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  • Invisible Illness, Visible Clues: Tuning Into Your Skin, Your Labs, and Your Inner Wisdom Differently with Dr. Jonathan Carp

    Invisible Illness, Visible Clues: Tuning Into Your Skin, Your Labs, and Your Inner Wisdom Differently with Dr. Jonathan Carp
    2026/09/10
    "You are fully capable of becoming your own authority in your health." —Dr. Jonathan Carp Invisible illness rarely announces itself with a clean diagnosis — but the body often leaves clues, if you know where to look. In this conversation, board-certified dermatologist and lifestyle medicine physician Dr. Jonathan Carp joins Donna Piper to talk about what 25 years of practice have taught him about the connection between skin, gut health, and insulin — and why so many of these clues get missed in a rushed appointment. Dr. Carp walks through how conditions like SIBO, celiac sensitivity, and insulin resistance show up on the skin long before they show up on a standard lab panel, and why fasting insulin can flag metabolic problems five to ten years before a diabetes diagnosis. He also shares how he uses mental imagery techniques with patients — including one who healed chronic skin picking using an image she created herself — and why he tells patients to keep major lifestyle changes private from anyone outside their household. This episode is especially for anyone managing chronic illness, invisible symptoms, or the exhausting feeling of not being believed by their own doctor. It's a reminder that visible clues — on your skin, in your labs, in your own instincts — are worth trusting, even when no one else has connected the dots yet. Key takeaways: • Rosacea has a strong documented link to small intestinal bacterial overgrowth (SIBO), and Dr. Carp expects SIBO testing to become standard for rosacea patients within five years. • Fasting insulin can climb for years while blood sugar stays normal, meaning elevated insulin can predict diabetes risk five to ten years before it would otherwise be caught. • A normal fasting insulin range is roughly 15–25; results consistently above 10 are worth discussing with a provider. • Fasting insulin and SIBO tests can both be ordered independently through labs like Quest or LabCorp, without waiting on a doctor's approval. • Only about 1 in 200 patients in Dr. Carp's practice are ready to make a full diet and lifestyle overhaul, which is why he recommends picking one path and going deep rather than jumping between approaches. • Mental imagery — where patients generate their own healing image rather than following a guided visualization — has helped patients manage conditions ranging from neurodermatitis to chronic warts. • Sharing a major lifestyle change with people outside your immediate household often invites judgment that can derail progress before it takes hold. Connect with Donna: Website: https://www.donnapiper.com/ LinkedIn: https://www.linkedin.com/in/donnapiper Instagram: https://www.instagram.com/thedonnapiper Facebook: https://www.facebook.com/thedonnapiper YouTube: https://www.youtube.com/@thedonnapiper Apple Podcast: https://tinyurl.com/Dear-Body-Im-Listening Resources: 🤔Got a question for me? Every month, I do a listener coaching episode—and I'd love to hear from you! Send your questions, stories, or flare-up confessions to donna@donnapiper.com, and you just might hear your answer on the show. 💲Discount Get $20 off the Visible Wrist Band 2.0 Click the link: https://join.makevisible.com/73784699c7db3e **Wearable heart-rate and activity sensor, with charging cable and strap included. 5 days battery life Manufactured by Polar, the world leader in heart-rate monitoring Designed for illness, not fitness HSA/FSA Eligible 💗Springrose Give $20, GET $20 When you share Springrose with friends, they get $20 off their first purchase and you get $20 towards your next purchase!* Share the love. https://oken.do/0l3hpr6v 💗Equip Fuel With Real Food Meet Prime Protein, the original beef protein powder, with over 20g of delicious grass-fed beef protein. No junk or fillers https://www.equipfoods.com/DONNA15 Episode Highlights: 03:28 Meet Dr. Jonathan Carp: From Dermatology to Lifestyle Medicine 07:42 The Gut-Skin Connection: SIBO, Celiac & Psoriasis 10:30 Acne, Insulin Resistance & the Fasting Insulin Test 14:09 Reversing Insulin Resistance Through Diet 18:28 Inside Wednesday Night Live & Miracle Noodle 20:16 How a Trip to Japan Sparked Miracle Noodle 23:34 Why Ordering Your Own Blood Tests Is Empowering 28:48 The 1-in-200 Rule: Why Lifestyle Change Is Hard 36:27 Mental Imagery Healing With Dr. Gerald Epstein 47:10 Final Advice: Pick One Health Path and Go Deep
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    55 分
  • Ground Control for Bendy Bodies: How to Move Without Pain (Finally!) with Dr. Melissa Koehl

    Ground Control for Bendy Bodies: How to Move Without Pain (Finally!) with Dr. Melissa Koehl
    2026/08/27

    "You have to give your body the time to repair between sessions and respect, from a cellular perspective, how much energy it can effectively produce on any given day." —Dr. Melissa Koehl

    Hypermobility exercise isn't supposed to leave you in more pain than when you started — but for most bendy bodies, it does, because nobody ever taught them the rules were different. In this episode, Donna sits down with Dr. Melissa Koehl, a Doctor of Physical Therapy, Pilates instructor, and founder of Chimera Health, to unpack why traditional fitness advice can actively work against people with joint hypermobility, hypermobility spectrum disorder, and Ehlers-Danlos Syndrome (EDS).
