“Ordinarily, such patients [Editor’s note: with lipohyperplasia dolorosa (“lipedema”)] are very sensitive about the appearance of their limbs; they wear long skirts and stand behind chairs when in the presence of strangers. They avoid swimming. Evidence of neurosis is likely to be found. Occasionally, a patient feels that her legs have ‘ruined her life’. Many are ‘ashamed’ of their legs.” (Allen and Hines 1940). Even then, it was known that patients suffer not only physically, but also emotionally. This burden, however, was not the focus of considerations about the origin of the disease and how it can be treated until a few years ago. Today, in times of great awareness in professional debate and lay discussion, there is increasing understanding also for the psychodynamics of the disease, even if the fat distribution disorder remains primarily a somatic disease of body shape and pain. Lipohyperplasia dolorosa is: