Body weight and the management of lymphoedema

The incidence and prevalence of overweight and obesity are increasing globally, with many developed nations struggling to reduce the rate. This, and the consequences of obesity, are often discussed in the literature at both the individual and population levels (Scottish Government, 2018; World Health Organization, 2018). Articles on lymphoedema are no different, with several published in the last year mentioning overweight and obesity as a risk factor for development of or a complicating factor in the management of the lymphoedema (Todd, 2018a; Duyur Cakit et al, 2019; Shallwani et al, 2019). Papers published in previous years highlight this point, while simultaneously describing an increased prevalence of overweight and obese individuals presenting in lymphoedema clinics and an additional level of complexity and treatment burden (from both the individual and service perspective) (Fife and Carter, 2008; Wilkins et al, 2014; Lockwood et al, 2017; Todd, 2018b). With this in mind, and an array of strategies, guidelines and management options, what should practitioners be recommending to clients? What should treatment goals look like? And what factors prevent or enable practitioners and patients in successfully incorporating weight within the lymphoedema assessment and management plan?