Lipedema & Stress: Cortisol, Inflammation and Mental Health
What cortisol, inflammation and looking in the mirror have to do with one another
For many women with lipedema, looking in the mirror is associated with negative feelings. Their legs seem too large, their proportions do not match the rest of their body, and despite exercise or weight loss, their body often does not change in the way they would like.
What may seem to outsiders like a purely aesthetic issue can become a significant psychological burden for those affected. Frustration, shame, constant self-monitoring or the feeling of not being comfortable in one’s own body can cause stress for years.
And this stress does not just take place in the mind. Our body reacts to it – among other things by releasing cortisol.
What happens to cortisol when we experience stress?
Cortisol is often referred to as the “stress hormone.” But cortisol is not inherently bad. It is produced in the adrenal cortex and performs numerous important functions in the body.
During an acute stressful situation, cortisol release increases. The body mobilises energy and prepares to respond to the strain. Once the situation is over, the stress system should return to a regulated state.
It can become a problem when stress is not just short-term, but becomes a permanent state.
Chronic psychological stress can affect the regulation of the so-called hypothalamic–pituitary–adrenal axis. This stress axis controls, among other things, the release of cortisol and is closely connected with our metabolism and immune system.
Lipedema and Inflammation in the Tissue
At the same time, research is increasingly focusing on inflammatory processes in lipedema.
Studies suggest that low-grade inflammatory processes and changes occur within the affected fatty tissue. Researchers are examining, among other things, changes in fat cells, immune cells, blood vessels and tissue structure.
However, it is important to distinguish between local inflammatory processes in the tissue and conventional inflammatory markers in the blood.
Having lipedema does not automatically mean that every patient will, for example, have a significantly elevated CRP level. Inflammatory changes can occur locally in the tissue without the usual blood values necessarily showing any abnormalities.
When your body image itself becomes a source of stress
Chronic stress can affect various processes in the immune and inflammatory systems. Cortisol plays an important role, but the relationship is more complex than “more stress means more cortisol and therefore more inflammation.”
Persistent stress can alter the regulation between the nervous system, hormonal system and immune system. Scientific studies therefore associate chronic psychological stress with altered regulation of inflammatory processes.
For people affected by lipedema, this connection is particularly interesting: If low-grade inflammatory processes are already taking place in the affected fatty tissue, additional ongoing stress may be another factor affecting overall physical well-being.
This emphatically does not mean that stress causes lipedema. Nor can lipedema be “cured” through positive thinking or stress reduction.
When your body image itself becomes a source of stress
For many people affected, this creates a difficult vicious cycle.
Lipedema changes the body. The legs, hips or arms in particular can remain noticeably disproportionate to the upper body despite weight loss. Many patients also experience pain, tenderness, a feeling of heaviness or a tendency to bruise easily.
As a result, looking in the mirror can repeatedly trigger negative thoughts:
“Why do my legs look like this?”
“Why does exercise barely change these exact areas?”
“Why don’t I feel comfortable in my body?”
When such thoughts become a daily companion for months or years, they can contribute to considerable psychological distress.
Negative comments from others, unsuccessful diets or years of feeling that their symptoms were not taken seriously may also play a role. Some women have already spent years blaming themselves before they are even diagnosed with lipedema.
WHAT CAN HELP REDUCE STRESS?
That is precisely why one statement is so important: A patient is not responsible for her lipedema.
Stress reduction, exercise, good sleep or a more positive body image do not replace medical treatment for the condition.
However, they can form part of a holistic approach to living with lipedema. In addition to the condition itself, it is important to take into account the psychological burden that living with a chronic condition can bring.
It is not about having to love your body from one day to the next. Rather, small changes can help you see your body less as an opponent you have to face every day.
That is why a holistic approach to lipedema should not focus solely on what the legs look like. It is equally important to ask: How is the patient coping with her body and her condition?
Looking in the mirror should not become a daily battle.
Because lipedema is not just about how your body looks – it is above all about how you feel in it.
