Have you noticed swelling in your legs or ankles? For people living with obesity, this may be more than just temporary puffiness — it could signal a deeper health issue. Research shows a connection between obesity and edema, the medical term for swelling caused by fluid buildup.

Health experts are still studying exactly why edema develops in people with obesity. But it’s often linked to how obesity affects the body’s circulation and fluid balance. In many cases, too much fluid builds up in the lower limbs — especially the feet, ankles, and legs — causing visible swelling that may feel uncomfortable or heavy.

When related to obesity, edema is often chronic (long-lasting). But that doesn’t mean you’re stuck with it. With the right strategies, it can often be managed or reduced.

In this article, we’ll explain why edema may happen in people with obesity, what signs to look out for, and how you can work with your health care provider on short- and long-term ways to manage swelling and feel more comfortable.

What Is Edema?

Edema is the medical term for swelling caused by excess fluid trapped in the body’s tissues. While it can occur anywhere, it’s most commonly seen in the legs, ankles, and feet. Edema in the lower extremities is prevalent among individuals diagnosed as overweight.

Edema vs. Lymphedema

When discussing obesity and edema, health experts often focus on a specific type: lymphedema.

Edema refers broadly to fluid accumulation in the body’s tissues. Lymphedema, however, is a chronic form of edema resulting from a buildup of lymphatic fluid, known as lymph. The lymphatic system circulates this fluid to help nourish cells and defend against infections. When lymph accumulates, it leads to swelling.

Phlebolymphedema, also called phlebitic lymphedema, is a common cause of swelling in the legs. It happens when weakened or “leaky” veins allow blood to flow backward, a condition known as venous reflux. Over time, this can make it harder for both blood and lymph fluid to return to the heart, leading to a mix of vein and lymphatic problems.

Although they sound similar, lymphedema differs from lipedema. Lipedema involves an abnormal accumulation of fat in the lower body, including the calves, thighs, and buttocks. It’s a long-term condition that’s resistant to diet and exercise and often requires specialized treatment.

Obesity Increases the Risk of Edema

Living with overweight or obesity is linked to a higher risk of chronic edema, including lymphedema. People living with obesity are significantly more likely to develop lymphedema than those without obesity. Health experts note that obesity-related edema often appears in individuals with a body mass index (BMI) over 40 and tends to worsen as BMI increases.

In one study, about 18 percent of people with class 1 obesity (BMI 30 to less than 35) and class 2 obesity (BMI 35 to less than 40) had the most advanced stage of edema. That number rose to about 39 percent among people with class 3 obesity (BMI 40 and higher).

Why Obesity Causes Edema

Anything that slows the return of fluid from body tissues back to the heart can lead to edema. This swelling may take time to become noticeable because the body’s tissues can hold a significant amount of fluid — up to 2.5 to 3 liters — before swelling becomes visible.

Researchers are still figuring out how obesity contributes to lymphedema, but several theories may explain this link:

• Extra body weight can compress lymphatic vessels, making it harder for lymph fluid to drain properly.
• Breathing can be less efficient in people living with obesity, which may reduce blood and lymph flow.
• People with obesity may produce more lymph than their lymphatic system can manage.
• Reduced physical activity, which is common in obesity, may limit lymph flow. Normally, movement helps push lymph through the body.
• Inflammation caused by fat tissue (also called adipose tissue) may damage the lymphatic system.
• Obesity is also linked to chronic venous disorder (when veins struggle to return blood to the heart), which increases the risk of long-term edema

Damage to the lymphatic system itself can also raise the risk of lymphedema. Studies show that people living with obesity are more likely to develop lymphedema after lymphatic damage, such as from cancer treatment. But even without injury or surgery, severe obesity alone has been associated with a higher risk of lymphedema.

More research is needed to fully understand the relationship between obesity and edema. But health experts agree that people living with obesity are more likely to experience this condition — and earlier treatment can help improve outcomes.

