A woman with a rare and painful medical condition which makes people think she's obese has spoken about her struggle.
Natalie Hanks, who is from Aintree near Liverpool, first noticed her legs swelling when she was only 11 years old.
But it took 20 years for doctors to finally diagnose the mum-of-three with lipoedema, an excruciating medical condition which causes an abnormal build-up of fat cells.
The 32-year-old told the Liverpool Echo: "I absolutely hated myself. I experienced hurtful comments all the way through school and I was bullied for how I looked.
"I've always covered up when I was out, meaning I've never worn shorts or skirts.
"My husband says I’m beautiful, but other people were just like ‘go to the gym’.
"Even a family member told me I had a 'shelf on my bum' but everyone thought that, even me."
Despite altering her diet and exercising, Natalie ballooned to a size 22.
Lipoedema causes the thighs, buttocks, lower legs, and sometimes the arms to become enlarged due to a build-up of abnormal fat cells, which causes a lot of pain and extreme discomfort due to inflammation.
The hands and feet are not affected, which creates a 'bracelet' effect or 'band-like' appearance above the ankles and wrists.
Natalie said: "Because I'm smaller on the waist, but larger below I do get stared at. At restaurants, I’ve had people make comments.
"Online comments, even aimed at other people, also really affected me - no one knows a lot of the time that you have it, they just think you're fat."
The hurtful remarks, which saw Natalie being mistaken for being 'obese', led her to develop bulimia.
She said: "I've overcome it myself but I always knew in the back of my head that something was wrong.
"I didn't find out that I could have lipoedema until a couple of years ago when a client informed me about the condition."
In September 2018 Natalie finally received a formal diagnosis, but there was still uncertainty about the best way to treat the condition.
She said: "I was recommended on a Facebook group about surgeons who perform lymphatic-sparing liposuction."
The procedure usually uses tumescent or water jet-assisted, lymph-sparing liposuction to remove lipoedemic fat.
So far, Natalie has lost 19 litres of lipoedemic fat and will have her final round of surgery in January next year.
She said: "I've got no pain in my calves anymore and people have been complimenting me.
"But they're saying it about my overall weight, which is bizarre as I haven't lost anything off my stomach."
Natalie would like to see improvements made in the NHS and hopefully see perceptions change about the condition in future.
Even the NHS website states: "There's been little research into lipoedema, so there's some uncertainty about the best way to treat the condition."
She said: "I would like other people to see that it's not obesity, it's a condition."
