A group of disorders characterised by abnormal distribution or metabolism of body fat. In some forms, fat is lost from certain areas while accumulating excessively in others; in others, overall fat storage is impaired. Causes include genetic mutations, HIV antiretroviral therapy, and autoimmune conditions. Because adipose tissue regulates energy storage and secretes hormones such as leptin, lipodystrophy disrupts metabolism, often producing insulin resistance, high triglycerides, and fatty liver despite a lean appearance. Management addresses the metabolic complications through diet, exercise, and medication, and may include metreleptin therapy for generalised forms. The condition highlights fat’s essential role as an active endocrine organ.