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July 2013

Psoriasis and the Obesity Epidemic: The Effect of Weight Loss

Author Affiliations
  • 1Department of Dermatology, University of Utah, Salt Lake City
JAMA Dermatol. 2013;149(7):786-787. doi:10.1001/jamadermatol.2013.4512

Man’s desire to control chronic disease inevitably turns to how diet could affect the disease state; we would purport that this notion is likely related to the common wisdom “you are what you eat.” Since even before the now widely appreciated association between obesity and psoriasis, the effect of weight loss on the management of psoriasis has been under consideration. Soon after World War II, Simons1 reported observations of 13 subjects with psoriasis who were imprisoned in Japanese starvation camps in Java. He noted that weight loss and disease severity were inconsistent in these persons. The more recent associations of psoriasis and obesity—increased risk of onset of psoriasis, more of the body surface affected with disease, increased risk of psoriatic arthritis (PsA), and increased cardiovascular risk—establish that obesity has a very negative impact on psoriasis.2,3 Furthermore, these associations are strongly supported by the often dramatic response of psoriasis and PsA to treatment with agents that target tumor necrosis factor (TNF) and the fact that TNF has a strong association with obesity: levels of TNF increase and decrease, respectively, with weight gain and weight loss.4