Professional Statements and Societal Positions Guidelines
CLINICAL PRACTICE GUIDELINES
American Association of Clinical Endocrinologists, Obesity Society, American Society for Metabolic & Bariatric Surgery
In 2013, the American Association of Clinical Endocrinologists, Obesity Society, and American Society for Metabolic & Bariatric Surgery updated a co-sponsored guideline regarding perioperative support of bariatric surgery individuals. The group stated that adequate healing time from bariatric surgery takes 12 to 18 months.
German Society of Phlebology (DPG)
In 2017, the German Society of Phlebology published guidelines on lipedema diagnosis and treatment. The guidelines state:
'Treatment consists of four (4) therapeutic mainstays that should be combined as necessary and address current clinical symptoms: complex physical therapy (manual lymphatic drainage, compression therapy, exercise therapy, and skin care), liposuction and plastic surgery, diet, and physical activity, as well as psychotherapy if necessary. Surgical procedures are indicated if - despite thorough conservative treatment - symptoms persist, or if there is progression of clinical findings and/or symptoms. If present, morbid obesity should be therapeutically addressed prior to liposuction.'
Dutch Society of Dermatology and Venereology
In 2016, the Dutch Society of Dermatology and Venereology published guidelines on lipedema. The guidelines found that there is inconsistent information concerning diagnosis and treatment of lipedema in the literature, and that the condition is likely frequently misdiagnosed or wrongfully diagnosed as only an aesthetic problem, leading to poor treatment. The guidelines recommend the following:
'To ensure early detection and an individually outlined follow-up, the committee advises the use of a minimum data set of (repeated) measurements of waist circumference, circumference of involved limbs, body mass index and scoring of the level of daily practice and psychosocial distress. Promotion of a healthy lifestyle with individually adjusted weight control measures, graded activity training programs, edema reduction, and other supportive measures are pillars of conservative therapy. Tumescent liposuction is the treatment of choice for individuals with a suitable health profile and/or inadequate response to conservative and supportive measures.