Psychological Challenges of Lipedema and Lymphedema

„Why can’t a body just be a body?“

What psychological challenges do lipedema and lymphedema present? We spoke with naturopath Eva Hilbich about this topic. In her practice, she supports people living with lipedema and lymphedema both physically and mentally. As someone who is personally affected by these conditions, she knows from firsthand experience how deeply they can impact mental well-being.

In this interview, she shares her perspective on emotional stress, self-acceptance, and ways to foster greater self-efficacy in everyday life.

For more information about Eva and her practice, visit her website or follow her on Instagram.

Hi Eva, one of the key topics you focus on is the psychological impact of lipedema and lymphedema. How do you experience this in your practice?

Eva: Hi, and thank you for inviting me! I’m really glad we’re talking about this topic. In my practice, I very often see that both lipedema and lymphedema can place a significant psychological burden on those affected. Common issues include disordered eating, low self-esteem, and a distorted body image. However, it’s important to make a distinction here. Lipedema and lymphedema are not the same condition. Secondary lymphedema, for example after breast cancer treatment, and lipedema each come with very different experiences and psychological challenges.
What they do have in common, though, is their potential to profoundly affect mental well-being—especially when it comes to body image. Legs or arms often differ significantly from conventional beauty standards and may feel unfamiliar or “not right” to those affected. This can have a tremendous impact on how people see themselves. On top of that, there is societal pressure and, in many cases, a long history of unsuccessful dieting attempts and self-blame.Geben Sie Ihr Feedback zu BizChat ab.

When we talk about psychological stress, does it remain purely on the mental level, or do you also observe direct effects on the body?

Eva: Psychological stress is not just something that happens in the mind. It can also have very direct effects on the body, particularly on how pain is perceived. When I’m struggling emotionally, I tend to experience pain more intensely. This is well supported by scientific research. Many people become trapped in a cycle of pain: they experience pain, the brain becomes more sensitive, and it starts sounding the alarm earlier and earlier. This is often referred to as a psychosomatic response.

What can help people break out of this cycle of pain?

Eva: An important first step is simply becoming aware of your own thoughts. Instead of immediately judging them or trying to push them away, start by noticing them and acknowledging: Okay, I’m having a negative thought right now. This won’t immediately break the cycle, but it can relieve some of the pressure and create a bit of distance from those thoughts.

Sometimes, receiving a diagnosis can also be a huge relief because it finally provides an explanation for what someone may have been experiencing for years—the pain, the frustration, the feeling of constantly failing. At the same time, a diagnosis can also be difficult because it comes with the realization that this is a chronic condition that will not simply go away. Feelings of relief and overwhelm can exist side by side—and that is completely normal.

Do your patients speak openly about what is emotionally burdening them?

Eva: In fact, many people are quite open with me about these topics. I believe that’s mainly because they know that I’m affected myself. I sit across from them wearing my compression garments quite naturally, and that lowers the barrier significantly.

That said, not everyone is immediately able to put their feelings into words. Some people simply sense that something doesn’t feel right. In those situations, it’s my job to ask questions and explore further. I often hear statements like, “My body is ugly” or “I’m too weak.” Examining these thoughts together is incredibly important. Many people realize for the first time that these beliefs are not necessarily their own, but rather learned patterns and messages they have absorbed over time. That realization alone can be tremendously relieving.

What’s important to me is this: the goal is not to immediately see your body in a positive light. For me, the journey didn’t begin with self-love—it began with radical self-acceptance. Sometimes that can be as simple as looking at your legs and thinking, “Okay, this is what they look like,” without judging them. This kind of neutrality is often much more realistic and attainable than instantly loving your body. Especially because movements like body positivity can sometimes create pressure of their own.

"Why do we feel the need to constantly judge everything? Why can't a body just be a body?"

Many people living with these conditions find themselves caught between acceptance and resistance. On the one hand, there is the idea of accepting the edema; on the other, there is anger about the condition and the desire to fight against it. Do these approaches contradict each other?

Eva: No, I don’t think they do. Personally, fighting against my body no longer works for me. I did that for many years, and it mainly led to self-criticism and self-sabotage. At the same time, anger can be an incredibly powerful motivator. Some people channel that energy into making changes and taking action. In the end, both approaches are valid. What matters is not the approach itself, but whether it helps the individual and does not cause further harm.

Looking back, is there any advice you received years ago that you now think would have been better ignored?

Eva: Yes, the classic “Just lose weight and everything will get better” is something I heard throughout my life. That advice was not a solution—it mainly created pressure. Another point I view more critically in hindsight relates to compression therapy. From the very beginning, I understood how important compression was, but I convinced myself that I had to like it immediately. That simply didn’t work. I created a lot of stress for myself because of that expectation. Today, I would say that it’s completely normal to need time to adjust. I could have been much kinder to myself.

Would you say that compression can provide a sense of security or control, and therefore also have emotional significance?

