The Difficulties in Emotional Regulation among a Cohort of Females with Lipedema

Abstract

Background: Lipedema is a chronic and progressive adipose tissue disorder that causes significant morbidity and negatively influences mental health and quality of life, and increases the risk of depression, anxiety, and eating disorders. One construct of relevance to better understanding psychological disorders is emotion regulation (ER). Therefore, the aim of this study is to investigate the difficulties in ER among lipedema patients compared to healthy people without lipedema. Methods: This cross-sectional study assessed differences in ER and anxiety between two groups: 26 female patients with lipedema and 26 sex- and age-matched healthy controls. The Difficulties in Emotion Regulation Scale (DERS) assessed emotional regulation across six dimensions: Impulse control, goal-directed behavior, awareness, clarity, non-acceptance, and strategies. Anxiety was assessed by the Hamilton Anxiety Scale (HAM-A). ANOVA assessed differences in measures between lipedema and healthy control groups. Results: Lipedema patients presented with significantly more difficulties in ER and a higher level of anxiety than those without lipedema. Specifically, the lipedema group showed higher and significant differences in total DERS and anxiety scores and all DERS subscales scores compared to those without lipedema. Conclusions: Lipedema patients showed significant difficulties with ER, and were associated with anxiety symptoms, indicating that ER difficulties may play a role in developing emotional disorders, such as anxiety, for patients with lipedema. The health care provider should pay more attention to ER difficulties and psychological status among lipedema patients.

Disability and emotional symptoms in women with lipedema: A comparison with overweight/obese women

“…55 Similarly, in the study by Erbacher and Bertsch, the percentage of women with lipedema and mental health disorders (such as depression, anxiety disorders, eating disorders, or post-traumatic stress disorder (PTSD)) was significantly greater in the subgroup with a BMI ≥ 40 kg/m 2 than with a BMI < 40 kg/m 2 (49.3% compared to 25.9%, respectively). 18 The lack of difference between our study groups in severity of anxiety and depressive symptoms can be explained by the fact that in the previous studies, the lipedema group was only compared to healthy individuals, 54 while our results demonstrate the comparison of lipedema to lifestyleinduced overweight/obesity group. Moreover, the majority of women in our lipedema group (96%) were in the 1 st and 2 nd stages of the disease.…”

“…52 Al-Wardat et al showed that women with lipedema had significant difficulties with emotion regulation associated with anxiety symptoms. 54 Clarke et al revealed that women with lipedema in stages 3-4 compared to stages 1-2 were more likely to report depression, emotional lability, eating disorders, as well as feeling lonelier, more fearful, more likely to stay at home and less likely to have visited a psychologist. 55 Similarly, in the study by Erbacher and Bertsch, the percentage of women with lipedema and mental health disorders (such as depression, anxiety disorders, eating disorders, or post-traumatic stress disorder (PTSD)) was significantly greater in the subgroup with a BMI ≥ 40 kg/m 2 than with a BMI < 40 kg/m 2 (49.3% compared to 25.9%, respectively).…”

Lipedema: a new phenomenon for many people and a new field of study for psychiatry, nutrition, and psychology in Brazil

“…Is there extreme control during treatments or diets? All of these questions need to be unraveled because they are associated with much suffering and can cause psychological and psychiatric distress and impairment 13 . Lipedema has been linked to emotional regulation difficulties and eating disorders 13 , 14 , both of which are related to body image.…”