ClinicalTrials.gg
CompletedNCT04632810LipodietUpdated Jul 21, 2026

Effect of Ketosis on Pain and Quality of Life in Patients With Lipedema

An interventional study of Ketogenic low energy diet and non-ketogenic low energy diet in Lipedema, sponsored by Helse Nord-Trøndelag HF. Completed at 2 sites in Norway. Open to female participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2026-07-21.

Sponsored by Helse Nord-Trøndelag HF · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
70
Allocation
Randomized
Ages
18 Years to 75 Years
Sex
Female
01

Study summary

Lipedema is a female progressive fat disorder, characterized by a symmetrical increase in subcutaneous adipose tissue in the lower extremities with the exception of the waist. The condition is often misdiagnosed and underdiagnosed. The etiology is poorly understood. Affects about 11% of all women and may lead to pain and immobility. The pathophysiology may be related to sex hormones and inflammatory response. Lipedema fat has been reported not to respond to lifestyle changes or bariatric surgery, both in terms of weight loss and symptom reduction; including pain and quality of life. Clinical research on the effect of dietary interventions on lipedema does not exist, but a pilot study with a ketogenic diet showed a significant reduction in pain regardless of weight loss. The aim of the research project will be to investigate whether a ketogenic diet can be a treatment option for patients with lipedema. Therefore, a randomized controlled trial will be conducted to compare the effects of two diets. 1) energy-restricted ketogenic diet and 3) energy-restricted low-fat non-ketogenic diet for 8 weeks. Pain and quality of life will be mesured at start and immediately after the intervention. The hypothesis is that a ketogenic diet may reduce pain and improve quality of life.

Read the detailed description

Study design RCT comparing a low-energy ketogenic diet to a non-ketogenic low-energy diet (non-keto) in females with lipedema. This study was approved by the Reginal Ethical Committee (REK 93888) All participants have to provided written informed consent in line with the Helsinki Declaration, before entering the study. Participants will be randomized by block randomization with stratification by BMI categories.

Study population Females diagnosed with lipedema, aged 18-75 years old, and a BMI between 30-45 kg/m2, will be invited to participate in this study. Participants had to be diagnosed with lipedema by physiotherapists before inclusion. Inclusion criteria includs weight stability for the last three months (±3 kg).

Dietary interventions Diets were matched for energy (1200 kcal/day) and protein, but differed in carbohydrate (CHO) and fat content.

The dietary plans are adjusted with respect to food preferences, intolerances, and allergies. The participants will be asked not to change their physical activity levels throughout the study period.

Compliance Participants will have weekly follow-ups. Participants will be asked to fill out daily food records throughout the intervention period.

Ketostix will be used in the weekly follow-ups to measure urinary acetoacetate (AcAc). If the participants in the keto group were outside of ketosis, or participants in the non-keto group in ketosis, >2 times throughout the study period, they were excluded from the per-protocol (PP) analysis.

Outcome variables

The following variables were assessed at baseline and at the end of the intervention:

Anthropometrics and body composition Height and weight will be measured at baseline. Body composition will be assessed in fasting state with Bioelectrical Impedance Analysis before and after the intervention..

Pain Pain will be assessed with the brief Pain Inventory. The participants rated their pain in a numerical rating scale (NRS), where 0 = no pain and 10 = Worst imaginable pain. The BPI assesses pain intensity: strongest pain, weakest pain, average pain, pain now, pain severity score using an average of pain intensity domains, and pain inference from daily activities, mood, walking, regular work, relationships, sleep and life joy. A pain inference score is also computed as the average of all pain inference domains.

Three different questionnaires are used to assess Quality of life. RAND-36. The Impact of Weight on Quality of Life-Lite (IWQOL-Lite) q and the Lymphoedema Quality of Life (LYMQOL).

02

Conditions studied

  • Lipedema

Keywords

  • Diet therapy
  • Ketosis
  • Pain
  • Weight loss
03

In context

Lipedema

85 studies on the registry are indexed under Lipedema; 32 are open to participants now.

This study's enrollment of 70 is above the median of 35 across 42 interventional studies indexed under Lipedema.

