Rare adipose disorders (RADs) masquerading as obesity
- 3 February 2012
- journal article
- review article
- Published by Springer Science and Business Media LLC in Acta Pharmacologica Sinica
- Vol. 33 (2), 155-172
- https://doi.org/10.1038/aps.2011.153
Abstract
Rare adipose disorders (RADs) including multiple symmetric lipomatosis (MSL), lipedema and Dercum's disease (DD) may be misdiagnosed as obesity. Lifestyle changes, such as reduced caloric intake and increased physical activity are standard care for obesity. Although lifestyle changes and bariatric surgery work effectively for the obesity component of RADs, these treatments do not routinely reduce the abnormal subcutaneous adipose tissue (SAT) of RADs. RAD SAT likely results from the growth of a brown stem cell population with secondary lymphatic dysfunction in MSL, or by primary vascular and lymphatic dysfunction in lipedema and DD. People with RADs do not lose SAT from caloric limitation and increased energy expenditure alone. In order to improve recognition of RADs apart from obesity, the diagnostic criteria, histology and pathophysiology of RADs are presented and contrasted to familial partial lipodystrophies, acquired partial lipodystrophies and obesity with which they may be confused. Treatment recommendations focus on evidence-based data and include lymphatic decongestive therapy, medications and supplements that support loss of RAD SAT. Associated RAD conditions including depression, anxiety and pain will improve as healthcare providers learn to identify and adopt alternative treatment regimens for the abnormal SAT component of RADs. Effective dietary and exercise regimens are needed in RAD populations to improve quality of life and construct advanced treatment regimens for future generations.Keywords
This publication has 213 references indexed in Scilit:
- Assessment of Lymphatic Contractile Function After Manual Lymphatic Drainage Using Near-Infrared Fluorescence ImagingArchives of Physical Medicine and Rehabilitation, 2011
- Preliminary Outcomes 1 Year after Laparoscopic Sleeve Gastrectomy Based on Bariatric Analysis and Reporting Outcome System (BAROS)Obesity Surgery, 2011
- Lipedema: An inherited conditionAmerican Journal of Medical Genetics Part A, 2010
- Whole-body vibration slows the acquisition of fat in mature female ratsInternational Journal of Obesity, 2008
- Lipomas treated with subcutaneous deoxycholate injectionsJournal of the American Academy of Dermatology, 2005
- Liposuction in Dercum's disease: impact on haemostatic factors associated with cardiovascular disease and insulin sensitivityJournal of Internal Medicine, 1998
- Indomethacin and Atrial Natriuretic Peptide in Pseudo-Bartter's SyndromeThe New England Journal of Medicine, 1987
- Long-standing pain relief of adiposis dolorosa (Dercum's disease) after intravenous infusion of lidocaineJournal of the American Academy of Dermatology, 1986
- TUMORS OF THE SOFT SOMATIC TISSUESAnnals of Surgery, 1958
- ADIPOSIS DOLOROSAThe American Journal of the Medical Sciences, 1909