Obesity and Lymphedema

There is a relationship between excess weight and lymphedema.

Obesity is a national epidemic of grave concern in the US. This condition is of even greater concern for many Lymph Notes readers since research indicates that obesity increases a patient’s risk of multiple health issues including:

• Breast cancer and other forms of cancer.
• Lymphedema as a result of cancer treatment.
• Lymphedema associated with circulatory problems such as chronic venous insufficiency or chronic heart failure.

The term obesity describes an excessive accumulation of fat in the body. The term is usually used to refer to individuals who are more than 20 percent to 30 percent over the normal weight standard established based on height, age, and sex.

Those who are classified as having morbid obesity are at even greater risk. Morbid obesity is described as being the condition of weighing two to three times, or more, than the ideal weight or having a body mass index value greater than 39. (As used here the term morbid means a diseased state.)

Body mass index (BMI) is another way of evaluating weight. BMI is calculated based on weight and height. For adults aged 20 years or older, a BMI greater than 39 is a sign of morbid obesity.

Dr. Reid’s Online Survey

Peninsula Medical, the manufacturer of the Reid Sleeve and similar garments, recently conducted an online survey on this topic. The results of approximately 100 responses were studied by Dr. Reid and, not surprisingly, he found a correlation between being overweight and having problems with lymphedema. [1]

These results are interesting and well presented; however as Dr. Reid pointed out,“In any survey of this type it is important to remember (1) how the questions were worded, (2) who responded, and (3) how the responses were interpreted.”

National Lymphedema Network Concern

In an effort to keep their members well informed, the National Lymphedema Network devoted a major portion of the July-September 2007 issue of Lymph Links to articles on topic. [2]

Excess Weight Adds Risk Factors

In normal tissue lymph flows between the cells, collects waste, returns to the lymph capillaries, and is eventually returned to the venous circulation. This normal flow can be disrupted by any of the factors that make an individual “at risk” for lymphedema.

When this disruption occurs, the lymphatic system continues working until it is so overwhelmed that it can no longer remove all of the lymph. It is at this tipping point, where there is more lymph present than the system can handle, that the swelling of lymphedema occurs.

Gaining weight places yet another stress factor on the lymphatic system. As weight is added, the fat cells that were already present enlarge. In addition, new fat cells form.

This creates more cells to be serviced by the circulatory system and more waste products to be removed by the lymphatic system.

Despite increased weight and body size the number of lymph capillaries and vessels do not increase. Therefore more lymph must be collected and transported by a system that is not large enough to effectively serve the body mass.

Excess weigh also increases the risk of developing other conditions such as diabetes and coronary artery disease.

As the weight increases, the individual becomes less mobile and able to exercise. Yet, the motion of the muscles is an important factor in maintaining the normal flow of lymph. Exercise also helps to burn calories, improves cardiovascular health, and increase general well-being.

References

[1] To read the results of Dr. Reid’s survey, and to view the relevant charts, see Dr. Reid Reports.

[2] National Lymphedema Network "Lymph Link," Vol 19. No.3, July-September 2007.

Morbid Obesity and Lymphedema Management by C.E. Fife MD, et al., page 1

Research Perspectives by S. Ridner, PhD, RN page 9.

Question Corner: Weight Management and LE by Kathryn M. Thrift, BS, CLT-LANA

[3] Living Well With Lymphedema by A. Ehrlich, A. Vinjé-Harrewijn PT, CLT-LANA, and E. McMahon PhD. Lymph Notes 2005. See Chapter 7 pages 86-87 and Section IV, page 224. Buy now from Amazon.com or click here for other options.

© LymphNotes.com 2007. This information does not replace the advice of a qualified health care professional.

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Category: Lymphedema and Other Conditions Updated: 2010-11-03