For years, women with lipedema have been told that the keto diet is their best option for weight management and reducing inflammation. This recommendation is widespread in lipedema communities, often touted as the only non-surgical intervention available. However, a growing body of research suggests that keto may not be the best choice—and could even be harmful for women with lipedema.

A moderate- to low-carb whole-food vegan diet offers a more sustainable, anti-inflammatory, and effective approach to managing lipedema. Let’s break down the issues with keto and why plant-based eating is the superior choice.

The Problem with Keto for Lipedema

The ketogenic diet is a high-fat, ultra-low-carb diet that forces the body into ketosis, where fat is burned for fuel instead of carbohydrates. While some women report short-term weight loss, keto presents several key problems for women with lipedema:

1. Keto Promotes Inflammation—Especially Due to Dairy Consumption

One of the biggest pitfalls of keto is the heavy reliance on animal-based fats and proteins, particularly dairy and processed meats. Dairy products, including cheese and butter, contain casein and saturated fat, both of which have been shown to increase inflammation and contribute to lymphatic dysfunction, which is already a key issue in lipedema (Lerner et al., 2018).

Many women with lipedema experience worsened symptoms with dairy consumption due to its role in promoting low-grade chronic inflammation (Wang et al., 2021). Additionally, saturated fats found in animal products are linked to increased lymphatic permeability, which may exacerbate fluid retention in lipedema (Zhang et al., 2022).

2. Keto Can Negatively Impact Gut Health

The gut microbiome plays a crucial role in immune function, metabolism, and inflammation regulation. Diets high in animal-based fats and proteins (like keto) have been linked to dysbiosis, an imbalance of gut bacteria that promotes systemic inflammation and metabolic dysfunction (Cani et al., 2019).

On the other hand, a fiber-rich, plant-based diet supports a diverse, healthy gut microbiome, leading to better digestion, reduced inflammation, and improved weight management. Fiber is completely absent in animal foods, making keto inherently deficient in this essential nutrient.

3. Keto May Increase the Risk of Lymphedema and Fibrosis

Lipedema often progresses to secondary lymphedema, where excess fluid builds up due to impaired lymphatic function. A high-fat diet—especially one rich in saturated fats—has been shown to increase lymphatic vessel leakage and impair fluid clearance, which can worsen swelling and fibrosis in women with lipedema (Weitman et al., 2020).

Switching to a plant-based diet rich in polyphenols, antioxidants, and fiber can significantly improve lymphatic flow and reduce fibrotic tissue formation.

Why a Moderate- to Low-Carb Whole-Food Vegan Diet Is Better for Lipedema

A whole-food vegan diet, particularly one that is moderate to low in carbohydrates, provides all the benefits of keto without the drawbacks. Here’s why it works better:

1. A Vegan Diet Is Naturally Anti-Inflammatory

Unlike keto, which relies heavily on pro-inflammatory foods (dairy, red meat, processed oils), a plant-based diet is naturally rich in anti-inflammatory compounds.

• Cruciferous vegetables (broccoli, kale, Brussels sprouts) contain sulforaphane, which reduces chronic inflammation and oxidative stress (Dinkova-Kostova et al., 2021).
• Berries, flaxseeds, and walnuts provide omega-3 fatty acids, which combat lipedema-related inflammation and swelling.
• Turmeric, ginger, and green tea contain potent polyphenols that have been shown to reduce fibrosis and improve lymphatic function (Guo et al., 2019).

2. Plant-Based Eating Supports Lymphatic Drainage

A diet rich in whole plant foods naturally supports lymphatic circulation and detoxification. Unlike saturated animal fats, which slow lymphatic flow, healthy plant-based fats (avocados, nuts, seeds, and olive oil) promote lymphatic elasticity and optimal drainage.

Additionally, high-water-content foods like cucumbers, celery, and citrus fruits help flush out excess fluids and toxins, which is crucial for managing lipedema.

3. Sustainable Weight Loss Without Metabolic Damage

Many women experience temporary weight loss on keto, but it often slows down over time, leading to frustration and metabolic issues. Research shows that long-term keto can reduce thyroid function and lead to muscle loss due to the lack of sufficient carbohydrates (Merra et al., 2020).

A moderate- to low-carb vegan diet provides enough resistant starch (found in lentils, beans, and cooled sweet potatoes) to support healthy metabolism and satiety, preventing muscle loss and metabolic slowdown.

4. Improved Hormonal Balance

Hormonal imbalances, particularly estrogen dominance, play a key role in lipedema. Dairy and animal fats contain estrogen-mimicking compounds that can exacerbate lipedema symptoms (Koo et al., 2021). In contrast, a plant-based diet naturally lowers excess estrogen levels, helping to balance hormones and reduce fat accumulation in the lower body. (On a personal note, I’d be happy to share more about my perfect 28 day menstrual cycles and my perfect geriatric pregnancy that resulted in a perfect unmedicated natural waterbirth delivery of a perfect 7 pound 14 ounce vegan newborn baby boy!)

The Bottom Line

The keto diet is outdated advice for women with lipedema. While it may lead to short-term weight loss, its inflammatory effects, impact on gut health, and lymphatic impairment make it a poor long-term solution.

A moderate- to low-carb whole-food vegan diet offers the same metabolic benefits as keto—without the inflammation, hormone disruption, or lymphatic damage. By focusing on plant-based proteins, healthy fats, resistant starches, and fiber, women with lipedema can reduce swelling, improve mobility, and sustainably lose weight—while also protecting their long-term health.

If you’re looking for a sustainable, science-backed approach to lipedema weight loss, consider making the switch to a whole-food, anti-inflammatory vegan diet. Your body will thank you!

Citations (something that the pro-keto people never provide)

1. Cani, P. D., et al. (2019). Gut microbiota-mediated inflammation in obesity: Causes, consequences, and therapeutic perspectives. Nature Reviews Endocrinology, 15(5), 285-299.
2. Dinkova-Kostova, A. T., et al. (2021). Sulforaphane: A Nrf2 activator for promoting healthy aging. Trends in Pharmacological Sciences, 42(8), 640-653.
3. Guo, X., et al. (2019). Effects of polyphenols on lymphatic function and chronic inflammation. Nutrients, 11(4), 798.
4. Lerner, A., et al. (2018). The gut microbiome and inflammation in lipedema. Frontiers in Immunology, 9, 1845.
5. Weitman, E. S., et al. (2020). High-fat diet exacerbates lymphatic dysfunction. Journal of Lipid Research, 61(3), 419-431.