The diagnosis "lipoedema" can be made from the history, the typical symptoms and the observation. Lipedema is still little known even among doctors and is often confused with obesity or lymphedema. Lipoedema is a chronic disease that only affects women. The thick legs or upper arms are often noticed in childhood, and the mother or aunts may also be affected. Initially, only individual parts of the body are affected (thighs or calves). The findings can increase after puberty, sometimes relapses with rapid increases in size occur later or after pregnancy. The typical pattern of fat distribution indicates lipoedema: below the hips, on the outside, inside and front of the thighs. Unsightly cushions form on the inside of the knee, the calves become columnar, and boots no longer fit. Water can accumulate in the calves, and there is a kind of sleeve on the ankles with a transition to the rather slender feet. A specialist in angiology or phlebology should use ultrasound to rule out the presence of varicose veins that require surgery (if they exist, varicose veins should be operated on as a first step). Further examinations are not necessary, in particular no contrast medium examination of the lymphatic vessels, because this can damage them and this examination is also uncomfortable.

Lipoedema can be divided into 3 stages: In stage 1, the skin is smooth and the subcutaneous fatty tissue is thicker but without knots. In stage 2, the skin surface is uneven, the subcutaneous tissue is thickened and interspersed with small knots. In stage 3, the skin surface is very uneven, the subcutaneous tissue thickens and hardens, and there are large bulges of fat under the skin. A distinction must be made between lipedema and lymphedema. Lipoedema always occurs on both sides, causes pain, the feet or hands are not affected and there is a tendency to bruise spontaneously. The cause is an increased storage of lymph in the fatty tissue. Lymphedema usually occurs on one side, causes less pain and the feet or hands are involved. The cause is damage to the lymphatic drainage system.