    Melissa isn't just speaking from 24 years of clinical experience — she's speaking from her own late-stage EDS diagnosis, which reshaped how she trains clients and how she sees "healthy movement" altogether. This conversation is for anyone who's been told their pain is "just anxiety," anyone chasing more reps and more stretching with less relief, and anyone who suspects their fatigue, brain fog, or chronic soreness is connected to something deeper than a bad workout plan.
    Together, Donna and Melissa dig into the real symptoms of hypermobility beyond bendy joints — including fatigue, dysautonomia, and mast cell activation — and why connective tissue needs a fundamentally different recovery timeline than the average client's muscles do.
    Key Takeaways:
    • Hypermobility symptoms extend far beyond flexible joints — fatigue and brain fog are two of the most common and most overlooked signs, often driven by blood pooling in the lower body instead of circulating back to the heart and brain.
    • Movement for hypermobile bodies should prioritize stability and controlled strength work over stretching, since excess flexibility is already the problem, not the solution.
    • Connective tissue — tendons, ligaments, and fascia — repairs more slowly than muscle, so rest between sessions isn't optional; it's a cellular requirement for actual progress.
    • Hypermobility spectrum disorder and hypermobile EDS are frequently misunderstood as separate tiers of severity, when in reality the two overlap significantly.
    • A formal diagnosis and self-advocacy with providers can be the difference between years of dismissed symptoms and a treatment plan that finally makes sense.
    • Chronic pain and fatigue in hypermobile bodies is not a personal failure — it's a physiological pattern with an identifiable cause and a manageable path forward.
    Melissa is currently offering a free 32-page Hypermobility Posture Guide, and her Ground Control program opens again on September 21st.
    Download the free Hypermobility Posture Guide here: https://www.chimera-health.com/hypermobility-posture-guide-donna-piper

    Connect with Donna:
    Website: https://www.donnapiper.com/
    LinkedIn: https://www.linkedin.com/in/donnapiper
    Instagram: https://www.instagram.com/thedonnapiper
    Facebook: https://www.facebook.com/thedonnapiper
    YouTube: https://www.youtube.com/@thedonnapiper

    Episode Highlights:
    04:09 Meet Dr. Melissa Koehl: Her Own Hypermobility Journey
    07:15 Inside the Ground Control Program
    10:26 Hypermobility Symptoms and Misconceptions Explained
    21:13 Why Rest Is Non-Negotiable for Hypermobile Bodies
    32:08 Getting Diagnosed and Advocating for Yourself
    36:31 Resources and Support for Hypermobile Patients
    39:43 You Are an Orchid, Not a Dandelion

    Resources:
    Ready to move smarter, not harder? Melissa's free 32-page Hypermobility Posture Guide is exactly where to start — link below to grab your copy. 👇 https://www.chimera-health.com/hypermobility-posture-guide-donna-piper

    Two courses that are always available:
    Navigating Healthcare as a Hypermobile Human: https://www.chimera-health.com/NavigatingHealthcare
    ChimeraFit Video library: https://www.chimera-health.com/ChimeraFit-Video-Library
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    48 分
  • Dear Body, It Runs in the Family: What Lipedema Genetics is Finally Revealing

    Dear Body, It Runs in the Family: What Lipedema Genetics is Finally Revealing
    2026/08/13
    "This is fascinating, and is also exactly the kind of science we need to handle responsibly because epigenetics is not a new way to blame yourself. If future research shows environmental or epigenetic factors and how they influence lipedema expression, that is exciting. But that does not mean that you caused the disease to come out when you were stressed, that you ate wrong, that you failed to regulate your nervous system. No. Susceptibility, predisposition, hormones, biology, environment, and gene expression can interact in extraordinary, complicated ways, and this is a very complicated disease. The purpose is understanding that interaction to create better treatments, not better ways to blame