Disease-specific quality of life improvement after conservative treatment in women with lipedema: A prospective observational study using QuASiL

BackgroundLipedema is a chronic adipofascial disorder characterized by pain, edema and progressive functional impairment. Conservative treatment is widely recommended as first-line therapy, but evidence on its impact on disease-specific quality of life remains limited. This study evaluated changes in quality of life following 6 months of partially standardized conservative treatment in women with lipedema, using the Lipedema Symptom Assessment Questionnaire (QuASiL).MethodsThis prospective observational cohort study included 86 women with stage I-III lipedema treated at a specialized outpatient clinic. Participants underwent a multimodal conservative treatment including manual lymphatic drainage, compression therapy, exercise recommendations and pharmacological therapy when indicated. The primary outcome was change in total QuASiL score between baseline and 6 months (ΔQuASiL). A clinically meaningful improvement was defined as a ≥10 point reduction (0.5 SD). Multivariable regression analyses identified predictors of improvement.ResultsMean QuASiL score decreased from 89.9 ± 19.6 at baseline to 74.4 ± 24.7 at 6 months (mean difference -15.6; 95% CI -20.4 to -10.7; p < 0.001), corresponding to a moderate-to-large effect size (Cohen's dz = 0.69). Clinically meaningful improvement occurred in 56.0% of participants. Baseline QuASiL score independently predicted greater improvement (β = 0.36; p = 0.011), whereas weight change, baseline BMI and age were not significant predictors. The regression model explained 11.2% of variance score change (R2 = 0.11).ConclusionsMultimodal conservative treatment was associated with statistically and clinically significant improvements in disease-specific quality of life in women with lipedema, independent of weight loss. Controlled studies are needed to establish causality and identify predictors of therapeutic response.