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(And Why Its Not Just Weight Gain) Lipedema is a chronic condition affecting mainly women, characterized by (Cifarelli, 2025): Disproportionate fat accumulation (typically in the legs and sometimes arms) Inflammation and fibrosis Impaired microvascular and lymphatic circulation Resistance to traditional weight loss approaches Recent research shows that lipedema is not simply a fat storage issueit is a complex condition involving: Chronic inflammation Fibrosis (thickening and stiffening of tissue) Hormonal influences (especially estrogen signaling) Microvascular and lymphatic changes Metabolic dysfunction This helps explain why conventional approaches like calorie restriction or even bariatric surgery may fail to meaningfully change lipedema tissue (Viana et al., 2025)

He points to Orangetheorys Transformation Challenge as evidence of that approach

Dual protective role of HO-1 in transplanted liver grafts: a review of experimental and clinical studies

Others use it intermittently when a plateau occurs

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