yourself." —Donna Piper For most of her life, Donna was told her body was a lifestyle problem — eat less, move more, blah blah blah. In this Dear Body Book Club episode, she opens Lipedema: Principles and Practice of Diagnosis and Treatment, edited by Stanley Rockson, MD, Leslyn Keith, OTD, and Catherine Seo, PhD, and dives into the genetics section — Chapters 3, 4, and 5. Donna doesn't read the book to you line by line. She translates the genome-wide association studies, the acronyms, and the dense clinical language into plain English, then filters it through her own 53 years of living undiagnosed. The question shifts from "why does my body look this way?" to "what's actually happening inside the tissue?" — and that shift changes everything. In this episode, we discuss: Why an estimated 40% to 89% of women with lipedema report a family history — and why that range is so wide Why researchers believe lipedema is often passed down through the paternal line, even though men rarely show visible symptoms What a genome-wide association study (GWAS) actually is, explained without the jargon The UK Biobank study and how researchers built a "proxy lipedema phenotype" to work around chronic underdiagnosis Two genetic regions — VEGFA and GRB14-COBLL1 — linked to blood vessel formation and body fat distribution Findings from a 200-woman UK cohort, including an average age of onset around 16.8 years old The AKR1C1 gene and its connection to progesterone metabolism Why there is still no single validated genetic or blood test for lipedema The TNXB gene and its overlap with a form of Ehlers-Danlos syndrome, connecting hypermobility to lipedema biology What multiomics research (transcriptomics, metabolomics, lipidomics) revealed inside lipedema tissue itself Elevated inflammatory markers, including IL-1beta, IL-6, and TNF-alpha, found in lipedema tissue The "Fat Atlas" concept — why fat in different parts of the body may behave like different tissue entirely How estrogen, progesterone, and major hormonal transitions like puberty and menopause factor into lipedema onset Why epigenetics matters here, and why it is not a reason to blame yourself The real technical reasons lipedema research moves slowly, from liposuction-damaged samples to small patient cohorts 🗒️ Donna's Sticky Notes The highlights I don't want you to miss — if you only remember three things from this episode, remember these: Sticky Note #1: Don't forget dad's side of the family. If lipedema doesn't seem to show up on your mother's line, look to your father's — photos, family members, body shapes. Inheritance appears to run through the paternal line even when fathers show no visible symptoms themselves. Sticky Note #2: There probably isn't one lipedema gene. It's not one gene causing lipedema on its own — it's how genetic predisposition interacts with hormones, fat biology, connective tissue, vascular pathways, metabolism, lymphatic function, and inflammation, all at once and differently in every body. Sticky Note #3: Lipedema tissue appears to be biologically different tissue. Researchers are finding real differences in gene expression, lipids, metabolites, inflammatory signaling, fat cell development, blood vessel pathways, and connective tissue genes. The better question isn't "why do I have so much fat here?" — it's "what is happening inside this tissue to make it behave this way?" 💛 What this means in plain English None of this research hands you a genetic test you can take to your doctor tomorrow. What it does offer is direction. Researchers are seeing real, measurable differences inside lipedema tissue — in genes, lipids, hormones, and inflammation — not just differences in how much fat someone carries. That distinction matters, because it moves the story away from blame and toward biology. It also explains why two women can have the same diagnosis and completely different experiences of pain, swelling, and progression. And it's why looking at your father's side of the family, not just your mother's, can open up a piece of your history you didn't know to look for. Key Takeaways Family history shows up in an estimated 40% to 89% of lipedema cases, but the strongest inheritance signal appears to run through the paternal ...
