Neuroscientific models GLP-1R expression in the NTS (nucleus of the solitary tract) , the ARC (arcuate nucleus) and the PVN (paraventricular nucleus) opens paradigms on central appetite regulation, homeostatic/hedonic coupling and dopaminergic interactions (VTA, NAc)
The psychosocial impact is further compounded by the frequent misdiagnosis or underdiagnosis of the condition, which can delay appropriate care.27 Several studies have demonstrated that the quality of life in patients with lipedema is markedly reduced compared to age-matched controls.15,17,28 Some of the tools used included assessments of symptom severity, quality of life, satisfaction with life, psychological flexibility, and social connectedness
Understanding these variables helps clinicians provide individualized counseling and helps patients maintain realistic expectations during the initial treatment phase
Monozygotic twin studies, which allow an assessment of the epigenome (gene x environment) independent of underlying genomic sequence mutations, showed high discordance rates and related epigenetic changes [14] in monozygotic twins discordant for psychiatric illnesses
