What Is the Link Between Lymphedema and Obesity?

Obesity can lead to several health conditions, ranging from diabetes and high blood pressure to heart disease and stroke. It might not be a surprise to you that lymphedema and obesity are also linked, both in terms of your risk of developing lymphedema and the severity of your symptoms. Managing your weight is a crucial step in preventing lymphedema and other medical conditions that obesity may exacerbate. Below, you’ll learn more about the connection between lymphedema and obesity, as well as the steps to prevent and manage lymphedema.

What Is Lymphedema?
What Is Obesity?
Can Obesity Cause Lymphedema?
What Are Symptoms of Lymphedema that Obese Patients Should Look Out For?
Can Obese Patients Prevent Lymphedema?
How to Manage Lymphedema Once You’re Diagnosed
Wrapping Up: Lymphedema and Obesity

What Is Lymphedema?

Lymphedema is a medical condition characterized by the improper function of your lymphatic system. The lymphatic system is responsible for maintaining fluid levels in our body tissues by removing all fluids that leak out of our blood vessels. The lymphatics also function to transport fat, protein, and other nutrients, as well as prevent infections. This is all accomplished as a result of lymph fluid moving throughout your lymphatic system, through a series of lymph vessels, in addition to being filtered through lymph nodes, and eventually draining through one of the main lymphatic ducts, where it reenters the bloodstream again. Finally, the lymph fluid is drained through one of the main ducts, where it enters the bloodstream again.

In patients with lymphedema, lymph fluid builds up due to a problem with lymphatic drainage. This can be caused by a damaged lymph vessel, a blocked or removed lymph node, or any other drainage-related problem with your lymphatic system. As this lymph fluid continues to build up in the tissues, it can potentially cause visible swelling, pain, itching, and other symptoms, including skin changes and an increased risk of infections. Common causes of lymphedema include cancer, particularly breast cancer, cancer-related surgery, radiation, chronic venous disease, direct trauma, and obesity.

Compression garments for lymphedema can help promote the flow of lymph fluid, which helps reduce swelling in the affected part of the body. There are several steps to successfully managing lymphedema, including getting plenty of exercise, staying hydrated, and using compression and other treatments to reduce swelling.

What Is Obesity?

Obesity is an excessive accumulation of fat that presents a health risk, not to be confused with overweight. According to the CDC, a person is classified as overweight if they have a body mass index (BMI) of at least 25, while a person is obese if they have a BMI of at least 30.¹ Common causes of obesity can include a poor diet, a lack of exercise, genetics, or a combination of these factors.

The biggest concern with obesity is that it can put you at risk for several medical conditions and complications. For example, people who are obese are more likely to experience high blood pressure and heart disease, which can lead to heart attacks and strokes. Excess fat may result in your circulatory system working harder to circulate blood, while your lymphatic system has to work harder to move and drain lymphatic fluid.

You can figure out your BMI by using a BMI calculator online. If your BMI is lower than 18.5, you’re considered underweight. If your BMI is 18.5 to 24.9, you’re considered to be in the healthy weight range. A BMI of 25 is considered overweight, and a BMI of 30 or higher is considered obese.¹ If you fall into the overweight or obese BMI range, you should talk to your doctor about losing weight and maintaining a healthy weight.

Can Obesity Cause Lymphedema?

The short answer to this question is yes. According to an article published on PubMed Central by Drs. Babak J. Mehrara and Arin K. Greene, obesity is a major risk factor for lymphedema, and you can develop lymphedema as a result of obesity without surgery or any other risk factors.²

Drs. Mehrara and Green found that patients with breast cancer who had a body mass index of at least 30 were three times more likely to develop lymphedema in the upper body when compared to patients with a body mass index of 25 or less. In addition to this study, there have been several studies linking the connection between lymphedema and obesity.

While there is a link between lymphedema and obesity, experts don’t know exactly why you can develop lymphedema from obesity. It could be a result of an injury to the lymphatic system caused by a change in weight, or it could be a result of excess production of lymph fluid that’s putting pressure on the lymphatic system.

Regardless of why you’re experiencing lymphedema, complete decongestive therapy is a popular treatment option. With compression garments, lymphatic drainage massages, and exercise, you can encourage lymphatic drainage and reduce the swelling and symptoms that come with lymphedema.

What Are Symptoms of Lymphedema that Obese Patients Should Look Out For?

If you’re obese, you may experience more severe lymphedema or lymphedema that occurs without a secondary cause, such as an injury or surgery. For these patients, weight management is an important part of keeping lymphedema symptoms in check and preventing complications. This also means that you need to keep an eye out for lymphedema symptoms if you’re obese. Here are the symptoms to be aware of if you’re obese and are worried about developing lymphedema.