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    53 分
  • Move Smart, Not Hard: The Movement Mindset Chronic Illness Actually Needs with Tyler Bramlett

    Move Smart, Not Hard: The Movement Mindset Chronic Illness Actually Needs with Tyler Bramlett
    2026/08/06
    "It's not about pushing yourself and judging yourself and trying to change how you look. It's about accepting yourself and learning how to appreciate your body and using that as fuel to show up and take care of it at the end of the day." —Tyler Bramlett Chronic illness movement doesn't have to mean choosing between pain and progress — and this episode makes the case for a third option. Donna sits down with Tyler Bramlett, co-founder of WeShape, whose own body forced him to rebuild everything he thought he knew about fitness after two major injuries and five knee surgeries. What emerges is a conversation less about workouts and more about relearning how to trust a body that hasn't always felt trustworthy. This episode is for anyone living with hypermobility, EDS, POTS, migraine, fibromyalgia, lipedema, or any invisible condition where movement helps — but the wrong kind of movement makes everything worse. Tyler and Donna dig into why high-intensity, no-pain-no-gain fitness culture actively harms chronically ill bodies, and what mindful, scalable movement looks like instead. Listeners will walk away understanding why "20-plus failed routines" is the norm, not the exception — and why that's a sign the model is broken, not the person. Key takeaways: Hypermobile joints get injured by overshooting end range of motion, not by moving too much — awareness of that range matters more than intensity. Chronic tension in the neck and traps can worsen migraine symptoms, and learning to engage opposing muscles can help release that tension over time. Self-hatred as a motivator eventually backfires, because it trains the brain to keep disliking the body no matter what changes. Movement scores — tracking strength, mobility, balance, and core function — offer a way to measure progress without relying on the scale. Starting with two 10-minute sessions a week is more sustainable than an hour five days a week, and consistency over years builds capacity that intensity never will. Recovery isn't linear — peaks and valleys are part of the process, not evidence that something has gone wrong. Try Tyler's free movement assessment: www.weshape.com/dearbody Connect with Donna: Website: https://www.donnapiper.com/ LinkedIn: https://www.linkedin.com/in/donnapiper Instagram: https://www.instagram.com/thedonnapiper Facebook: https://www.facebook.com/thedonnapiper YouTube: https://www.youtube.com/@thedonnapiper Apple Podcast: https://tinyurl.com/Dear-Body-Im-Listening Resources: 🤔Got a question for me? Every month, I do a listener coaching episode—and I'd love to hear from you! Send your questions, stories, or flare-up confessions to donna@donnapiper.com, and you just might hear your answer on the show. 💲Discount Get $20 off the Visible Wrist Band 2.0 Click the link: https://join.makevisible.com/73784699c7db3e **Wearable heart-rate and activity sensor, with charging cable and strap included. 5 days battery life Manufactured by Polar, the world leader in heart-rate monitoring Designed for illness, not fitness HSA/FSA Eligible 💗Springrose Give $20, GET $20 When you share Springrose with friends, they get $20 off their first purchase and you get $20 towards your next purchase!* Share the love. https://oken.do/0l3hpr6v 💗Equip Fuel With Real Food Meet Prime Protein, the original beef protein powder, with over 20g of delicious grass-fed beef protein. No junk or fillers https://www.equipfoods.com/DONNA15 Episode Highlights: 02:13 Meet Tyler Bramlett: The Injury That Redefined Fitness 06:44 Hypermobility, EDS, and Overshooting Your Limits 11:34 Why High-Intensity Workouts Fail Chronic Illness Bodies 14:48 Breaking the One-Step-Forward, One-Step-Back Cycle 19:58 Becoming Your Own Guru: Mindful vs Mindless Movement 23:07 Body Image, the Fitness Industry, and Raising Daughters 31:41 Inside WeShape: Personalized Movement Progressions 40:00 Quantifying Progress With Movement Scores 43:03 Start Small: The Power of Two 10-Minute Routines 50:28 Try WeShape Free and Where to Find Tyler
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    55 分
  • Dear Doctor, Please Look Again | Dear Body Book Club: Chapter 2

    Dear Doctor, Please Look Again | Dear Body Book Club: Chapter 2
    2026/07/30
