One of the limitations of BMI is that it fails to account for either body composition or body fat distribution. While patients with lipedema may have a BMI >30kg/m2, their condition is very different from most obesity associated with positive energy balance. Accumulation of fibroadipose tissue in the lower body and arms has distinct pathologic features as well as resistance to conventional therapies. This session will examine how lipedema is different from most forms of obesity, how it is diagnosed, and the unique treatment strategies used to combat this challenging condition.