• Pain: A buildup of lymph fluid in the fatty tissues in your body can lead to pain, although this pain may not always present. Pain as a result of lymphedema is more likely when severe swelling is present, so proper lymphedema management can help prevent this pain. If you’re experiencing lymphedema pain that makes it difficult to continue with your normal routine, complete decongestive therapy can help you get relief from the pain and swelling.
• Swelling: Swelling in lymphedema patients occurs from the buildup of lymph fluid in the fatty tissues underneath the skin. This swelling may result in pain, or it may be purely cosmetic. Swelling that is caused from lymphedema can also make it difficult to fit into your clothes, which means you may need to switch to something looser when swelling progresses. Compression garments, elevation, regular exercise, and hydration can help promote the flow of lymph fluid and reduce swelling.
• Decreased range of motion: Depending on the severity of your lymphedema, the swelling may eventually get to a point where it affects your range of motion. You might experience pain and tightness in your legs when you walk, or you may feel discomfort when you lift your arm above your head or stretch it out to reach for something. This decreased range of motion usually goes away when the swelling goes down. Because obesity can already make it more difficult to move around and live a pain-free life, lymphedema combined with obesity can make things significantly more challenging.
• Hardened skin/fibrosis: In very severe cases of lymphedema, the skin may begin to harden and take on the look and feel of a tough animal hide, such as an elephant. Hardening of the skin is also called fibrosis. You may also notice your skin changing from its regular color to a brownish color. In some cases, patients with hardened skin also have small bumps on their skin called papillomas, which can leak fluid. Hardened skin is a sign of advanced lymphedema, so medical intervention is necessary.
• Limb heaviness: Like other types of edema, lymphedema can make your limbs feel heavy. This is largely a result of the swelling in the limbs, but it’s compounded for obese patients who may already have a tough time moving around comfortably. You may also experience a sort of “tight” feeling in the skin, which might get worse when you stretch your legs to climb stairs or stand up.
• Numbness: While pain and discomfort are somewhat common with lymphedema, sometimes you won’t feel anything at all. Numbness and tingling are common sensations for lymphedema patients, although these symptoms may not last for extended periods of time.
• Pitting: Pitting is when you can leave a mark on the affected limb by gently pressing a finger into the swollen area. You should talk to your doctor about lymphedema treatment and management if you notice pitting along with other symptoms on this list.

Can Obese Patients Prevent Lymphedema?

The good news about lymphedema in obese patients is that there are steps you can take to prevent it. Even if you do develop lymphedema, following these steps can help you minimize symptoms to make it easier to live with your condition. Here’s what you can do to reduce your risk of developing lymphedema and make it easier to live with.

• Daily exercise: Exercise helps you keep your weight under control, which reduces your risk of developing lymphedema. Regular exercise also helps promote lymphatic drainage, which keeps lymph fluid from collecting in your tissues, which leads to swelling. Even if you have lymphedema already, regular exercise is a crucial part of complete decongestive therapy to promote lymphatic drainage.
• Hydrate throughout the day: Because your lymphatic system is mostly made up of water, you need to be hydrated for maximum lymphatic function. Dehydration can cause the flow of lymph fluid to slow down, which can lead to a buildup of fluid in your lymphatic system.
• Eat a nutritious diet: Since obesity is a risk factor for lymphedema, managing your weight by exercising and eating a healthy diet can help you prevent lymphedema. Try to follow the CDC’s Dietary Guidelines or any nutrition plans prescribed by your doctor that can help you can shed some weight and lower your risk. Some recommended foot and nutrients you can integrate into your diet include omega-3 fatty acids, leafy greens, cruciferous vegetables, and berries.
• Get quality sleep: Sleep is crucial when it comes to your health, and lymphedema prevention is no exception. Make sure you get plenty of sleep to ensure your lymphatic system is functioning properly. Aside from reducing your risk of lymphedema, getting adequate sleep will help improve your overall health.
• Consult a doctor: If you need help losing weight to lower your risk of developing lymphedema, consult with a doctor. Losing weight is easier when you have professional help, whether that’s a special diet, an exercise plan, or a doctor who can help you figure out what lifestyle and genetic factors may be playing a role in your inability to manage your weight. From there, your doctor may recommend a personal trainer who can help you achieve a healthy weight.

How to Manage Lymphedema Once You’re Diagnosed

Once you’re diagnosed with lymphedema, there are several actions you can take to manage your symptoms. As previously stated, getting plenty of exercise and staying hydrated will help promote the flow of lymphatic fluid, plus exercising and eating a healthy diet will help you lose weight.

In addition to these steps, you should also learn how to do a lymphatic massage to promote drainage. These massages can be performed at home, and you can have a lymphedema specialist show you how to do it during your next appointment. You can also use compression garments and pneumatic compression devices, such as Tactile Medical’s Flexitouch Plus System, to manage swelling and other symptoms.

Wrapping Up: Lymphedema and Obesity

Research has found there is a link between lymphedema and obesity, whether you’ve recently had surgery or not. However, more research needs to be done to determine the exact link between the two conditions. Managing your weight is an important part of lowering your risk of developing lymphedema, plus it can help you manage symptoms if you already have lymphedema.

If you need help getting relief from lymphedema swelling and pain, the Flexitouch Plus System from Tactile Medical can help. This pneumatic compression device gently encourages the flow of lymph fluid, which helps reduce swelling and the symptoms that come with it. Check out the Flexitouch Plus System to learn more about how you can get lymphedema relief today.

Sources
1. Centers for Disease Control and Prevention. Defining Adult Overweight and Obesity. CDC.gov. https://www.cdc.gov/obesity/basics/adult-defining.html
2. Mehrara BJ, Greene AK. Lymphedema and obesity: is there a link? Plast Reconstr Surg. 2014 Jul;134(1):154e-160e. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4393748/