    "Dear Body… I will remember that I am not only a patient. I am your witness. I am your advocate, and I am your partner." —Donna Piper In this episode of the Dear Body Book Club, Donna explores Chapter Two of the new medical textbook Lipedema: Principles and Practice of Diagnosis and Treatment, edited by Stanley G. Rockson, MD; Leslyn Keith, OTD; and Catherine Seo, PhD. "Chapter Two, Addressing Lipedema: Challenges to the Primary Care Physician," was written by Matthew Carmody, MD. This chapter looks at seven major challenges primary care providers face when diagnosing and caring for people with lipedema. But it also asks something bigger: What would healthcare look like if the patient's lived experience were treated as a form of expertise? Donna translates the chapter's clinical language into everyday conversation and explores what compassionate, collaborative lipedema care can look like—from differential diagnosis and physical examination to pain, weight stigma, treatment planning, mental health support, and multidisciplinary referrals. BUY THE BOOK Read along with the Dear Body Book Club: Lipedema: Principles and Practice of Diagnosis and Treatment Affiliate disclosure: This may be an affiliate link, which means I may receive a small commission if you purchase through it, at no additional cost to you. IN THIS EPISODE We discuss: - Why lipedema may be missed or diagnosed as obesity or lymphedema - How lipedema, obesity, and lymphedema can occur together - Why each condition still needs to be recognized and treated separately - Why BMI alone does not provide a complete clinical picture - How body-fat distribution and waist-to-height ratio can offer additional information - Why coping with chronic symptoms may cause patients to underreport their pain - The value of asking a patient to describe a typical day in her life - How lipedema can affect pain, fatigue, heaviness, movement, sleep, social life, and quality of life - A plain-language explanation of what may be happening inside lipedema tissue - Why the patient is an important co-expert in her own care - What a respectful, collaborative lipedema examination can look like - Why treatment goals need to be individualized - The role of office staff, follow-up systems, and care coordination - The psychological effects of lipedema and repeated medical dismissal - Weight stigma, internalized anti-fat bias, and healthcare avoidance - Why primary care physicians are important in coordinating multidisciplinary care - Possible referrals for compression, MLD, CDT, movement, nutrition, mental health support, weight management, vascular care, and surgery - Why sustainable, patient-specific changes are more realistic than an overwhelming list of new rules THE SEVEN CHALLENGES PRESENTED IN CHAPTER TWO 1. Differentiating lipedema from—and identifying it alongside—obesity, lymphedema, and other co-occurring conditions 2. Understanding the patient's lived experience 3. Defining and explaining the pathophysiology of lipedema to patients and healthcare colleagues 4. Transforming the traditional medical model into one based on patient-provider collaboration 5. Accommodating and caring for people with lipedema within a primary care practice 6. Supporting the psychological effects and addressing biases associated with lipedema 7. Coordinating care, providing resources, and making appropriate referrals DONNA'S STICKY NOTES Sticky Note 1 Lipedema, obesity, and lymphedema can coexist—but they are not interchangeable. A patient may have one, two, or all three conditions. Each one needs to be identified so that the patient receives care for what is actually present instead of having every symptom blamed on weight. Sticky Note 2 Coping can hide the severity of chronic illness. People who have lived with pain, heaviness, fatigue, and restricted movement for years may stop reporting those symptoms because they have learned to build their lives around them. Sometimes asking, "What is a typical day in your life like?" reveals more than asking for a number on a pain scale. Sticky Note 3 The patient is not the least-informed person in the room. The clinician brings medical education and diagnostic knowledge. The patient brings years of experience living inside the body being examined. The best care happens when both kinds of expertise are treated with respect. KEY TAKEAWAYS - A thorough lipedema assessment involves more than weighing the patient or calculating BMI. - Lipedema can exist without obesity, and obesity can exist without lipedema. - Obesity may aggravate lipedema and may contribute to secondary lymphedema, but it should not erase the presence of lipedema. - Pain may be experienced as aching, tenderness, burning, tightness, congestion, heaviness, or discomfort with light touch. - People with lipedema may minimize their symptoms because those symptoms have become their normal. - A respectful physical examination should include explanation, consent, communication, ...
