This blog is not meant to diagnose or treat medical conditions. If you have suspect stubborn fat on your body and wonder if you might have lipedema, then read this blog to review the differences between lipedema and cellulite.
Can Our Environment Make Us Fat?
There is some evidence that our environment is making us fat – this is referred to as an “obesogenic environment” (Nappi, 2016). It’s not just that we’ve gotten used to larger portion sizes or we eat more take-out food, it’s also because some aspects of our environment can introduce endocrine-disrupting chemicals such as unhealthy foods, contaminated water and airborne pollutants. But, becoming obese is not simply a matter of our environments however, there are many factors at play, that includes our metabolic system, our endocrine system, genetic predisposition and various non endocrine-disrupting environmental factors.
What is the Endocrine System?
The endocrine system includes any organs that can secrete hormones. An endocrinologist is a medical doctor that specializes in treated conditions related to these glands, for example diabetes, hypothyroidism or menopause. There are several endocrine organs, including:
- The pancreas which makes and secretes insulin
- The thyroid gland which makes and secretes thyroxin
- The adrenal gland which makes and secretes adrenalin
- The ovaries which makes and secretes estrogen and progesterone
- The testes which make and secrete testosterone
In addition to all of these, it’s important to note that fat tissue is also an endocrine organ, which means our fat stores can be susceptible to endocrine disruption as well. This is especially true during fetal development, early life and puberty. While weight gain in adults comes from an increase in the size of fat cells, an increase in fat cell number during early development leaves an adult with an increased number of fat cells.
What are Endocrine Disrupting Chemicals?
These are chemicals that alter some aspect of the endocrine system. They do this by mimicking, blocking or interfering with the body’s hormones. The World Health Organization defines them as “exogenous chemicals or mixtures of chemicals that alter function(s) of the endocrine system and consequently cause adverse health effects in an intact organism, or its progeny, or (sub)populations”(WHO).
What is the Obesogen Hypothesis?
The obesogen hypothisis is the theory that exposure to environmental chemicals during pre-natal and early life may play a role in predisposing to obesity later in life (Gore, 2015). The key concept being that fat is not only a storage location for endocrine disruptors, but that, being an endocrine organ itself, could be vulnerable to endocrine disruption, especially during prenatal, early life and puberty (Nappi, 2016).
Puberty is also the time that lipedema generally presents itself in young girls. Is this a coincidence? Could a young girl that inherits the genetic defect to develop lipedema experience an altered response due to a greater deposit of endocrine disrupting chemicals? There is no evidence of this, and hopefully, research could investigate any connection between lipedema and endocrine disruptors.
Where do Endocrine Disruptors Come From?
They are pervasive in our environment including in the atmosphere, sediments, soil and water. They also include in industrial chemicals namely, bisphenol A and phthalates (more on these below). They can also come from pesticides, fungicides, insecticides, or herbicides or can occur naturally such as in phytoestrogens (Nappi, 2016).
We take in endocrine disruptors from:
- Water
- Food
- Skin absorption from the air
- Breathing in volatile contaminants
- Fuel combustion
- Heat decomposition of waste
Many of them are fat-soluble and can accumulate in your fat stores (WHO). If you have lipedema and greater fat stores, what does this mean for you? The answer is we don’t know. But, an educated guess might lead us to speculate that you could be holding more of these fat-soluble endocrine disruptors in your body. To date, I have not found any published research looking an endocrine disruptor burden and lipedema.
What is Bisphenol A?
Also know as BPA, this is a chemical used in the production of polycarbonate plastics, which are hard, clear plastics, including shatterproof windows, lenses of eye glasses, hard plastic water bottles, and resins that line the inside of food cans (NIEHS, 2023). It’s also used in thermal paper receipts – the receipts that pretty much every cash register, bank machine and payment tap system produces.
BPA is also found in air, dust and water, and even breast milk, so you won’t be able to avoid it completely. But, you do still have some control over your exposure to it, because our greatest exposure to this chemical is from the food supply (NIEHS, 2023).
According to Health Canada, most adults have low exposure levels of BPA and there is no associated health risk. But, there is reason for concern with infants, simply because of their small body weight and their potential exposure through the infant formula packaging as well as the baby bottles. Currently, it is illegal to import, advertise, or sell polycarbonate baby bottles that contain BPA in Canada (Health Canada, 2020). This is likely the case in many countries around the world.
How To Reduce Exposure to BPA (Health Canada, 2020 and NIEHS, 2023)
Here are some steps you can take to help reduce your exposure to BPA:
- Don’t microwave plastic, especially the polycarbonate food containers -these are the harder plastics
- Check the recycle codes on the bottom of your containers – codes 3 or 7 may contain BPA
- Avoid the word “polycarbonate” on containers
- Reduce your use of canned foods, choose cans labelled “non-BPA” and rinse select foods well that come in cans. You can’t rinse everything that comes in a can, like tuna for example, but you can rinse chickpeas or lentils.
- When storing hot food or reheating foods, choose glass, porcelain or stainless steel containers
- Avoid plastic containers that are damaged, stained or have an unpleasant smell
- Don’t handle thermal paper receipts before eating
- Follow these same guidelines for your children
What are Phthalates?
