ESR1 and Lipedema: By targeting the interrelated metabolic, inflammatory, and fibrotic pathways, tirzepatide delivers unique therapeutic advantages in the management of lipedema during the climacteric period—a condition where fat accumulation arises not solely from caloric excess but from complex endocrine, inflammatory, and bioenergetic dysfunctions driven by intracrine estrogen production, estrogen receptor imbalance, and progesterone resistance.