Browse Lipedema studies →

Lead sponsor

Helse Nord-Trøndelag HF is the lead sponsor of 27 studies on the registry; 5 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
Female
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Diagnosed with lipedema by skilled physical therapists
  • > 30kg/m2 and \< 45kg/m2
  • Stable weight over the last three months (+2-3kg)
  • Not currently dieting to lose weight
  • Willing to meet for follow-ups every second week during the intervention
  • Willing to sign an before entering the study

Exclusion criteria

Exclusion Criteria:

  • Pregnant or breast feeding
  • History of infectious diseases
  • Medication known to affect obesity
  • Enrolled in any other obesity treatment
  • Having had bariatric surgery.
  • Kidney disease is excluded
  • History of psychological disorders
  • Not mastering a Scandinavian language
  • Being mentally disabled
  • Malign disease
  • Diabetes
  • Any disease that leads to dietary advice that is not consistent with intervention advice
Terms in these criteria, in plain language(2)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
70 participants (actual)

Study arms

  • Experimental
    Ketogenic low energy diet

    Ketogenic low energy diet for 8 weeks

    Other: Ketogenic low energy diet

  • Active comparator
    non-Ketogenic low energy diet

    non-Ketogenic low energy diet for 8 weeks

    Other: non-ketogenic low energy diet

Interventions

  • OtherKetogenic low energy diet

    Participants will follow a low energy diet, with 1200 kcal per day. Carbohydrates 75g (25E%), protein 60 g (20E%), fat 73 g (55E%) in 8 weeks

  • Othernon-ketogenic low energy diet

    Participants will follow a low energy diet, with 1200 kcal per day. Carbohydrates 180g (60E%), protein 60 g (20E%), fat 27 g (20E%), in 8 weeks

06

What researchers measure

Primary outcomes

  1. change in pain intensity

    A difference in mean pain score of 2 units on a continuous scale from 0 to 10 on a visual analog scale (VAS) is considered clinically interesting

    Time frame: 8 weeks

  2. change in quality of life

    Likert Scale

    Time frame: 8 weeks

07

Study locations

2 sites
  • Levanger Hospital, Nord-Trøndelag Hospital Trust
    Levanger, Norway
  • St Olavs Hospital
    Trondheim, Norway
08

References and documents

Publications

  • Lundanes J, Nes VF, Aakervik O, Ryan L, Hansson P, Rokstad AM, Martins C, Nymo S. Changes in Cytokines and Fibrotic Growth Factors after Low-Carbohydrate or Low-Fat Low-Energy Diets in Females with Lipedema. Curr Dev Nutr. 2025 Feb 20;9(3):104571. doi: 10.1016/j.cdnut.2025.104571. eCollection 2025 Mar. PubMed 40125475 ↗
  • Lundanes J, Storlilokken GE, Solem MS, Dankel SN, Tangvik RJ, Odegard R, Holst JJ, Rehfeld JF, Martins C, Nymo S. Gastrointestinal hormones and subjective ratings of appetite after low-carbohydrate vs low-fat low-energy diets in females with lipedema - A randomized controlled trial. Clin Nutr ESPEN. 2025 Feb;65:16-24. doi: 10.1016/j.clnesp.2024.11.018. Epub 2024 Nov 19. PubMed 39566600 ↗
  • Lundanes J, Garseth M, Taylor S, Crescenzi R, Pridmore M, Wagnild R, Hyldmo AA, Martins C, Nymo S. The effect of a low-carbohydrate diet on subcutaneous adipose tissue in females with lipedema. Front Nutr. 2024 Nov 7;11:1484612. doi: 10.3389/fnut.2024.1484612. eCollection 2024. PubMed 39574523 ↗
  • Lundanes J, Sandnes F, Gjeilo KH, Hansson P, Salater S, Martins C, Nymo S. Effect of a low-carbohydrate diet on pain and quality of life in female patients with lipedema: a randomized controlled trial. Obesity (Silver Spring). 2024 Jun;32(6):1071-1082. doi: 10.1002/oby.24026. Epub 2024 Apr 16. PubMed 38627016 ↗

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Mar 2021 to primary completion in Jul 2023, 27 months.

Of 29 interventional studies with no phase under Lipedema, half reached primary completion within 15 months of starting (the median), counting those still running; a quarter within 6 and three quarters within 31. This study's 27 months is above that.

How these figures are worked out, and which studies are left out of them.

Registered
Nov 12, 2020
First posted
Nov 17, 2020
StartActual
Mar 22, 2021
Primary completionActual
Jul 1, 2023
CompletionActual
Aug 11, 2025
Last update
Jul 21, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jul 21, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04632810
Lead sponsor
Helse Nord-Trøndelag HF
Responsible party
Sponsor
First posted
Nov 17, 2020
Start date
Mar 22, 2021
Primary completion
Jul 1, 2023
Completion
Aug 11, 2025
Last update
Jul 21, 2026

Study contacts

Siren Nymo, PhD
principal investigator · Nord-Trøndelag Hospital Trust, Namsos Hospital, Clinic of Surgery
Hallvard Græslie, md
study director · Nord-Trøndelag Hospital Trust, Namsos Hospital, Clinic of Surgery

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Jul 2026. You cannot join it, but the record below documents what was studied.

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