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    34 分
  • Acceptance Isn't A White Flag

    Acceptance Isn't A White Flag
    2026/07/23
    "Acceptance is not saying 'I love everything about this'. Acceptance is saying 'I'm done making myself the enemy. Acceptance is not a white flag. It is not surrendering into suffering. It is surrendering the war against yourself." —Donna Piper Body acceptance gets messy fast when your body is changing without your permission — and that's exactly what this episode of Dear Body, I'm Listening digs into. Host Donna Piper unpacks the real, often uncomfortable difference between acceptance, resignation, and avoidance for anyone living with chronic illness, invisible symptoms, or a body that no longer looks or functions the way it used to. This isn't a "just love your body" pep talk. Donna is mid-recovery from lipedema surgery, dealing with swelling, a changed shape, and a formal event she has nothing to wear to — and she's not pretending she's at peace with it. Instead, she walks through why acceptance, resignation, and avoidance can look identical from the outside but feel completely different inside the nervous system, and why chasing acceptance too fast can backfire. Along the way, she brings in Acceptance and Commitment Therapy (ACT) and what chronic pain research actually says about psychological flexibility — without turning it into toxic positivity. This episode is for anyone who's been medically gaslit, dismissed, or told to just "accept" a diagnosis they never wanted. It's for the days when body positivity feels like a lie and grief feels more honest than gratitude. Key takeaways: • Acceptance, resignation, and avoidance can look the same from the outside but feel completely different in the body — and most people cycle through all three. • Resignation says "there's nothing I can do"; acceptance says "I may not be in control of this, but I still have choices." • Chronic pain research links acceptance to better adjustment and less disability — but acceptance never means the pain isn't real or symptoms are "in your head." • Avoidance isn't a failure — it can be a protective emotional airbag, but it becomes a problem when it becomes the whole house. • You can accept that you don't accept your body yet, and that's still a valid form of honesty. • A simple breath practice (inhale, longer exhale, "this is where I am today") can help regulate the nervous system without forcing false positivity. • Ready to stop fighting your body and start listening to it? Press play on this episode now. Connect with Donna: Website: https://www.donnapiper.com/ LinkedIn: https://www.linkedin.com/in/donnapiper Instagram: https://www.instagram.com/lipedema_donna Facebook: https://www.facebook.com/thedonnapiper YouTube: https://www.youtube.com/@thedonnapiper Podcast: https://podcasts.apple.com/us/podcast/dear-body-im-listening/id1822768774 Episode Highlights: 01:06 Acceptance, Resignation, and Avoidance: The Difference 05:08 Real Talk: Why Body Acceptance is Complicated 19:56 Connective Thread: Acceptance and Commitment Therapy (ACT) 29:38 Myth Busters 33:20 Feel Good Flow 36:25 Shared Education and Lived Experience Resources: 🤔Got a question for me? Every month, I do a listener coaching episode—and I'd love to hear from you! Send your questions, stories, or flare-up confessions to donna@donnapiper.com, and you just might hear your answer on the show. 💲Discount Get $20 off the Visible Wrist Band 2.0 Click the link: https://join.makevisible.com/73784699c7db3e **Wearable heart-rate and activity sensor, with charging cable and strap included. 5 days battery life Manufactured by Polar, the world leader in heart-rate monitoring Designed for illness, not fitness HSA/FSA Eligible 💗Springrose Give $20, GET $20 When you share Springrose with friends, they get $20 off their first purchase and you get $20 towards your next purchase!* Share the love. https://oken.do/0l3hpr6v 💗Equip Fuel With Real Food Meet Prime Protein, the original beef protein powder, with over 20g of delicious grass-fed beef protein. No junk or fillers https://www.equipfoods.com/DONNA15 Reference: The research language in this episode is mostly drawn from Acceptance and Commitment Therapy, or ACT, which uses acceptance, mindfulness, values, and committed action to support psychological flexibility. ACBS describes ACT as using acceptance and mindfulness strategies alongside commitment and behavior-change strategies to increase psychological flexibility. For chronic pain, research has repeatedly found that higher pain acceptance is associated with better adjustment — including less depression, anxiety, disability, pain interference, fear, catastrophizing, and greater life satisfaction or self-efficacy. A 2023 overview of systematic reviews and meta-analyses summarized ACT evidence for adults with chronic pain across pain intensity, pain-related functioning, quality of life, and psychological factors. Another meta-analysis found significant effects on depression, anxiety, and quality of life ...