Phthalates are chemicals used to soften plastics to increase flexibility. They are also used as solvents in many household products. Phthalates can be contained in many things, including (Health Canada, 2020):
- Cosmetics
- Non-prescription drugs
- Natural health products
- Fabrics and textiles
- Electrical items and electronics
- Children’s toys and childcare items
- Construction materials
- Pest control products
- Some food packaging materials
- Printing inks
While the Canadian government found that most phthalates don’t pose a health risk, a particular one called Di(2-ethylhewyl) phthalate (DEHP) was found to be the exception. DEHP is a hazardous substance and was banned in cosmetics, is managed in its use in medical devices and is regulated for vinyl products in children’s toys and child care items (Health Canada, 2020). But, like BPA, exposure to phthalates can also be from exposure to indoor air, dust, water and food, so it’s not possible to avoid it completely.
How Do Endocrine Disruptors Make Us Fat?
Endocrine disruptors (EDCs) are often referred to as “obesogenic” or “diabetogenic” this means that they create obesity or diabetes. They are suspected of doing this by a few mechanisms, such as (Nappi, 2016):
- By disrupting the normal control over the creation of new fat cells and energy balance
- By influencing appetite and satiety in animal research
- By increasing chronic inflammation, which contributes to further build-up of abdominal fat and insulin resistance
- Epigenetic changes – changing gene expression without changing the DNA
- By increasing Peroxisome Proliferator-Activated Receptors-y (PPAR-y) which is a molecule that regulates the creation of fat cells
- Changes to the gut microbiota
What Makes a Substance Hazardous?
The ATSDR of the Center for Disease Control and Prevention (CDC) reminds us that the effects that you suffer after exposure to any hazardous substance depends on the dose, the duration, the method of exposure, your personal traits and habits and what other chemicals are also present. So, when taking all of this into consideration, you can see how incredibly complicated the issue of becomes (ATSDR, 2002).
Could Toxins be Responsible for Lipedema?
There is no evidence of this. So far, what we know is that lipedema is a genetic condition that is accelerated by hormones, specifically estrogen. But, could it be made worse by endocrine disruptors? That’s certainly a good question that demands additional research. In the meantime, you may choose to act with the assumption that it is related and take steps to reduce your exposure. I think that’s a reasonable approach and many people share this concern, with and without lipedema.
How to Reduce My Exposure to Endocrine Disrupting Chemicals?
While this article highlighted two chemicals – BPA and Phathlates, there may be hundreds of chemicals with potential to act on our endocrine system. Some of the main prevention strategies rely on women of childbearing years to avoid exposure, to protect their future fetus from exposure during development. The most vulnerable time for exposure is the fetus being exposed during pregnancy (Yilmaz, 2020). If you are raising daughters, you can take care to choose appropriate cosmetics, toiletry items, household chemicals, foods and food containers.
It’s important to point out that not all countries regulate these products in the same way. The European Union bans more than 1400 dangerous chemicals from cosmetics while the USA bans less than 20 chemicals (Ferreira, 2022). So, if you live in the USA and are purchasing cosmetics and toiletry products without paying attention to labels, you could be introducing more endocrine-disrupting chemicals into your system, and if you have lipedema, it’s unclear what affect that might have on your condition.
As a cancer survivor myself, I pay attention to what I eat and what I apply to my skin. If you have lipedema, I think it’s especially important to pay attention to lotions and body washes, that you apply directly to your lipedema skin. I purchase my soaps, creams and deodorant at the health food store exclusively rather than the pharmacy, as I can find a good selection of items with the labels “phathlate free”, “BPA free” and “paraben free”. I find this easier then trying to memorize a list of ingredients and scrutinizing the labels at the pharmacy. In the past when I’ve used a bar-code scanning app to help with this, none of the pharmacy items got an approval rating from the app.
Further Reading
If you enjoyed this blog, you may also enjoy reading:
Serrapeptase for Lymphedema and Lipedema
If you want to track your lipedema and changes to your diet or personal care, then order a Lipedema Journal.
References for Endocrine Disruptors and Lipedema
ATDSR (Agency for toxic substances and disease registry). Public Health Statement Di)2-ethylhesyl)phthalate (DEHP). Last updated Sept 2002. Accessed Mar 15, 2024.
Ferreira M, Matos A, Couras A, Marto J, Ribeiro H. Overview of Cosmetic Regulatory Frameworks around the World. Cosmetics. 2022; 9(4):72.
Health Canada. Bisphenol A (BPA). Last updated July 29, 2020. Accessed Mar 15, 2024.
Health Canada. Phthalates. Last updated Dec 4, 2020. Accessed Mar 15, 2024.
Nappi F, Barrea L, Di Somma C, Savanelli MC, Muscogiuri G, Orio F, Savastano S. Endocrine Aspects of Environmental “Obesogen” Pollutants. Int J Environ Res Public Health. 2016 Jul 28;13(8):765. doi: 10.3390/ijerph13080765. PMID: 27483295; PMCID: PMC4997451.
National Institute of Environmental Health Sciences (NIEHS). Bisphenol A (BPS). Last reviewed Aug 31, 1023. Accessed Mar 10, 2024.
World Health Organization (WHO). Identification of risks from exposure to endocrine disrupting chemicals at the country level. 2014. Accessed Mar 10, 2024.
Yilmaz B, Terekeci H, Sandal S, Kelestimur F. Endocrine disrupting chemicals: exposure, effects on human health, mechanism of action, models for testing and strategies for prevention. Rev Endocr Metab Disord. 2020 Mar;21(1):127-147. doi: 10.1007/s11154-019-09521-z. PMID: 31792807.
