I'm not convinced lipedema is a legitimate thing, but it's described as the collection of fat in the hips/thighs/legs, disproportionately so. It doesn't act like normal water retention, where it indents when pressure is applied, and only happens below the waist.  But honestly, it's basically "fat accumulates more in the lower body than the upper body", so it's only going to happen if the person has a caloric surplus, since fat doesn't just develop out of nothing. So it seems like a medically-legitimate-sounding excuse/denial of reality.