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Lipedema is a chronic disorder of adipose tissue characterized by symmetrical, dispro portionate enlargement of subcutaneous adipose tissue, most commonly affecting the lower extremities, and accompanied by pain, heaviness, and easy bruising. Its pathophysiology involves alterations in adipocytes, microcirculation, extracellular matrix, inflammatory activity, and, in some patients, fluid retention or lymphatic insufficiency. Weight reduction may be beneficial, particularly in patients with con comitant overweight or obesity, but it does not provide causal treatment and its effects are variable. Nutritional therapy is a supportive component of comprehensive management, aimed at symptom relief, potential metabolic risk, functional status, and quality of life. The approach should be individualized, sustainable, and ideally guided by a qualified nutrition therapist. Care should also include lifestyle measures, physical activity, compression therapy, patient education, appropriate communication, and consideration of psychological aspects.