No principal simpósio internacional de cirurgia vascular do país, especialista discute o conceito do “Iceberg do lipedema” e uma abordagem integrada que vai além do acúmulo da gordura para tratamentos mais eficazes
Por Janaína Lira – Ascom/Imprensa Prime
Durante a 9ª edição do Simpósio Internacional de Cirurgia Endovascular – Science 2025, realizado em São Paulo na última quinta-feira (3), Especialistas discutiram uma nova abordagem integrada e multidisciplinar para o tratamento do Lipedema – doença que atinge cerca de 10 milhões de mulheres no Brasil. O evento, que reuniu profissionais de saúde nacionais e internacionais de diferentes áreas, trouxe à tona a complexidade dessa condição, muitas vezes mal compreendida, e destacou a importância de um tratamento que aborde todos os aspectos sistêmicos que afetam a saúde da paciente.
Para o idealizador do Science e um dos principais especialistas no tratamento clínico de Lipedema, Dr. Vitor Cervantes Gornati, é essencial visualizar o conceito do “Iceberg do Lipedema”, enfatizando que a doença não se resume ao que é visível – o acúmulo de gordura – mas envolve fatores submersos, como Disfunção Microvascular, Inflamação Crônica, Alterações Musculares e Metabólicas, Fibrose e Dor Crônica. “O tratamento do Lipedema deve ir além do foco apenas na gordura. Deve incluir também estratégias na modulação da inflamação, na melhoria da Saúde Vascular e na promoção da mobilidade e tratamento da dor de maneira multifatorial”.
Por ser um distúrbio inflamatório complexo, a abordagem inadequada do lipedema pode levar a tratamentos ineficazes, visto que a doença envolve seis pilares interligados que demandam uma atenção multifatorial, conforme destacado no evento:
- Inflamação Crônica – A inflamação causa Hipertrofia das Células de Gordura, além de gerar dor e Fibrose.
- Disfunção Vascular – Problemas como Insuficiência Venosa e Congestão Linfática podem agravar o quadro de Edemas e Fibrose.
- Fibrose e Matriz Extracelular – A ativação de Fibroblastos altera a matriz extracelular, dificultando a Drenagem Linfática.
- Disfunção Neurossensorial – A dor intensa, muitas vezes resistente a analgésicos, reflete a atividade inflamatória nos Nervos Periféricos.
- Alterações Metabólicas – O Lipedema está ligado a desequilíbrios hormonais, dificultando a perda de peso, mesmo com dieta e exercício.
- Dificuldade no Ganho Muscular – O aumento da massa muscular é crucial para melhorar o retorno Venoso e Linfático, mas o Lipedema pode dificultar esse processo.

Dr. Vitor Cervantes Gornati e Gabriela Pereira durante o Fórum Brasileiro de Lipedema para Pacientes – Foto: Divulgação
Relação com os Hormônios – A Endocrinologista Dra. Juliana Bicca, que esteve no Science 2025, acrescentou que o tratamento do Lipedema deve levar em consideração a Metabolização Hormonal distinta do Tecido Adiposo. “O Tecido Adiposo no Lipedema não apenas armazena gordura, mas também funciona como uma unidade de produção hormonal, o que impacta a Metabolização Hormonal local”, explica. Ela destacou que as mulheres com Lipedema frequentemente enfrentam irregularidades menstruais e condições como a síndrome dos ovários policísticos (SOP), tornando o tratamento hormonal uma abordagem eficaz para aliviar sintomas como dor e inchaço.
Fórum de lipedema para pacientes – No último sábado, o 2º Fórum Brasileiro de Lipedema para Pacientes, promovido pela ONG Movimento Lipedema, reuniu dezenas de mulheres de diferentes regiões do país. Pela primeira vez, o evento foi realizado dentro do Simpósio Science. “Desde 2019, venho trabalhando para que o Lipedema seja reconhecido e tratado com seriedade. Ver esse Fórum acontecer dentro de um Congresso Científico tão importante e encontrar tantas mulheres que acompanho há anos foi emocionante. É a prova de que estamos avançando. Mas, nada disso teria sentido sem a decisão delas de aderirem ao tratamento. A adesão é o que transforma conhecimento em resultado real”, comenta a Farmacêutica e presidente da ONG Movimento Lipedema, Gabriela Pereira, que também é portadora da condição.
Foto Capa: Dr. Vitor Cervantes Gornati durante sua apresentação no Science 2025 – Foto: Divulgação






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