Signs of Edema To Watch Out For

Edema usually appears as swelling or puffiness just under the skin. You might notice it in your feet, ankles, legs, or other parts of the body. Other signs and symptoms can include:

• Skin that looks stretched or shiny
• Difficulty walking or moving due to swelling in the lower body
• A feeling of heaviness in one or more limbs, such as legs that feel unusually heavy
• Pain or tenderness in the swollen area
• Tightness in the affected area
• Skin that stays dimpled after pressing it (known as pitting edema)
• Swelling in the abdomen (stomach area)
• Shortness of breath or frequent coughing, which may be signs of fluid buildup in the lungs

If you notice any of these signs, especially if one part of your body looks noticeably more swollen than it did the day before, reach out to your healthcare provider. Edema can take time to become visible, but early attention can help prevent complications.

When It’s Time To Seek Immediate Medical Attention

In most cases, edema isn’t an emergency. But sometimes, it can be a sign of a more serious health issue. If you experience any of the following symptoms along with swelling, seek medical attention right away:

• Shortness of breath or difficulty breathing
• Chest pain
• Irregular or fast heartbeat
• Leg pain or swelling that doesn’t improve
• Swelling in only one leg

Shortness of breath, chest pain, and irregular heartbeat may be signs that fluid has built up in the lungs — a potentially life-threatening condition that needs immediate care.

Leg pain and swelling that doesn’t go away, especially if it’s only in one leg, can mean there’s a blood clot. Blood clots can be very serious and need to be looked at by a doctor right away.

Edema may also be caused by cirrhosis, a serious liver condition. If swelling spreads to your abdomen, or if you notice itchy skin or a yellow tint in your eyes or skin (a condition called jaundice), see a doctor as soon as possible. Liver problems can result from untreated hepatitis, heavy alcohol use, or other health conditions.

Ways To Manage Edema While Living With Obesity

Chronic edema can be challenging to manage, but there are both short-term and long-term strategies that may help reduce swelling. Edema care may vary from person to person, so it’s important to find what works best for your body — and to check in with your healthcare provider for guidance.

Trying Compression — With Care

Compression is a common way to manage swelling. Light to moderate pressure on swollen areas can help move fluid through tissues. However, for people with larger limbs or skin folds, it may be harder to get a proper fit with compression garments like stockings. In these cases, bandages or wraps may be needed to provide the right amount of pressure.

Compression should always be used with caution and under a doctor’s direction — especially if you have other health conditions. It’s also essential to care for your skin, especially in folds, to reduce the risk of irritation or infection.

Elevating Affected Body Parts

Elevating swollen areas can also help. For example, if your lower legs are swollen, propping them up on pillows while lying down may reduce fluid buildup.

Staying Active

It’s important to avoid sitting or standing still for long periods. Inactivity can cause fluid to pool in the lower body. Short walks or simple exercises can help — even household tasks or gentle chair exercises make a difference.

“A short walk or even just doing household chores counts as exercise. I walk from room to room several times a day,” one MyObesityTeam member wrote. Another shared, “I find doing chair exercises are great.”

Devices that move your limbs may also help. One MyObesityTeam member shared, “I bought a LifePro on Amazon. I can sit and it jiggles my legs and stomach while burning calories and easing my edema on my legs. It’s a little spendy, but it’s worth it in the long run.”

Losing Weight Over Time

While compression and daily movement help manage symptoms, they don’t fix the underlying cause. For some people, a longer-term solution may involve weight loss.

Losing weight can help reduce swelling and ease strain on the lymphatic and vascular systems. Some health experts believe that weight loss may also protect the lymphatic system from further damage, though more research is needed. Some studies suggest that inflammation in fat tissue may remain even after weight loss, so the benefits may vary.

If weight loss helps with edema, it may take time to see results. Research suggests that people living with obesity may need to lose at least 10 percent of their body weight to see meaningful improvements in health. Sustainable weight loss typically involves a combination of physical activity, balanced eating, and long-term support.

Talk With Your Doctor

Managing edema with obesity will look different from person to person. Talk to your doctor for their advice on what to watch out for and tips on how to manage edema in the day-to-day and over the long run. It may be overwhelming at first, but taking small steps to manage edema is important for your health and quality of life now and later.

Connect With Others Who Understand

MyObesityTeam is the social network for people with obesity and their loved ones. On MyObesityTeam, more than 56,000 members come together to ask questions, give advice, and share their stories with others who understand life with obesity.

Have you experienced edema or lymphedema? What symptoms do you have and what helps you manage it? Share your experience in the comments below, or start a conversation by posting on your Activities page.