Article Test

Objective: Women with lipedema have painful excess subcutaneous fat on the limbs sparing the trunk.  The fat in lipedema has fibrosis making it resistant to loss by diet and exercise (persistent fat). People with Dercum disease (DD) have painful masses in their fat tissue on the trunk and limbs.  Lipedema can be confused with DD.  Sympathomimetic amines such as amphetamine, dextroamphetamine or phentermine anecdotally appear to improve weight loss and quality of life in people with lipedema or DD.  The primary objective was to address perceived benefits and downsides of prescribed sympathomimetic amines (SA) including dextroamphetamine, amphetamine or phentermine in women with lipedema and men and women with DD. 

Methods: Fifty-four participants with lipedema and 26 with DD prescribed SA for ³3 months were consented to respond to a set of 82 categorical scale and descriptive questions and the validated lower extremity functional scale, based on the clinical experience of one of the authors (XXX) and her patients.  Significance was set at a<0.05.  Data were analyzed by Wilcoxon signed rank tests; continuous data was assessed by t-tests.

Results: Participants with lipedema and DD prescribed SA perceived significant improvements in energy level, ability to exercise, leg heaviness, body pain, functionality, and memory. Average self-reported weight decreased by ~25 kg in participants with DD and ~12 kglothing size  About 90% of participants felt their quality of life improved.  Less than 20% of participants reported side effects from the sympathomimetic amines including insomnia, abdominal pain and visual changes.

Conclusions: People with lipedema and DD report a significant benefit to risk ratio for their fat, pain and quality of life when prescribed sympathomimetic amines. A randomized prospective study would confirm benefits, safety and side effects.