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    38 分
  • What Is Lipedema, Really? | Dear Body Book Club: Chapter 1

    What Is Lipedema, Really? | Dear Body Book Club: Chapter 1
    2026/07/16
    "Maybe we don't have every answer yet, but we have something we didn't have before: momentum, curiosity, research, hope, a textbook." —Donna Piper Welcome to the very first official Dear Body Book Club episode! In this new series, we're opening the books that are shaping the future of chronic illness care and translating the research into everyday language. Today we're exploring Chapter One of the newly released medical textbook: Lipedema: Principles and Practice of Diagnosis and Treatment Edited by Stanley G. Rockson, MD, Leslyn Keith, OTD, and Catherine Seo, PhD (Springer Nature, May 2026). Together, we discuss Chapter One: "What Is Lipedema? Moving Towards a Widely Accepted Definition" by Sandro Michelini and José Luis Simarro Rather than reading the chapter word for word, I pull out the concepts that stood out to me, translate the medical language into plain English, and explain why these ideas matter for those of us living with lipedema. In this episode, we discuss: What lipedema is—and what it isn't The history of lipedema and why recognition matters The World Health Organization's recognition of lipedema in ICD-11 Germany's recognition of lipedema within its healthcare system The newly approved U.S. ICD-10-CM diagnosis codes expected to take effect in October 2027 Why lipedema is different from obesity Why BMI alone often misses women with lipedema Genetics and why lipedema may be inherited through either side of the family Hormones, puberty, pregnancy, perimenopause, and menopause Emerging research on connective tissue and childhood-onset lipedema Clinical diagnosis and staging Pain, inflammation, and tissue changes Common comorbidities associated with lipedema Current diagnostic tools Conservative and surgical treatment options discussed in Chapter One Where lipedema research is headed Resources Table 1.1 – Differential Diagnosis of Lymphedema and Lipedema Adapted from Chapter One of Lipedema: Principles and Practice of Diagnosis and Treatment (Michelini & Simarro, 2026). Clinical Feature Lymphedema Lipedema Family history Possible Often present Gender Male or female Almost exclusively female Limb involvement One or both limbs Usually both limbs (bilateral) Hands and feet Usually involved Usually spared Age of onset Birth, childhood, or adulthood Most commonly at puberty (may occur before puberty) Joint hypermobility Usually absent Often present Pitting edema Usually present Usually absent Stemmer sign Usually positive Usually negative Pain Usually absent Common Response to conservative therapy Generally good Varies Response to surgery Variable Generally good for appropriate candidates Compression garments Flat-knit custom garments (Class II–IV) Flat-knit custom garments (Class I–III), depending on the individual Clinical follow-up Regular As needed 💛 What this means in plain English One of the biggest takeaways from this table is that lipedema and lymphedema are not the same condition, even though they're often confused. Women with lipedema are more likely to have: Symmetrical enlargement of both legs (and sometimes arms) Feet and hands that are usually spared Painful fat tissue Joint hypermobility A negative Stemmer sign A family history of similar body shapes People with lymphedema are more likely to have: Swelling that includes the feet or hands A positive Stemmer sign Pitting edema Less pain in the affected tissue Different treatment goals and progression A trained clinician looks at all of these features together—not just one—to help determine the correct diagnosis. Key Takeaways from Chapter One Lipedema is a recognized disease of adipose tissue—not simply obesity. Lipedema most commonly affects women and often runs in families. Hormones appear to influence lipedema, but genetics and connective tissue may also play important roles. There is currently no single laboratory test to diagnose lipedema. Diagnosis is based on clinical examination. Complete Decongestive Therapy (CDT) can improve symptoms but does not remove pathological lipedema tissue. There is currently no medication scientifically proven to treat lipedema itself. Liposuction is an important therapeutic option for appropriately selected patients. Bariatric surgery does not treat lipedema. More research is still needed to better understand the disease. Research & References This episode is based primarily on: Michelini, S., & Simarro, J. L. (2026). What Is Lipedema? Moving Towards a Widely Accepted Definition. In S. G. Rockson, L. Keith, & C. Seo (Eds.), Lipedema: Principles and Practice of Diagnosis and Treatment. Springer Nature. Additional references cited by the chapter's authors can be found in the reference section of Chapter One (pp. 13–15) of the textbook. About the Dear Body Book Club The Dear Body Book Club is a series on Dear Body, I'm Listening, where we explore books that are shaping the future of chronic illness care. Each episode translates medical research into plain language while ...
