Psoriasis is a chronic autoimmune condition that targets the skin and joints. Treatments are designed to reduce symptoms by lowering inflammation in the skin and throughout the body.

There’s always interest in things other than medications that may help manage psoriasis. Research has found a possible link between psoriasis symptoms and a higher body weight. Because of this connection, people with psoriasis who live in bigger bodies are often told to lose weight.

This article will explore the arguments for and against weight loss as part of psoriasis management.

Studies have shown that people with larger bodies are more likely to have psoriasis. It’s unclear exactly why this connection exists.

We know that fat cells release inflammatory proteins known as cytokines. This includes the specific ones that cause the symptoms of psoriasis. The greater the number of fat cells, the more inflammatory proteins are released.

Leptin may also play a role. Leptin is a hormone involved in appetite regulation. It increases the release of inflammatory proteins. Research shows that people with psoriasis and people with more body fat tend to have higher levels of leptin.

High levels of leptin may indicate leptin resistance. Normally, when leptin levels rise, this sends fullness signals to the brain. In someone with leptin resistance, this message no longer works. As a result, the body keeps pumping out more leptin, hoping to get a response. Leptin levels stay high, increasing the number of inflammatory proteins.

Medications may also affect weight. Biologics are a class of medication used to block specific proteins that cause inflammation in psoriasis. They may increase weight gain in some people. Some biologics have been shown to lower leptin levels in the body. This is helpful for reducing inflammation. When leptin levels drop, it can stimulate appetite.

In some cases, medication is less effective for someone at a higher weight. It can be harder to get symptoms under control.

There are a number of studies that show an association between weight loss and an improvement in psoriasis symptoms. These studies are all short term, ranging from 4 to 24 weeks. We don’t have data to determine whether weight loss would continue to help manage psoriasis symptoms in the long term.

And weight loss isn’t necessarily a simple, long-term solution. A review of 29 long-term weight loss studies shows that over time, weight is regained. Within 5 years, about 80% of the weight lost will be regained.

The stress of weight stigma can also increase inflammation in the body. Weight stigma contributes to worse emotional and physical health outcomes.

Many people with bigger bodies feel that their health needs are dismissed or blamed on their size. It also prevents consistent follow-up care. We know that psoriasis, or any chronic disease, needs regular follow-up support.

Even when there’s an association between higher body weight and psoriasis symptoms, it doesn’t prove that one causes the other. People of all body shapes and sizes can develop psoriasis.

The reality is that there’s no proven long-term way to lose weight and keep it off. Focusing on weight loss may result in disordered eating behaviors. Repeated weight loss attempts are actually one of the biggest causes of long-term weight gain. Weight loss shouldn’t be viewed as a strategy to manage psoriasis.

There’s ongoing interest in whether diet can play a role in reducing inflammation. The Mediterranean diet in particular has been shown to lower inflammation in the body.

A Mediterranean diet isn’t designed for weight loss. Instead, it emphasizes a variety of foods that may help to reduce inflammation to improve symptoms of psoriasis.

A Mediterranean diet includes:

  • a variety of fruits and vegetables
  • beans, legumes, nuts, and seeds
  • extra virgin olive oil as the primary source of added fat
  • a variety of whole grains
  • fish and seafood as the primary sources of animal protein

The omega-3 fatty acids found in fish and seafood and the monounsaturated fats in olive oil help to reduce inflammation in the body.

Vitamin D may be useful as part of managing psoriasis. Topical vitamin D and oral supplements may play a role in improving psoriasis. It’s difficult to get enough from your diet since there aren’t many sources. Sunlight is a main source of vitamin D. Otherwise, supplements are needed.

Studies suggest that many people with psoriasis have lower levels of physical activity. There are many factors that may contribute to this. Many people find sweat irritating on their skin.

Others feel uncomfortable showing skin when playing team sports. Exercise can reduce inflammation in the body, which could play a role in reducing psoriasis symptoms. This is true whether or not exercise changes your body weight.

If you’re able to exercise outside, there is the added bonus of UV from sunlight, which can be helpful for some people with psoriasis. People with psoriasis have a higher risk of depression. Exercise can be an important part of managing your mental health.

If you’re trying to be more active, do your best to find something you enjoy. Start out slow and easy. This can help make the habit more sustainable.

There are some potential links between psoriasis and your weight. Fat cells release inflammatory proteins, which can make psoriasis feel worse.

Even with the connections, weight loss shouldn’t be a recommendation for people to manage their psoriasis. There’s no proven long-term approach to weight loss. There are also risks of focusing on weight loss.

A Mediterranean-type diet and being more active can both be part of managing psoriasis. Whether or not a person loses weight, the result of making dietary and activity changes can be beneficial.