The purpose of this study was to characterize obesity as a novel cause of lower extremity lymphedema. Fifty-one patients with a body mass index greater than 30 kg/m(2) without any potential cause of lymphedema were evaluated with lymphoscintigraphy. Group 1 patients (n = 33) were at their maximum body mass index; individuals with lymphatic dysfunction had a greater body mass index (72.0 kg/m(2)) compared with subjects with normal function (37.7 kg/m(2)) (p < 0.0001). Body mass index predicted the lymphoscintigram result, which was abnormal if the body mass index was greater than 60 kg/m(2) and normal if it was less than 50 kg/m(2). Group 2 patients (n = 18) had lost weight and were not at their maximum body mass index: patients who reduced their body mass index from greater than 60 kg/m to less than 50 kg/m(2) had normal (n = 4) or abnormal (n = 3) lymphatic function. Patients with obesity-induced lymphedema, or who were at risk for the condition, were referred to a surgical weight loss center.
Clinical question/level of evidence: Risk, III.