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    40 分
  • 19 Liters Later: The Progress Update No Before-and-After Could Tell You

    19 Liters Later: The Progress Update No Before-and-After Could Tell You
    2026/07/09
    "Remember that you can celebrate what your body can do without demanding more than it has to give… Progress does not have to be perfect, linear, or photogenic to be real." —Donna Piper Six months into her lipedema surgery recovery, Donna sits down to tell the truth about what actually changed — and what didn't. In this honest update, she shares what life looks like after two leg surgeries and 19 liters removed: more mobility, less pain, better circulation, and wearing shorts in public for the first time in decades. But this isn't a polished before-and-after story. Donna also opens up about the parts no one shows — appetite loss, hair shedding, upper-body swelling, and the emotional whiplash of feeling free in her legs while her nervous system, MCAS, POTS, and hypermobility EDS keep asking for patience. She walks through her shifting compression routine, the aqua therapy classes that rebuilt her ability to move, and what it meant to host friends for the Fourth of July after years of watching life from her bedroom window. Along the way, she busts three persistent myths about surgical recovery — including the idea that healing should be linear, photogenic, or total. This episode is a grounded, unfiltered look at what it really means to heal inside a chronically ill body: not a straight line, but two things being true at once. If you're navigating lipedema, surgical recovery, or a body that's changing faster than your emotions can keep up, this one's for you. Listen to the full episode now: https://tinyurl.com/29njdb9n Connect with Donna: Website: https://www.donnapiper.com/ LinkedIn: https://www.linkedin.com/in/donnapiper Instagram: https://www.instagram.com/lipedema_donna Facebook: https://www.facebook.com/thedonnapiper YouTube: https://www.youtube.com/@thedonnapiper Podcast: https://podcasts.apple.com/us/podcast/dear-body-im-listening/id1822768774 Episode Highlights: 02:01 Real Talk: 19 Liters and 6 Months Later 15:24 Connective Thread: More Mobility Does NOT Mean Unlimited Energy 31:32 Myth Busters 35:01 Feel Good Flow Resources: 🤔Got a question for me? Every month, I do a listener coaching episode—and I'd love to hear from you! Send your questions, stories, or flare-up confessions to donna@donnapiper.com, and you just might hear your answer on the show. 💲Discount Get $20 off the Visible Wrist Band 2.0 Click the link: https://join.makevisible.com/73784699c7db3e **Wearable heart-rate and activity sensor, with charging cable and strap included. 5 days battery life Manufactured by Polar, the world leader in heart-rate monitoring Designed for illness, not fitness HSA/FSA Eligible 💗Springrose Give $20, GET $20 When you share Springrose with friends, they get $20 off their first purchase and you get $20 towards your next purchase!* Share the love. https://oken.do/0l3hpr6v 💗Equip Fuel With Real Food Meet Prime Protein, the original beef protein powder, with over 20g of delicious grass-fed beef protein. No junk or fillers https://www.equipfoods.com/DONNA15 Quotes: 01:34 "Healing is rarely a straight line; sometimes it looks like a miracle, sometimes it looks like needing two days recovery after a beautiful day, and sometimes it looks like both things being true at the exact same time." —Donna Piper 08:17 "There's something about not having to manage your body every single second that creates some more spaciousness, more choice, and more freedom." —Donna Piper 18:58 "I have to remember that I still have this multitude of symptoms that are not in my control. I hear them, I listen to them, and then I manage my energy as best I can throughout the day." —Donna Piper 25:44 "That is also something that comes up with surgery— as your body changes and morphs, so is your idea of your body, how it feels like." —Donna Piper 29:24 "With these conditions, it's really about every single day reframing yourself that you haven't fallen behind, you didn't do anything wrong. Some of these things with your body are just out of control. The reality is, sometimes we're just at the mercy of our bodies, and we just need to listen to what they need every moment of every day." —Donna Piper 33:23 "Something that is joyful doesn't mean that you're not going to have flares and fatigue… If you exert yourself past your capacity, you're going to have to take some time to rest and recover." —Donna Piper 39:54 "Remember that you can celebrate what your body can do without demanding more than it has to give… Progress does not have to be perfect, linear, or photogenic to be real." —Donna Piper Your Host: Donna Piper is a Relationship Coach, Trauma Expert, and Akashic Records Healer dedicated to empowering successful single women to transform their love lives and attract fulfilling partnerships without sacrificing their professional ambitions. With a holistic approach blending therapeutic coaching, trauma-informed techniques, and Akashic Records wisdom, she...
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