctor directly. The doctor can identify a problem with fat formation and refer the patient to a nutritionist who will work with the patient to develop an appropriate diet.
Accompanying this, the help of a therapist is often necessary, especially in the case of severe lipodystrophy. The disease is a major burden for most of those affected. Within the framework of therapeutic measures, the disease can be worked up and suitable measures can be developed to restore the former well-being. People who are sick from birth need to be closely monitored. The medication and diet must be regularly adapted to the current state of health of the person concerned so that an optimal course is guaranteed. Those affected should consult their family doctor or an internist. In the case of physical complaints, an orthopedist should also be consulted.
Treatment & Therapy
As already mentioned, there is currently no way to cure lipodystrophy. There are, of course, very effective drugs against the secondary diseases that often result from the disease, such as insulin resistance, impaired glucose tolerance, dyslipidemia and inflammation of the pancreas and kidneys.
Because the fat deposits in the neck, stomach and chest areas that are present with lipohypertrophy are not only unhealthy, but often also cosmetically very disturbing, in some cases liposuction is also a treatment option. However, its sustainability is very questionable and it is not paid for by the health insurance companies.
If there is a lack of subcutaneous fat, especially in the facial area, there is now the option of injecting filling substances into the skin. Depending on the material, these offer a shelf life of around twelve months. The method is also not covered by health insurance and should only be carried out by experienced specialists.
This is the only way to achieve satisfactory cosmetic results and minimize possible side effects. In Parry-Romberg syndrome, plastic surgery is performed due to the severity of the damage and the involvement of the bone substance.
Outlook & Forecast
The prognosis of lipodystrophy is linked to the causative disorder. The disorder of lipid metabolism can be genetic. In these cases there is no recovery. If there is a chronic underlying disease, this also does not lead to a permanent freedom from symptoms. In this case, the existing disease must be cured for changes in the adipose tissue. Only then would a regression of the lipodystrophy be conceivable.
In the case of an HIV infection, there is also no prospect of a cure. Nevertheless, there are good treatment methods for chronic disease progression to alleviate the symptoms. Although no healing will take place, there are rarely serious consequences. In most cases, these concentrate on psychological consequences, since the visual changes result in a state of emotional stress. In very rare cases, it can be observed that the metabolic disorder leads to a serious secondary disease. Nevertheless, if the disease progresses unfavorably, diabetes and renal insufficiency can occur. If left untreated, the latter can lead to a fatal course of the disease.
Patients with lipodystrophy are treated with medication in long-term therapy. In addition, liposuction can be initiated. This procedure is associated with risks and side effects. Nevertheless, it is a routine process that rarely causes complications. In many cases, the person affected learns how to deal well with the disease in everyday life.
There are no preventive measures against the development of lipodystrophy.
Because lipodystrophy is a serious condition that cannot heal on its own, follow-up care focuses on managing the condition well, both physically and mentally. In most cases, those affected suffer from diabetes as a result of lipodystrophy, which requires regular check-ups by the doctor treating them.
Due to the mental stress associated with the disease, those affected sometimes develop depression or moodiness. This can also happen to parents or family members. The further course depends on the individual condition of the person concerned and cannot be generally predicted. In many cases, however, the life expectancy of those affected is significantly reduced by this disease.
You can do that yourself
Since lipodystrophy has not yet been cured, self-help measures focus on alleviating the symptoms. Early liposuction, accompanied by a change in diet, can reduce physical discomfort and cosmetic blemishes. In less severe cases, sporting measures, especially endurance sports such as jogging or swimming, can also help. Alternatively, the fat deposits can be reduced by heat treatment, which can be supported by targeted massages at home.
If the aesthetic flaws represent a significant burden for the person concerned, a therapeutic consultation is also useful. The person concerned should contact their family doctor for this, as it is often possible for the health insurance company to cover the costs. In the long term, however, the cosmetic limitations must be accepted. In particular, the fat deposits in the face and neck can return again and again and thus represent a chronic problem for which no satisfactory treatment has yet been found.
Nevertheless, close medical monitoring is important, as lipodystrophy increases the risk of diabetes, pancreatic inflammation and other diseases. To avoid complications, patients should see a doctor if they have any unusual symptoms.