Association between pain, body mass index, and clinical characteristics in lipedema: Segmental analysis using bioimpedance

OBJECTIVE: We aimed to evaluate the association between pain, body mass index (BMI), clinical stage, and morphological type in women with lipedema, using segmental bioimpedance to correlate with clinical symptoms. METHODS: We conducted a cross-sectional observational study of adult women with a confirmed clinical diagnosis of lipedema. We collected clinical variables, body composition by multifrequency bioimpedance, and pain intensity (visual analog scale 0-10). We examined associations between clinical and biophysical parameters using correlation analyses and group comparisons based on data distribution. RESULTS: Pain was present in most participants, regardless of BMI, clinical stage, or morphological type. Pain showed the strongest associations with touch hypersensitivity and leg heaviness. Bioimpedance measurements indicated notably higher fat accumulation in the lower limbs, whereas lean mass remained relatively preserved. BMI did not accurately reflect functional severity. CONCLUSIONS: In lipedema, pain correlates more closely with clinical symptoms such as touch hypersensitivity and leg heaviness than with morphological parameters or BMI; however, these symptoms are nonspecific and should be interpreted as exploratory findings rather than diagnostic markers. Segmental bioimpedance adds descriptive value to clinical stratification and supports multidisciplinary management, whereas early recognition of lipedema should continue to rely on established clinical diagnostic criteria.