Lipoedema causes a disproportionate distribution of body fat below the waist and sometimes the upper arms, making the hips, buttocks and legs look out of proportion with the rest of the body. Many women describe their legs as being like 'tree trunks', heavy and swollen. Symptoms of lipoedema include:

• Significant disproportion of hip-to-waist ratio

• Swelling in affected areas is symmetrical, affecting both sides of the body

• Feet and hands are not affected

• Skin folds appear on the upper legs and knees, with fatty deposits medially to the knees and lateral thighs

• Feet may be sparred with 'cuffing' or a 'bracelet' effect at the ankle or wrist

• Difficulties with clothing are common (some people require several sizes larger for their lower body)

• The texture of skin in affected areas is soft and doughy in texture

• Skin may have a dimpled, mattress-like appearance, with nodules discernible under the skin

• Skin is usually paler than in unaffected areas, and cold to touch

• Areas affected may be painful and bruise easily (see below)

• Weight-loss diets, exercise and bariatric surgery have little or no effect on reducing lipoedema fat

• Psychological distress, including depression and anxiety, are common, as is low self-esteem

• Fatigue and tiredness Pain is a key characteristic of lipoedema. Unlike normal weight gain caused by overeating or lack of exercise, lipoedema fat often (but not always) can be painful, or feel heavy or hurt when banged or scraped. Some people experience a high degree of pain and heightened sensitivity to touch or pressure. Lipoedema pain may vary in duration (it might be worse in the evening) and severity. Areas affected may also bruise easily – many women experience multiple, frequent bruising – and there does not appear to be any correlation between the size of the area affected and it's degree of painfulness.