How Are Obesity And Metabolic Syndrome Linked To Psoriasis?

The human metabolic system is a group of chemical processes in the body that work together to digest the food we eat and transform it into the energy needed to power all of the body’s functions¹. This process is called metabolism.

What is metabolic syndrome?

Metabolic syndrome is the name for a group of symptoms that are also called metabolic risk factors. These include:

• High blood pressure
• High blood sugar
• Low blood levels of HDL cholesterol
• High blood levels of triglycerides (a type of fat)
• Having a large waist, with excess fat carried around the stomach

A person is diagnosed with metabolic syndrome if he or she has three or more of these symptoms. Having metabolic syndrome increases a person’s risk of developing serious conditions such as diabetes, heart disease, and stroke².

What is obesity?

Obesity is a condition in which a person has an excess amount of body fat. To help make a diagnosis of obesity, healthcare providers use a measurement called the body mass index (BMI)³. To calculate a person’s BMI, they divide the person’s body weight (in kilos) with height (in meters). This number is used to determine whether the person has a healthy body weight:

• BMI less than 18.5 = underweight
• BMI between 18.5 - 24.9 = healthy weight
• BMI between 25 - 29.9 = overweight
• BMI more than 30 = obese

An online resource for calculating your BMI is available.

Obesity can cause a range of complications, including heart disease, high blood pressure, and diabetes.

How common are metabolic syndrome and obesity among people with psoriasis?

Evidence suggests that people with psoriasis are more likely to develop metabolic syndrome than the population in general. For example, a national study in the United States reported that around 40% of people with psoriasis also had metabolic syndrome (versus 23% of the general population)⁴. The study also found that among patients with psoriasis, women were more likely than men to have metabolic syndrome. Another study found that people with severe psoriasis were at a higher risk of metabolic syndrome (44%) than people with mild or moderate psoriasis⁵.

There is also a link between psoriasis and obesity. Many studies have found that the people with psoriasis are more likely to be obese than people without psoriasis. For example, one study found that people with obesity were nearly twice as likely to have psoriasis than people with a healthy body weight; the study also reported that a person’s chance of having psoriasis increased with higher body weight⁶. Another study found that people with psoriasis were more than twice as likely to be obese than people without psoriasis. People with severe psoriasis were also more likely to have obesity than people with mild psoriasis.

How are metabolic syndrome and obesity linked to psoriasis?

Researchers are continuing to learn about the links between psoriasis, metabolic syndrome, and obesity. The current thinking is that they may relate to the interaction of several elements, including lifestyle factors (such as smoking and alcohol use), shared genetic causes, and chronic inflammation in a person’s system⁴. For example, researchers think that the tendencies to develop psoriasis and obesity may run in families, and are probably caused by some of the same genes.

Psoriasis is a chronic autoimmune disorder in which inflammation in the body causes symptoms to appear on the skin⁵. The specific type of inflammation that causes psoriasis symptoms has also been tied to the development of other inflammatory conditions, including obesity and metabolic syndrome⁶.

How are metabolic syndrome and obesity treated?

It is important to treat both metabolic syndrome and obesity because both conditions can lead to serious complications².

For treating obesity, one of the first steps is to help the patient achieve a healthy body weight through lifestyle changes, improved diet, and regular exercise³.

Treatment for metabolic syndrome depends upon the patient’s specific symptoms, but in many cases, weight loss is also the first step. Healthcare providers may also prescribe medications such as⁷:

• Metformin, to improve blood sugar control
• Angiotensin-converting enzyme (ACE) inhibitors, to treat high blood pressure
• Statins, to help control cholesterol levels in the blood

Having obesity and/or metabolic syndrome can also affect the way that your psoriasis treatments work. For example, people with obesity and psoriasis are more likely to develop side effects to psoriasis medications, and certain types of systemic psoriasis medicines may not work as well for them⁸. To help deal with this issue, healthcare providers work closely with these patients to figure out a treatment plan that is effective for all of their conditions.