Eva: Absolutely. Compression is a very important part of self-management. If it helps reduce pain or minimize fluid retention, that can have a positive impact on mental well-being as well. The feeling that you can actively do something for yourself makes a huge difference. At the same time, we shouldn’t underestimate the fact that compression therapy can remain challenging. Many people find arm compression garments particularly difficult to wear. One reason is visibility: compression stockings on the legs are much more familiar in society and tend to attract less attention. Arm compression, on the other hand, is immediately noticeable and can make the condition feel very visible and ever-present.

What can help people accept compression therapy in everyday life and stick with it in the long term?

Eva: An important aspect is not putting too much pressure on yourself. Compression therapy is effective and a key component of treatment, but adapting to it can be a gradual process. Many people find it helpful to view compression garments not only as a medical aid but also as something they can personalize—for example through colors or outfit combinations.

It is also very important to give yourself permission to take things one step at a time. No one has to go from zero to wearing compression all day overnight. One hour is a start; two hours are a start as well. That’s exactly how I approached it, and I found that my wearing time increased naturally over time. I always say: small steps can have a huge impact.

Are there any other strategies or routines that can help people cope better with their condition in everyday life?

Eva: What helps me personally a great deal is starting the day intentionally and taking a moment for myself. Since my mornings often begin with putting on my compression garments, I make sure to take some time for myself first. For example, I do a short yoga session. It makes a big difference to me to start the day not with obligations, but by first reconnecting with my own body.

At some point, I realized that when I wear compression all day, I hardly ever see my legs—or even my feet. By creating this intentional time in the morning, I see my body, feel it, and become aware of it. Emotionally, that has been incredibly helpful.

In general, I think it’s important to create small anchors throughout the day. For me, those are yoga, meditation, mindfulness, and gratitude practices. I might ask myself questions like: What was I grateful for today? or What did I do well today? The answers can be very specific—for example: I’m proud of myself for wearing my compression garments for 16 hours today. Or: I moisturized my legs today, stayed active, or attended my lymphatic drainage appointment.

Especially on difficult days, it can be helpful to consciously focus on these small achievements and positive actions.

"It's also important to remember that we are more than just our condition. It is a part of our lives, but it is not our entire identity. That's something we need to remind ourselves of again and again— especially when we feel like we should always be doing more."

What role can support groups play in coping with the condition?

Eva: A very important one—depending on the individual. Not everyone feels comfortable in a group setting, but today there are many different formats available, including online communities and groups tailored to specific age ranges. For many people, that makes it much easier to get involved. In my experience, support groups offer one thing above all else: understanding. Not everyone has people in their personal lives who are affected by the same condition. Some experiences can truly only be understood by those who have gone through something similar themselves. At the same time, support groups can be incredibly empowering. People can benefit from one another’s experiences and provide practical support, whether it’s navigating the healthcare system or finding the right resources and specialists. You realize that many people face similar challenges, yet each person finds their own way of dealing with them. That sense of community is incredibly strengthening.

Have there been moments when you thought, “This is exactly why I do this work”?

Eva: Absolutely. Those moments happen again and again. Just a few weeks ago, I experienced one in my practice. A patient traveled from quite far away to see me. She was living with lipedema and had several other concerns as well. We spent a long time talking and working through different issues together. The next day, she sent me an email saying that she had already started implementing some of the things we discussed. I remember sitting there thinking, “Wow, how amazing is that?” Moments like these touch me every single time—when you see that a conversation has sparked meaningful change. I experience something similar in my support group. There are participants who arrive feeling completely overwhelmed or who strongly resist wearing compression garments. Then, a few months later, they share their breakthrough moments and explain how they found their own way of managing things. Seeing that progress is incredibly motivating for me as well.

Which three emojis best describe the emotional journey of living with lipedema and lymphedema?

Eva: The first one that comes to mind is the mending heart. ❤️‍🩹 I think it’s very fitting because it shows that something has been hurt, but also that healing is possible. And, of course, it reminds me of compression therapy.
At the same time, I think of something explosive, like a bomb or fire. 💣🔥 Because receiving the diagnosis can initially turn everything upside down. Suddenly, you have so much to learn—about your body, your condition, and yourself.
And finally, I would choose the butterfly. 🦋 For me, it represents transformation, change, and personal growth. I want to be very clear: no one should have to become ill in order to grow. But it is often true that crises can be powerful catalysts for personal development.

To conclude, what gives you hope when you think about the future of lipedema and lymphedema treatment?

Eva: What makes me particularly happy is that awareness of these conditions has increased significantly. Lipedema, in particular, is discussed far more openly today than it was just a few years ago. That is helping us move away from the stigma of “It’s just obesity.”
At the same time, research is finally gaining momentum. Although much of the work is still focused on foundational research, we are increasingly recognizing just how complex lipedema really is, including its connections to hormones, inflammatory processes, histamine, and gut health.
The fact that this complexity is becoming better understood and investigated gives me hope. Treatment has also evolved over the years. Compression therapy remains the foundation, but additional approaches such as liposuction and supportive nutritional therapy have become more established as well. All of this shows that progress is being made, and that is encouraging. At the same time, we have to be honest: there is still a great deal of work to be done.

Thank you very much, Eva, for your openness and for sharing these valuable insights.

Eva: It was my pleasure! Thank you for having me.