A.R. Shipman; G.W.M. Millington


The British Journal of Dermatology. 2011;165(4):743-750. 

In This Article

Obesity and Psoriasis

The association between psoriasis and obesity is the subject of a recent evidence-based review.[5] A key question is whether obesity is causal[29–33] or a consequence of psoriasis.[30,34,35] It could be argued that a lack of physical activity, due either to the cosmetic impact of psoriasis or to the locomotor effect of psoriatic arthropathy, might predispose an individual to obesity.[35] Childhood-onset obesity may particularly predispose to both psoriasis[36] and psoriatic arthropathy,[37] suggesting a genetic link. The association between psoriasis and obesity forms part of a wider association of psoriasis with a range of cardiovascular risk factors, namely atherosclerosis, diabetes mellitus and hypertension.[38–53] The separate association of psoriasis with smoking may be an important confounding variable, particularly with regard to hypertension and atherosclerosis.[52,53]

There is increasing evidence that progressive weight loss can produce significant improvements in the severity of psoriasis.[54–58] Perhaps the most direct evidence that obesity may be causal in psoriasis is the fact that bariatric sugery can produce rapid remission from psoriasis.[54,57,58] A confounding variable is the fact that the quality of life of the average patient undergoing bariatric surgery is significantly improved,[59] which would reduce psychological stress and thus potentially the disease burden of psoriasis.[5]


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