{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T13:48:57Z","timestamp":1789480137900,"version":"build-2803163510"},"reference-count":37,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T00:00:00Z","timestamp":1693353600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Deutsche Derma Gesell"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Lipedema, also known as lipohyperplasia dolorosa (LiDo), is a painful condition affecting women, causing a disproportionate accumulation of subcutaneous adipose tissue in the extremities. It carries a lower risk of diabetes and cardio\u2010metabolic dysfunctions compared to obesity, but coincident obesity can complicate diagnosis and treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p>This retrospective study included 607 female LiDo patients, \u2265\u00a018\u00a0years, stage 1\u20133, from Germany, the UK, and Spain. Data were collected as part of the standard initial assessment for LiDo patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Based on waist\u2010to\u2010height\u2010ratio (WHtR), 15.2% of patients were underweight, 45.5% normal weight, 22.1% overweight and 17.3% obese. There was a significant association between WHtR category and age group. Body mass index (BMI) is often overestimated, leading to misdiagnosis of obesity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The use of BMI also affects the recent decision of the German Federal Joint Committee on the reimbursement of liposuction costs by health insurance funds. Patients with BMI of more than 40\u00a0kg\/m<jats:sup>2<\/jats:sup> are excluded from cost coverage, and those with BMI between 35\u00a0kg\/m<jats:sup>2<\/jats:sup> and 40\u00a0kg\/m<jats:sup>2<\/jats:sup> must first receive conservative obesity therapy. In conclusion, the sole use of BMI in lipedema is unreliable and, in contrast to WHtR, leads to inaccurate diagnoses overestimating overweight and obesity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ddg.15182","type":"journal-article","created":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T10:03:14Z","timestamp":1693389794000},"page":"1179-1185","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Body mass index <i>vs<\/i>. waist\u2010to\u2010height\u2010ratio in patients with lipohyperplasia dolorosa (vulgo lipedema)"],"prefix":"10.1111","volume":"21","author":[{"given":"Erich","family":"Brenner","sequence":"first","affiliation":[{"name":"Institute for Clinical and Functional Anatomy Medical University of Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Forner\u2010Cordero","sequence":"additional","affiliation":[{"name":"Hospital Universitari i Polit\u00e8cnic la Fe University of Valencia  Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Faerber","sequence":"additional","affiliation":[{"name":"Centre for Vascular Medicine  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Rapprich","sequence":"additional","affiliation":[{"name":"Hautmedizin Bad Soden Bad Soden im Taunus  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Cornely","sequence":"additional","affiliation":[{"name":"LY.SEARCH  Cologne Germany"},{"name":"CG\u2010Lympha  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,30]]},"reference":[{"issue":"5","key":"e_1_2_7_2_1","first-page":"191","article-title":"Das Lip\u00f6dem \u2013 was genau ist das?","volume":"82","author":"Herpertz U","year":"1991","journal-title":"Physiotherapie"},{"issue":"5","key":"e_1_2_7_3_1","first-page":"271","article-title":"Terminologie des Lip\u00f6dems","volume":"35","author":"Cornely M","year":"2005","journal-title":"Phlebologie"},{"issue":"3","key":"e_1_2_7_4_1","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1055\/s-0037-1621766","article-title":"Pr\u00e4valenz des Lip\u00f6dems bei berufst\u00e4tigen Frauen in Deutschland","volume":"40","author":"Marshall M","year":"2011","journal-title":"Phlebologie"},{"key":"e_1_2_7_5_1","doi-asserted-by":"crossref","DOI":"10.1590\/1677-5449.202101982","article-title":"Lipedema prevalence and risk factors in Brazil","volume":"21","author":"Amato ACM","year":"2022","journal-title":"J Vasc Bras"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/ijo.2016.205"},{"issue":"1","key":"e_1_2_7_7_1","article-title":"Lipedema: friend and foe","volume":"33","author":"Sanchez\u2010De la Torre Y","year":"2018","journal-title":"Horm Mol Biol Clin Investig"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.1000094"},{"issue":"02","key":"e_1_2_7_9_1","first-page":"55","article-title":"Obesity and chronic inflammation in phlebological and lymphatic diseases","volume":"47","author":"Faerber G","year":"2018","journal-title":"Phlebologie"},{"key":"e_1_2_7_10_1","unstructured":"Gemeinsamer Bundesausschuss.Richtlinie Methoden vertrags\u00e4rztliche Versorgung: Liposuktion bei Lip\u00f6dem im Stadium III. 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