Authors and affiliations:
Ewa A. Burian, Tonny Karlsmark, Susan Nørregaard, Christine J. Moffatt – Dept. Dermatology-Venereology & Wound Healing Centre, Bispebjerg Hospital, Denmark – Jørgen Rungby – Steno Diabetes Center Copenhagen, Denmark – Marina Cestari – Pianeta Linfedema Study Centre, Italy – Peter J. Franks – CRICP, London, UK – and other LIMPRINT consortium members in 9 countries
The LIMPRINT survey enrolled 7 397 adults with chronic leg edema at 13 centers on three continents to explore the influence of body mass index (BMI) on disease severity. Forty-one percent were obese (BMI ≥ 30 kg/m²). After adjustment for age, sex, comorbidity, and duration of edema, obesity increased the odds of ISL stage III by 2.3-fold and the difficulty in maintaining volumetric reduction by 1.8-fold. Obese patients showed significantly worse LYMQOL scores in all domains (function, symptoms, body image, mental status) and a 26 percent incidence of cellulite in the past 12 months compared with 14 percent of normal-weight patients. They also needed higher interface pressures to achieve effective containment, with less adherence to the elastic brace.
The study highlights obesity as a disease modifier: it amplifies fibrotic progression, hinders compressive management, and deteriorates quality of life. The authors recommend integrating structured weight loss programs (low-calorie diet, unloading exercise, behavioral support) into the lymphology pathway, calibrating compression devices to BMI, and considering assisted hydrolipoclasia or selective liposuction in refractory cases. LIMPRINT’s cross-sectional and multicultural approach provides robust evidence for including weight control as an outcome indicator in international lymphedema registries.
Tags: Obesity; Lymphedema; Edema; Body Mass Index; Leg; Chronic Disease
